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Victor G, Ray B, Watson DP. Use of harm reduction strategies by individuals with a history of incarceration: A short report using baseline data collected from the STAMINA clinical trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 162:209376. [PMID: 38641053 DOI: 10.1016/j.josat.2024.209376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/20/2024] [Accepted: 04/14/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Due to the considerably heightened risk of overdose immediately following jail or prison release, expansion of harm reduction interventions for citizens returning to the community after an incarceration episode should be of utmost concern. However, there are no studies examining the adoption and use of harm reduction among this population. This short report examines the use of individual-level harm reduction strategies (HRS) among people who use drugs, comparing those who have lifetime histories of incarceration with those who do not. METHODS This study included baseline data (N = 274) from a larger clinical trial, which recruited participants at two syringe service programs. Fisher's exact tests examine correlations between HRS and lifetime incarceration. RESULTS Significant variation in HRS use were observed by demographic characteristics. Those with lifetime incarceration histories were less likely to report ensuring naloxone was available when using, using when others were present, using fentanyl test strips, using a trusted drug supplier, and using some other HRS compared to those without lifetime incarceration histories. Similarly, those with lifetime incarceration histories were also less likely to report using non-prescribed buprenorphine and methadone, which could potentially reduce overdose risk even if not explicitly used as an HRS. CONCLUSION The results suggest that one of the populations at highest risk of overdose is least likely to use strategies that may reduce overdose risk. Targeted efforts to increase exposure to HRS learning opportunities and access to these resources could help reduce overdose disparities for people returning to the community after incarceration.
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Affiliation(s)
- Grant Victor
- School of Social Work, Rutgers, The State University of New Jersey, 390 George Street, New Brunswick, NJ 08901, USA; Rutgers Addiction Research Center, The State University of New Jersey, 671 Hoes Lane West, Piscataway, NJ 08854, USA.
| | - Bradley Ray
- RTI International, Division for Applied Justice Research, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Dennis P Watson
- Chestnut Health Systems, 221 West Walton Street, Chicago, IL 60610, USA.
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2
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Prajapati P, Holmes E, Yang Y. Individual Beliefs and Experiences With Brain Health Dietary Supplements in the United States. J Acad Nutr Diet 2024:S2212-2672(24)00143-6. [PMID: 38527569 DOI: 10.1016/j.jand.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/27/2024] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Although the use of brain health dietary supplements (brain DS) has increased, there is limited research on safety and risk of these products. Brain DS may be beneficial for improving memory, concentration, and focus but may also carry risks. OBJECTIVES To assess brain DS users' utilization experiences and identify factors associated with likelihood of brain DS use among nonusers. DESIGN An internet-based cross-sectional survey study was conducted using a sample of middle-aged US adults. Respondents' sociodemographic characteristics and health beliefs regarding brain DS were collected. Brain DS users' utilization experiences such as negative side effects and spending were also collected. PARTICIPANTS AND SETTING Purposive sampling was utilized for users and nonusers sample recruitment. MAIN OUTCOME MEASURES Brain DS users' utilization experience and future likelihood of brain DS use among nonusers. STATISTICAL ANALYSES PERFORMED Descriptive statistics on brain DS users' utilization experiences were reported. Ordinal logistic regression with sociodemographic and belief characteristics as predictors was employed to identify factors associated with the likelihood of brain DS among nonusers. RESULTS Five hundred twenty-five respondents (mean age = 43.8 ± 9.2 years) completed the survey. Among 260 users, primary reasons for use were enhancing memory (n = 136) and helping concentration and focus (n = 108). During the past year, 40% spent $50 to $200 (range = $0 to >$1,000) and 37% reported experiencing negative side effects. Among 265 nonusers, being female (odds ratio 2.04, 95% CI 1.21 to 3.45), perceived susceptibility to brain problems (odds ratio 1.90, 95% CI 1.28 to 2.83), recommendation from others (odds ratio 1.55, 95% CI 1.03 to 2.35) and perceived benefits of brain DS (odds ratio 2.82, 95% CI 1.60 to 4.96) were significantly associated with increased likelihood of future brain DS use. CONCLUSIONS Individual spending on brain DS varies and about 40% of users reported experiencing negative side effects. As individuals primarily rely on healthcare providers for recommendations, health care providers should be prepared to engage in discussions about brain DS with patients.
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Affiliation(s)
- Prachi Prajapati
- Department of Pharmacy Administration, University of Mississippi, University, Mississippi
| | - Erin Holmes
- Department of Pharmacy Administration, University of Mississippi, University, Mississippi; Research Institute of Pharmaceutical Sciences, University of Mississippi, University, Mississippi
| | - Yi Yang
- Department of Pharmacy Administration, University of Mississippi, University, Mississippi; Research Institute of Pharmaceutical Sciences, University of Mississippi, University, Mississippi.
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3
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Zhang L, Harris Ao S, Francis Ye J, Zhao X. How does health communication on social media influence e-cigarette perception and use? A trend analysis from 2017 to 2020. Addict Behav 2024; 149:107875. [PMID: 37820562 DOI: 10.1016/j.addbeh.2023.107875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE E-cigarettes have achieved a high prevalence rapidly. While social media is among the most influential platforms for health communication, its impact on attitudes and behaviors of e-cigarettes and its changes over time remain underexplored. This study aims to address the gap. METHODS Four years of data (2017-2020) were derived from the U.S. Health Information National Trends Survey (HINTS) (aged 18-64 years, n = 9,914). Initially, key variables were compared across years. Furthermore, guided by the health belief model, we employed a moderated mediation model to examine the influence of social media health communication on the public's perceptions and behaviors related to e-cigarettes, distinguishing between smokers and non-smokers throughout the four-year period. RESULTS The evidence shows a process of dynamic interaction between communication, perception, and behavior. (1) We observed an increasing trend of social media health communication (SMH) and perceived relative harm of e-cigarettes (PHE). (2) Higher SMH was associated with more e-cigarette use directly in 2019. (3) Higher SMH was associated with less e-cigarette use indirectly through PHE in 2020. (4) Smokers consistently displayed heightened sensitivity in responding to harm perception compared to non-smokers. CONCLUSIONS The findings support two mechanisms underlying the association between SMH and e-cigarette use: direct and indirect. The changes in the pathways during the timespan may have been influenced by increased e-cigarette information on social media and public health events like COVID-19. Stricter regulations for unverified e-cigarette advertisements and anti-e-cigarette education on social media are called for to curtail e-cigarette use.
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Affiliation(s)
- Luxi Zhang
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau
| | - Song Harris Ao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau
| | - Jizhou Francis Ye
- Department of Communication / Institute of Collaborative Innovation, University of Macau, Macau
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Innovation / Center for Research in Greater Bay Area, University of Macau, Macau.
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4
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Bolts OL, Prince MA, Noel NE. Latent profiles of cannabis use, protective behavioral strategies, and health beliefs in college students. Addict Behav 2023; 144:107747. [PMID: 37163888 DOI: 10.1016/j.addbeh.2023.107747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/02/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023]
Abstract
College student cannabis use is prevalent and heterogeneous, with some students experiencing cannabis-related problems. Cannabis protective behavioral strategies (PBS) are cognitive-behavioral strategies associated with reduced cannabis use and problems. There is a need for theory-informed and person-centered research to better understand cannabis PBS. The current study applied the health belief model (HBM) and latent profile analysis to discern patterns of cannabis use, PBS, and health beliefs among college students. Students (n = 164; Mage = 18.8; 53% female) who endorsed past-month cannabis use completed an online survey between September and November 2017. The 3-profile model best fit the data. Profile 1 (24.3%) represents the "infrequent use/high protection" profile characterized by using cannabis about 1-9 times, high PBS use, high perceived threat and benefits, and moderate perceived barriers. Profile 2 (38.1%) represents the "occasional use/moderate protection" profile characterized by using cannabis about 20-59 times, moderate PBS use, moderate perceived threat and benefits, and low perceived barriers. Profile 3 (37.6%) represents the "frequent use/low protection" profile characterized by using cannabis about 80 or more times, low PBS use, low perceived threat and benefits, and high perceived barriers. Profiles did not differ by age, ethnicity/race, sex, or college year, though varied significantly by age at first cannabis use, cannabis availability, cannabis problems, use frequency, and use context. Results provide preliminary support for distinct patterns of cannabis use, PBS, and health beliefs that align with the HBM. Results highlight the importance of considering how students perceive cannabis PBS and problems and how those beliefs may influence their PBS and cannabis use.
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Affiliation(s)
- Olivia L Bolts
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523, USA.
| | - Mark A Prince
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523, USA.
| | - Nora E Noel
- Department of Psychology, University of North Carolina Wilmington, 601 South College Rd., Wilmington, NC 28409, USA.
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5
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Bass SB, Kelly PJA, Pandit-Kerr S, Pilla J, Morris K, Larsen E, Wisdom JP, Torralva PR. “It's my frenemy”: A qualitative exploration of knowledge and perceptions of fentanyl use during the COVID-19 pandemic in people who use drugs at a syringe services program in Philadelphia, PA. Front Public Health 2022; 10:882421. [PMID: 35937263 PMCID: PMC9353520 DOI: 10.3389/fpubh.2022.882421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Exacerbated by the COVID-19 pandemic and the proliferation of fentanyl and fentanyl analogs, overdose deaths have surged in the United States, making it important to understand how individuals who use drugs experience and perceive the risks of fentanyl use and how it has changed during the COVID-19 pandemic. Methods Twenty clients from a Philadelphia syringe services program completed a questionnaire and in-depth interview about their fentanyl experiences from January to March 2021. These interviews were transcribed and analyzed using thematic analysis methods. Results Sixty percent of participants were female and racial/ethnic minority. Participants indicated they believed fentanyl use accounted for most Philadelphia opioid-related overdoses and understood that fentanyl was different from other opioids. Fentanyl use was characterized as “all-consuming” by taking over lives and inescapable. While most perceived their risk of fentanyl overdose as high, there was low interest in and reported use of harm reduction strategies such as fentanyl test strips. The COVID-19 pandemic was noted to have negative effects on fentanyl availability, use and overdose risk, as well as mental health effects that increase drug use. Conclusions The divide between perceived risk and uptake of protective strategies could be driven by diminished self-efficacy as it relates to acting on and engaging with resources available at the syringe services program and represents a potential intervention target for harm reduction intervention uptake. But the COVID-19 pandemic has exacerbated risks due to fentanyl use, making an effective, accessible, and well-timed intervention important to address the disconnect between perceived overdose risk and use of preventive behaviors.
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Affiliation(s)
- Sarah Bauerle Bass
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
- *Correspondence: Sarah Bauerle Bass
| | - Patrick J. A. Kelly
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | | | - Jenine Pilla
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
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Gjersing L, Helle MK. Injecting Alone is More Common among Men, Frequent Injectors and Polysubstance Users in a Sample of People Who Inject Drugs. Subst Use Misuse 2021; 56:2214-2220. [PMID: 34565289 DOI: 10.1080/10826084.2021.1981388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Injecting alone increases the risk of a fatal overdose. We examined the extent of such behavior in a sample of people who inject drugs (PWID) and the typical characteristics of those injecting alone at least once during the past four weeks. A cross-sectional study. PWID recruited from the street and from low-threshold services in seven Norwegian cities in September 2017 (n = 359). Associations between characteristics and injecting alone were examined using logistic regression analysis. The independent variables were gender (female/male), age, having received overdose-prevention education (no/yes), and, in the past four weeks; homelessness/shelter use (no/yes), in opioid substitution treatment (no/yes), injecting ≥ four days a week (no/yes), and substances injected (opioids only/opioids and other/other only/central stimulants (CS) only/CS and other/CS and opioids/CS, opioids and other). The adjusted odds ratios (aOR) and 95% Confidence Intervals (CI) were reported. Of the 359 PWID, 84.4% reported having injected alone. Males were more likely than females to inject alone (aOR = 1.88 95% CI 1.00-3.54). Furthermore, those injecting frequently (aOR = 1.99 95% CI 1.02-3.86) and those injecting multiple substances (CS, opioids and other) (aOR = 2.94 95% CI 1.01-8.58) were more likely to inject alone compared to those injecting less frequently and opioids only. Although not statistically significant, the effect sizes in the logistic regression models suggest that polysubstance use may be driven by CS use. Injecting alone was common in our sample of PWID, and male gender, frequent injecting and polysubstance injecting were associated with this behavior.
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Affiliation(s)
- Linn Gjersing
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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7
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Harm Reduction for Injection Drug Users with Infective Endocarditis: A Systematic Review. CANADIAN JOURNAL OF ADDICTION 2020. [DOI: 10.1097/cxa.0000000000000080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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8
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Costa MF. Health belief model for coronavirus infection risk determinants. Rev Saude Publica 2020; 54:47. [PMID: 32491096 PMCID: PMC7190095 DOI: 10.11606/s1518-8787.2020054002494] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To use the advantages of a ratio scale with verbal anchors in order to measure the risk perception in the novel coronavirus infection, which causes covid-19, in a health belief model-based questionnaire, as well as its validity and reproducibility. METHOD We used the health belief model, which explores four dimensions: perceived susceptibility (five questions), perceived severity (five questions), perceived benefits (five questions), and perceived barriers (five questions). Additionally, we included a fifth dimension, called pro-health motivation (four questions). The questions composed an electronic questionnaire disseminated by social networks for an one-week period. Answers were quantitative values of subjective representations, obtained by a psychophysically constructed scale with verbal anchors ratio (CentiMax ® ). Mean time for total filling was 12 minutes (standard deviation = 1.6). RESULTS We obtained 277 complete responses to the form. One was excluded because it belonged to a participant under 18 years old. Reproducibility measures were significant for 22 of the 24 questions in our questionnaire (Cronbach's α = 0.883). Convergent validity was attested by Spearman-Brown's split half reliability coefficient (r = 0.882). Significant differences among groups were more intense in perceived susceptibility and severity dimensions, and less in perceived benefits and barriers. CONCLUSION Our health belief model-based questionnaire using quantitative measures enabled the confirmation of popular beliefs about covid-19 infection risks. The advantage in our approach lays in the possibility of quickly, directly and quantitatively identifying individual belief profiles for each dimension in the questionnaire, serving as a great ally for communication processes and public health education.
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Affiliation(s)
- Marcelo Fernandes Costa
- Departamento de Psicologia Experimental. Instituto de Psicologia. Universidade de São Paulo. São Paulo, SP, Brasil.,Núcleo de Neurociências Aplicada. Universidade de São Paulo. São Paulo, SP, Brasil
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Gibbs D, Peacock A, O'Keefe D, Butler K, Bruno R, Lenton S, Burns L, Larney S. Use of alcohol swabs to clean injecting sites among people who regularly inject drugs in Australia. Drug Alcohol Rev 2019; 39:83-92. [PMID: 31828864 DOI: 10.1111/dar.13006] [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: 04/26/2019] [Revised: 09/18/2019] [Accepted: 10/11/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Cleaning drug injection sites with alcohol swabs prior to injecting reduces risk of abscesses and other skin and soft tissue infections (SSTI). Better understanding of swabbing behaviours can inform interventions to improve injecting hygiene. We aimed to determine the socio-demographic, drug use and injecting risk exposure correlates of swabbing prior to injecting and reasons for not swabbing. DESIGN AND METHODS The Illicit Drug Reporting System recruited participants who had injected drugs at least monthly in the past six months in June-July 2017 from all Australian capital cities via needle and syringe programs and word-of-mouth. A structured interview was used to collect information on drug use and related behaviour, as well as swabbing practices. Logistic regression was used to identify factors associated with not swabbing at last injection. RESULTS Of 853 respondents, one-quarter (26%) reported that they did not swab prior to their last injection. In adjusted analyses, crystal methamphetamine as the last drug injected, past month receptive or distributive syringe sharing, and past month re-use of one's own needle were significantly associated with not swabbing at last injection. Among participants who did not swab at last injection, swabbing was frequently considered unnecessary and a small number disliked using alcohol swabs. DISCUSSION AND CONCLUSIONS Efforts are needed to increase awareness of the importance of injecting hygiene in preventing SSTI. Interventions to increase swabbing should be included as part of a wider package of injecting hygiene education, particularly in light of associations with receptive and/or distributive syringe sharing.
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Affiliation(s)
- Daisy Gibbs
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | - Kerryn Butler
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Discipline of Addiction Medicine, University of Sydney, Sydney, Australia
| | | | - Simon Lenton
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Medical School, Brown University, Providence, USA
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10
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The prevalence of non-fatal overdose among people who inject drugs: A multi-stage systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:172-184. [DOI: 10.1016/j.drugpo.2019.07.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/15/2019] [Accepted: 07/15/2019] [Indexed: 12/13/2022]
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11
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Moallef S, Nosova E, Milloy MJ, DeBeck K, Fairbairn N, Wood E, Kerr T, Hayashi K. Knowledge of Fentanyl and Perceived Risk of Overdose Among Persons Who Use Drugs in Vancouver, Canada. Public Health Rep 2019; 134:423-431. [PMID: 31211644 DOI: 10.1177/0033354919857084] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES In North America, the illicit drug supply is increasingly contaminated by illicitly manufactured fentanyl. We sought to assess the level and source of fentanyl risk knowledge, defined as knowledge of the overdose risks associated with fentanyl, and characterize the prevalence and correlates of perceived risk of personally having a fentanyl overdose among persons who use illicit drugs (PWUD) in Vancouver, British Columbia. METHODS We derived data from 3 prospective cohorts of PWUD in Vancouver from December 2016 through May 2017. We used multivariable ordinal regression analysis to identify factors associated with a lower perceived risk of having a fentanyl overdose. RESULTS Of 1166 participants, 1095 (93.9%) had fentanyl risk knowledge. Of 1137 participants who answered questions about their perceived risk of having a fentanyl overdose, 398 (35.0%) perceived having no risk, 426 (37.5%) perceived having low risk, and 313 (27.5%) perceived having moderate or high risk. Never or rarely using opioids (n = 541, 65.7%) was the most common reason for reporting no or low perceived risk (n = 824), whereas 137 (16.6%) participants reported daily heroin use. In multivariable analysis, compared with participants who perceived a moderate or high risk, participants who perceived a lower risk were less likely to report a recent nonfatal overdose (adjusted odds ratio [aOR] = 0.28; P < .001), recent injection drug use (aOR = 0.34; P < .001), and awareness of recent exposure to fentanyl (aOR = 0.34; P < .001). CONCLUSION Despite a high level of fentanyl risk knowledge, most study participants did not translate this knowledge into a risk of having an overdose. Although participants who perceived a lower risk were less likely to have had an overdose, a considerable proportion was engaged in daily opioid use, suggesting the need to improve overdose prevention efforts.
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Affiliation(s)
- Soroush Moallef
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,2 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Ekaterina Nosova
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,3 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - M J Milloy
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,3 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kora DeBeck
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,4 School of Public Policy, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Nadia Fairbairn
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,3 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Evan Wood
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,3 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Thomas Kerr
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,3 Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kanna Hayashi
- 1 British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada.,2 Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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12
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Bouchard M, Hashimi S, Tsai K, Lampkin H, Jozaghi E. Back to the core: A network approach to bolster harm reduction among persons who inject drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 51:95-104. [PMID: 29227844 DOI: 10.1016/j.drugpo.2017.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/31/2017] [Accepted: 10/11/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Injecting drugs safely almost always includes the presence of one's social network, especially for the prevention of overdose. Yet, the systematic analysis of users' social networks has yet to be established as a focal method in harm reduction research, and interventions. METHODS This study draws from 200 interviews with persons who inject drugs recruited from North America's first sanctioned supervised injection facility and a drug user's advocacy group. Respondents were asked about the individuals they personally considered as facilitators of harm reduction, and the relations between them. Collectively, these 200 respondents provided over 900 individuals whom they considered as members of their harm reduction network. The aim was to locate individuals that would potentially make the network denser (harm reduction champions) and users that were situated in the "periphery" of the network, and in practice, further away from the harm reduction core. RESULTS Of the 1135 network members, 63 individuals formed the "core" of the harm reduction network, collectively reaching approximately 70% of individuals in the network. We also uncovered 31 individuals that acted as "articulation points"- these individuals were not as connected, but were more effective at reaching peripheral individuals. CONCLUSION Former or current injecting drug users that were sampled were surrounded by a relatively rich harm reduction network, but the network approach showed that only a minority of individuals were true harm reduction "champions". Recruitment of a combination of well-connected harm reduction champions, and strategically connected articulation points, would be most effective in planning network interventions that encourage harm reduction behaviors among this population.
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Affiliation(s)
- Martin Bouchard
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Sadaf Hashimi
- Rutgers University, Center for Law and Justice, 123 Washington Street, Newark, NJ, 07102-309, United States
| | - Kristen Tsai
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Hugh Lampkin
- Vancouver Area Network of Drug Users, 380 East Hastings Street, Vancouver, BC, V6A 1P4, Canada
| | - Ehsan Jozaghi
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada; BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada
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13
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Silic M. Explaining Organizational Employee Computer Abuse Through an Extended Health Belief Model. SSRN ELECTRONIC JOURNAL 2017. [DOI: 10.2139/ssrn.3070823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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14
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Bonar EE, Bohnert ASB. Perceived Severity of and Susceptibility to Overdose Among Injection Drug Users: Relationships With Overdose History. Subst Use Misuse 2016; 51:1379-83. [PMID: 27245115 PMCID: PMC5139619 DOI: 10.3109/10826084.2016.1168447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Overdose is relatively common among injection drug users (IDUs) yet little is known about how overdose-related health beliefs influence overdose experiences or risk reduction. OBJECTIVES This study examines the association of perceived susceptibility to and perceived severity of nonfatal overdose with overdose history among IDUs attending needle exchange programs (NEPs) to inform prevention efforts. METHODS In 2009-2010, IDUs (N = 91) attending NEPs completed self-report surveys. Negative binomial regression modeled the association between demographics, age of injection initiation, length of time attending the NEP, perceived severity of overdose, and perceived susceptibility to overdose with lifetime history of nonfatal overdose. RESULTS Over half (55%) of participants reported lifetime overdose, with a mean of 2.9 overdoses. A multivariable negative binomial regression model revealed that younger current age, older age of first injection, non-Caucasian race, higher perceived severity of overdose, and lower perceived susceptibility to overdose were significantly correlated with fewer lifetime overdoses. CONCLUSIONS Although our methodology precludes causal inferences, these findings are consistent with the hypothesis that perceived severity and perceived susceptibility are among several factors associated with IDUs' use of protective behaviors, which could influence the likelihood of overdose. Future prospective research to explore the impact of this and other health beliefs on risk behaviors and overdose could help improve the effectiveness of behavioral interventions.
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Affiliation(s)
- Erin E Bonar
- a Addiction Center , University of Michigan , Ann Arbor , Michigan , USA.,b Department of Psychology , Bowling Green State University , Bowling Green , Ohio , USA
| | - Amy S B Bohnert
- a Addiction Center , University of Michigan , Ann Arbor , Michigan , USA.,c Department of Veterans Affairs Healthcare System , VA Center for Clinical Management Research , Ann Arbor , Michigan , USA
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Prevalence and associated factors of inhaled nitrites use among men who have sex with men in Beijing, China. Drug Alcohol Depend 2015; 149:93-9. [PMID: 25680516 DOI: 10.1016/j.drugalcdep.2015.01.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 01/21/2015] [Accepted: 01/21/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Inhaled nitrites are commonly used by men who have sex with men (MSM) in western countries. As such compounds are not illicit, they are widely available in China. Recent studies have documented a high prevalence of inhaled nitrites use in this population. METHODS Snowball sampling was used to recruit 576 MSM in Beijing, China, who completed an anonymous face-to-face interview. RESULTS Of the participants, 49.8% had heard of "Rush" or "inhaled nitrites". The prevalence of use in the last three months was 28.3% among all participants and 56.8% among those with awareness about the compounds. A stepwise model found that age group (26-35 years old, ORm= 3.91; ≤ 25 years old, ORm = 3.05; reference group: >35 years old, P < 0.01) and multiple male sex partnerships (ORm = 2.29, P < 0.01) were associated with inhaled nitrites use. Adjusted for these two variables, constructs based on the Health Belief Model (HBM) were significantly associated with inhaled nitrites use in the last three months: Perceived Severity Scale [Adjusted Odds Ratios (AOR) = 0.72, P < 0.001], the Perceived Benefit Scale (AOR = 1.20, P < 0.001), the Perceived Barrier Scale (AOR = 0.81, P < 0.01), the Cue to Action Scale (AOR = 1.45, P < 0.001), and the Perceived Self-efficacy Scale (AOR = 0.71, P < 0.001). CONCLUSIONS The prevalence of inhaled nitrites use was high. It may further increase sharply among MSM in China when awareness becomes more common. Cognitive variables derived from the HBM provided a useful framework for designing interventions at structural, inter-personal and individual levels. Policy changes should also be considered.
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Muñoz F, Burgos JL, Cuevas-Mota J, Teshale E, Garfein RS. Individual and socio-environmental factors associated with unsafe injection practices among young adult injection drug users in San Diego. AIDS Behav 2015; 19:199-210. [PMID: 24920342 DOI: 10.1007/s10461-014-0815-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Unsafe injection practices significantly increase the risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection among injection drug users (IDUs). We examined individual and socio-environmental factors associated with unsafe injection practices in young adult IDUs in San Diego, California. Of 494 IDUs, 46.9 % reported receptive syringe sharing and 68.8 % sharing drug preparation paraphernalia in the last 3 months. Unsafe injection practices were associated with increased odds of having friends who injected drugs with used syringes, injecting with friends or sexual partners, and injecting heroin. Perceived high susceptibility to HIV and perceived barriers to obtaining sterile syringes were associated with increased odds of receptive syringe sharing, but not with sharing injection paraphernalia. Over half the IDUs reported unsafe injection practices. Our results suggest that personal relationships might influence IDUs' perceptions that dictate behavior. Integrated interventions addressing individual and socio-environmental factors are needed to promote safe injection practices in this population.
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Humaidi N, Balakrishnan V. Leadership Styles and Information Security Compliance Behavior: The Mediator Effect of Information Security Awareness. ACTA ACUST UNITED AC 2015. [DOI: 10.7763/ijiet.2015.v5.522] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Bonar EE, Rosenberg H. Injection Drug Users' Perceived Barriers to Using Self-Initiated Harm Reduction Strategies. ADDICTION RESEARCH & THEORY 2014; 22:271-278. [PMID: 25419201 PMCID: PMC4238385 DOI: 10.3109/16066359.2013.838225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
INTRODUCTION AND AIMS Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs' perceived barriers to engaging in these behaviors. METHOD We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. RESULTS The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one's drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants' most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. DISCUSSION AND CONCLUSIONS Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated.
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Affiliation(s)
- Erin E Bonar
- University of Michigan, Addiction Research Center, 4250 Plymouth Road, Ann Arbor, MI 48109-0720
| | - Harold Rosenberg
- Bowling Green State University, Department of Psychology, Bowling Green, OH 43403
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