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Watson DP, Staton MD, Dennis ML, Grella CE, Scott CK. Variation in brief treatment for substance use disorder: a qualitative investigation of four federally qualified health centers with SBIRT services. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:58. [PMID: 34261499 PMCID: PMC8278761 DOI: 10.1186/s13011-021-00381-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 11/18/2022]
Abstract
Background Brief treatment (BT) can be an effective, short-term, and low-cost treatment option for many people who misuse alcohol and drugs. However, inconsistent implementation is suggested to result in BT that often looks and potentially costs similar to regular outpatient care. Prior research is also rife with inconsistent operationalizations regarding the measurement of BT received by patients. As such, there is a need to more explicitly identify and document variations in BT practice. Methods A qualitative investigation of BT in four Federally Qualified Health Centers (FQHC) was undertaken as a sub study of a larger clinical trial. Researchers interviewed 12 staff (administrators and clinicians) involved in BT oversight, referral, or delivery within the four FQHCs. Data were analyzed following an inductive approach guided by the primary research questions. Results Findings demonstrate considerable differences in how BT was conceptualized and implemented within the FQHCs. This included a variety of ways in which BT was presented and described to patients that likely impacts how they perceive the BT they receive, including potentially not understanding they received substance use disorder treatment at all. Conclusions The findings raise questions regarding the validity of prior research, demonstrating more objective definitions of BT and fidelity checklists are needed to ensure integrity of results. Future work in this area should seek to understand BT as practiced among a larger sample of providers and the direct experiences and perspectives of patients. There is also a need for more consistent implementation, quality assurance guidelines, and standardized stage of change assessments to aid practitioners.
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Affiliation(s)
- Dennis P Watson
- Chestnut Health Systems, 221 W Walton St, 60610, Chicago, IL, United States.
| | - Monte D Staton
- Center for Dissemination and Implementation Science, Department of Medicine, College of Medicine, University of Illinois at Chicago, 818 S. Wolcott, 60612, Chicago, IL, United States
| | - Michael L Dennis
- Chestnut Health Systems, 448 Wylie Dr, 61761, Normal, IL, United States
| | - Christine E Grella
- Chestnut Health Systems, 221 W Walton St, 60610, Chicago, IL, United States
| | - Christy K Scott
- Chestnut Health Systems, 221 W Walton St, 60610, Chicago, IL, United States
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Sahker E, Sakata M, Toyomoto R, Hwang C, Yoshida K, Luo Y, Watanabe N, Furukawa TA. Efficacy of brief intervention for drug misuse in primary care facilities: systematic review and meta-analysis protocol. BMJ Open 2020; 10:e036633. [PMID: 32878757 PMCID: PMC7470504 DOI: 10.1136/bmjopen-2019-036633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Drug misuse is associated with significant global morbidity, mortality, economic costs and social costs. Many primary care facilities have integrated drug misuse screening and brief intervention (BI) into their usual care delivery. However, the efficacy of BI for drug misuse in primary care has not been substantiated through meta-analysis. The aim of this systematic review and meta-analysis is to determine the efficacy of BI for drug misuse in primary care settings. METHODS AND ANALYSIS We will include all randomised controlled trials comparing primary care-delivered BI for drug misuse with no intervention or minimal screening/assessment and usual care. Primary outcomes are (1) drug use frequency scores and (2) severity scores at intermediate follow-up (4-8 months). We will retrieve all studies through searches in CENTRAL, Embase, MEDLINE and PsycINFO until 31 May 2020. The reference list will be supplemented with searches in trial registries (eg, www.clinicaltrials.gov) and through relevant existing study reference lists identified in the literature. We will conduct a random-effect pairwise meta-analysis for primary and secondary outcomes. We will assess statistical heterogeneity though visual inspection of a forest plot and calculate I2 statistics. We will assess risk of bias using the Cochrane Risk of Bias Tool V.2 and evaluate the certainty of evidence through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Sensitivity analyses will account for studies with control group variations and studies with a high risk of bias. If heterogeneity is present, subgroup analyses will consider patient variables of age, sex/gender, race/ethnicity, per cent insured, baseline severity and primary drug misused. ETHICS AND DISSEMINATION This study will use published aggregate data and will not require ethical approval. Findings will be disseminated in a peer-reviewed journal.
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Affiliation(s)
- Ethan Sahker
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
- Japan Society for the Promotion of Science (JSPS), Overseas Fellowship Division, Kojimachi, Chiyoda-ku, Tokyo, Japan
| | - Masatsugu Sakata
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Rie Toyomoto
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Chiyoung Hwang
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
- Japan Society for the Promotion of Science (JSPS), Research Fellowship Division, Kojimachi, Chiyoda-ku, Tokyo, Japan
| | - Kazufumi Yoshida
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Yan Luo
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Norio Watanabe
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
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Arble E, Daugherty AM, Arnetz BB. Models of First Responder Coping: Police Officers as a Unique Population. Stress Health 2018; 34:612-621. [PMID: 29882624 PMCID: PMC6830880 DOI: 10.1002/smi.2821] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 04/26/2018] [Accepted: 05/08/2018] [Indexed: 11/06/2022]
Abstract
The term "first responders" refers to a range of professional occupations, including police officers, fire fighters, search and rescue personnel, ambulance personnel, and military personnel. Research by the present authors has developed empirical models of first responder coping, identifying 2 coping pathways with differential outcomes: approach and avoidance coping. The present investigation considers police officers as a unique group and measures the extent to which police officers differ from other first responders in coping behaviours following trauma, based upon a nationally representative survey of 917 Swedish police officers. Although the model of coping behaviours following trauma and the effects on well-being displayed several similarities between police officers and other first responders, there was compelling evidence to suggest that there are professionally bound aspects of psychological coping, resilience, and well-being that merit further exploration. Among police officers, for example, avoidant coping was related to worse well-being, and police officers reported greater consequence to well-being related to substance use than other first responders. The unique aspects of police officer coping in comparison with other first responder groups are explored.
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Affiliation(s)
- Eamonn Arble
- Department of Psychology, Eastern Michigan University, Ypsilanti, Michigan
| | - Ana M. Daugherty
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Bengt B. Arnetz
- Department of Family Medicine, Michigan State University, East Lansing, Michigan
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Ohida N, Otsuka Y, Kaneita Y, Nakagome S, Jike M, Itani O, Ohida T. Factors Related to Alcohol Consumption Among Japanese Physicians. Asia Pac J Public Health 2018; 30:296-306. [DOI: 10.1177/1010539518754539] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study aimed to investigate the drinking habits of Japanese physicians, and clarify their causal factors. A self-administered questionnaire was sent to 6000 male and 1500 female physicians, selected from among members of the Japan Medical Association. We analyzed the correlation of drinking habits with age, medical department, smoking and exercise status, work environment, sleep problems, and mental health. The response rate was 79.4%. Physicians with a heavy drinking habit were most frequently men in their 60s and women in their 20s to 50s. Drinking or heavy drinking tendencies decreased with increasing age. Smoking status was correlated with heavy drinking. Exercise status was correlated with drinking among men, and drinking/heavy drinking among women. Mental health was not correlated with drinking habit. However, sleep problems were correlated with a heavy drinking habit. These results suggest that countermeasures need to be taken to decrease the rate of heavy drinking among physicians.
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Affiliation(s)
- Noriyasu Ohida
- Divison of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuichiro Otsuka
- Divison of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshitaka Kaneita
- Divison of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sachi Nakagome
- Divison of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Maki Jike
- Divison of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Osamu Itani
- Depatment of Public Health and Epidemiology, Faculty of Medicine, Oita University, Yufu-shi, Oita, Japan
| | - Takashi Ohida
- Divison of Public Health, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan
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