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Virtual Peer Support in Women's Health for Pregnant People and Mothers With Substance Use Disorder. Nurs Womens Health 2022; 26:226-233. [PMID: 35460640 DOI: 10.1016/j.nwh.2022.03.001] [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: 05/07/2021] [Revised: 01/10/2022] [Accepted: 03/03/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a virtual peer support group associated with a women's health unit for mothers and pregnant people with substance use disorder. DESIGN The project was guided by the Centers for Disease Control and Prevention's Framework for Program Evaluation in Public Health. Pre-/postintervention surveys were used to evaluate outcomes. SETTING Women's health unit in a 325-bed hospital with 900 births a year in the U.S. Midwest and a virtual online meeting format. PARTICIPANTS Thirteen people with substance use disorder. INTERVENTION/MEASUREMENTS Participants were recruited by nurses on the women's health unit and in existing online meetings. Participants attended a 12-week session of facilitated substance use disorder peer support meetings through an online virtual format. Surveys included the Depression, Anxiety, and Stress Scale; the Alcoholics Anonymous Intention Scale; and pre-/postintervention surveys developed by the authors. Descriptive statistics and narrative description of qualitative data were used. RESULTS The Depression, Anxiety, and Stress Scale scores were reduced, on average, by 25%, indicating that participants showed improvement in these conditions. Responses to open-ended questions showed that participants found the meetings helpful for developing coping mechanisms. The virtual space was seen as a comfortable, safe space where participants were able to develop community. CONCLUSION Substance use disorder treatment continues to challenge health care providers across the United States. Peer support meetings have been effective in the treatment of people with substance use disorder. Nursing has the holistic historical precedence of creating effectual education and support programs. This program evaluation exemplifies that women's health units are an appropriate location where nurses can integrate this established evidence-based treatment modality.
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Zemore SE, Ware OD, Gilbert PA, Pinedo M. Barriers to retention in substance use treatment: Validation of a new, theory-based scale. J Subst Abuse Treat 2021; 131:108422. [PMID: 34098296 PMCID: PMC8528875 DOI: 10.1016/j.jsat.2021.108422] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Few studies and no theory-based scales have addressed specific barriers to substance use disorder (SUD) treatment retention. The current study, building on the Theory of Planned Behavior (TPB), sought to (a) identify those barriers that are most strongly associated with treatment retention, and most common, and (b) develop and validate a new scale of retention barriers, focusing on TPB attitude and perceived control components. METHODS The study administered surveys to 200 participants initiating SUD treatment at a public, outpatient program in Northern California; the analytic sample (N = 156) included only those not strongly coerced into treatment. Surveys included TPB-based measures of treatment barriers; other motivational readiness measures; treatment coercion and social desirability measures; and clinical severity variables and demographics. Discharge status was collected from program records. RESULTS Item and scale analyses identified three dimensions of attitudinal barriers (i.e., Low Perceived Treatment Need/Value, Social Concerns, and Concerns about Missing Substances) and two dimensions of perceived control barriers (i.e., Personal Limitations and Basic Logistic Barriers). Results informed creation of a 19-item Barriers to Retention Scale (BRS) with 5 subscales and very good internal reliability (alpha = 0.88). While all subscale scores were correlated with treatment completion, only Concerns about Missing Substances and total BRS scores predicted treatment completion in multivariate analyses. CONCLUSIONS The present study identified core dimensions of treatment retention barriers and developed a new scale predictive of treatment completion and potentially useful as a screener and in future research. Results suggest that interventions to improve retention should focus strongly on concerns about the negative impacts of abstaining from alcohol and drugs on craving and quality of life.
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Affiliation(s)
- Sarah E Zemore
- Alcohol Research Group, Emeryville, CA, United States of America.
| | - Orrin D Ware
- School of Social Work, University of Maryland, Baltimore, MD, United States of America
| | - Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa, Iowa City, IA, United States of America
| | - Miguel Pinedo
- Department of Kinesiology and Health Education, College of Education, University of Texas at Austin, TX, United States of America
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Clough BA, Eigeland JA, Madden IR, Rowland D, Casey LM. Development of the eTAP: A brief measure of attitudes and process in e-interventions for mental health. Internet Interv 2019; 18:100256. [PMID: 31890610 PMCID: PMC6926169 DOI: 10.1016/j.invent.2019.100256] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Considerable evidence supports the efficacy of e-interventions for mental health treatment and support. However, client engagement and adherence to these interventions are less than optimal and remain poorly understood. OBJECTIVE The aim of the current study was to develop and investigate the psychometric properties of the e-Therapy Attitudes and Process questionnaire (eTAP). Based on the Theory of Planned Behaviour (TPB), the eTAP was designed to measure factors related to client engagement in e-interventions for mental health. METHODS Participants were 220 adults who reported current use of an e-intervention for mental health support. Participants completed the eTAP and related measures, with a subsample of 49 participants completing a one-week follow up assessment. RESULTS A 16-item version of the eTAP produced a clear four-factor structure, explaining 70.25% of variance. The factors were consistent with the TPB, namely, Intention, Subjective Norm, Attitudes, and Perceived Behavioural Control. Internal consistency of the total and subscales was high, and adequate to good one-week test retest reliability was found. Convergent and divergent validity of the total and subscales was supported, as was the predictive validity. Specifically, eTAP Intentions correctly predicted engagement in e-interventions with 84% accuracy and non-engagement with 74% accuracy. CONCLUSIONS The eTAP was developed as a measure of factors related to engagement and adherence with e-interventions for mental health. Psychometric investigation supported the validity and reliability of the eTAP. The eTAP may be a valuable tool to understand, predict, and guide interventions to increase engagement and adherence to e-interventions for mental health.
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Affiliation(s)
- Bonnie A. Clough
- School of Applied Psychology, Griffith University, Australia
- Menzies Health Institute Queensland, Australia
| | | | | | - Dale Rowland
- School of Applied Psychology, Griffith University, Australia
- Menzies Health Institute Queensland, Australia
| | - Leanne M. Casey
- School of Applied Psychology, Griffith University, Australia
- Menzies Health Institute Queensland, Australia
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Therapist Attitudes Towards Evidence-Based Practice: A Joint Factor Analysis. J Behav Health Serv Res 2018; 44:414-427. [PMID: 27230350 DOI: 10.1007/s11414-016-9517-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Despite the accumulated research support for the use of evidence-based practices (EBPs) with youth, these treatment approaches remain underutilized in community settings. Therapist attitudes towards EBPs play a pivotal role in their adoption and implementation of these practices. The present investigation employs joint exploratory factor analysis to evaluate the structure of two measures of therapist attitudes, the Evidence-Based Practices Attitudes Scale and the Modified Practice Attitude Scale. Results suggest three factors including (a) importance of clinical experience over EBPs, (b) clinician openness to change, and (c) problems with EBPs. Recommendations are provided for future evaluation of therapist attitudes and associated characteristics.
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Najavits LM, Enggasser J, Brief D, Federman E. A randomized controlled trial of a gender-focused addiction model versus 12-step facilitation for women veterans. Am J Addict 2018; 27:210-216. [DOI: 10.1111/ajad.12709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 02/07/2018] [Accepted: 03/03/2018] [Indexed: 11/26/2022] Open
Affiliation(s)
- Lisa M. Najavits
- Veterans Affairs Boston Healthcare System; Boston Massachusetts
- Boston University School of Medicine; Boston Massachusetts
| | - Justin Enggasser
- Veterans Affairs Boston Healthcare System; Boston Massachusetts
- Boston University School of Medicine; Boston Massachusetts
| | - Deborah Brief
- Veterans Affairs Boston Healthcare System; Boston Massachusetts
- Boston University School of Medicine; Boston Massachusetts
| | - Edward Federman
- Edith Nourse Rogers Memorial Veterans Hospital; Boston Massachusetts
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Hatch-Maillette M, Wells EA, Doyle SR, Brigham GS, Daley D, DiCenzo J, Donovan D, Garrett S, Horigian VE, Jenkins L, Killeen T, Owens M, Perl HI. Predictors of 12-Step Attendance and Participation for Individuals With Stimulant Use Disorders. J Subst Abuse Treat 2016; 68:74-82. [PMID: 27431050 DOI: 10.1016/j.jsat.2016.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/22/2016] [Accepted: 06/08/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Few studies have examined the effectiveness of 12-step peer recovery support programs with drug use disorders, especially stimulant use, and it is difficult to know how outcomes related to 12-step attendance and participation generalize to individuals with non-alcohol substance use disorders (SUDs). METHOD A clinical trial of 12-step facilitation (N=471) focusing on individuals with cocaine or methamphetamine use disorders allowed examination of four questions: Q1) To what extent do treatment-seeking stimulant users use 12-step programs and, which ones? Q2) Do factors previously found to predict 12-step participation among those with alcohol use disorders also predict participation among stimulant users? Q3) What specific baseline "12-step readiness" factors predict subsequent 12-step participation and attendance? And Q4) Does stimulant drug of choice differentially predict 12-step participation and attendance? RESULTS The four outcomes variables, attendance, speaking, duties at 12-step meetings, and other peer recovery support activities, were not related to baseline demographic or substance problem history or severity. Drug of choice was associated with differential days of Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) attendance among those who reported attending, and cocaine users reported more days of attending AA or NA at 1-, 3- and 6-month follow-ups than did methamphetamine users. Pre-randomization measures of perceived benefit of 12-step groups predicted 12-step attendance at 3- and 6-month follow-ups. Pre-randomization 12-step attendance significantly predicted number of other self-help activities at end-of-treatment, 3- and 6-month follow-ups. Pre-randomization perceived benefit and problem severity both predicted number of self-help activities at end-of-treatment and 3-month follow-up. Pre-randomization perceived barriers to 12-step groups were negatively associated with self-help activities at end-of-treatment and 3-month follow-up. Whether or not one participated in any duties was predicted at all time points by pre-randomization involvement in self-help activities. CONCLUSIONS The primary finding of this study is one of continuity: prior attendance and active involvement with 12-step programs were the main signs pointing to future involvement. Limitations and recommendations are discussed.
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Affiliation(s)
- Mary Hatch-Maillette
- University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105; University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific St., Seattle, WA 98105.
| | - Elizabeth A Wells
- University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105; University of Washington School of Social Work, 4101 15th Ave NE, Seattle, WA 98105
| | - Suzanne R Doyle
- University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105
| | | | - Dennis Daley
- University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15213
| | - Jessica DiCenzo
- San Francisco General Hospital, 1001 Potrero Ave., San Francisco, CA 98110
| | - Dennis Donovan
- University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105; University of Washington School of Medicine, Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific St., Seattle, WA 98105
| | - Sharon Garrett
- University of Washington Alcohol and Drug Abuse Institute, 1107 NE 45th St., Suite 120, Seattle, WA 98105
| | - Viviana E Horigian
- University of Miami Department of Public Health Sciences, Miller School of Medicine, 1120 NW 14th St., Miami, FL 33136
| | - Lindsay Jenkins
- Multnomah County Health Department, 426 SW Stark St, Portland, OR 97204
| | - Therese Killeen
- Medical University of South Carolina Department of Psychiatry and Behavioral Sciences, 67 President St., Charleston, SC 29425
| | - Mandy Owens
- University of New Mexico Center on Alcoholism, Substance Abuse and Addictions, 2650 Yale Blvd SE, Albuquerque, NM 87106
| | - Harold I Perl
- Independent Consultant, P.O. Box 169, Arroyo Seco, NM 87514
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Vederhus JK, Zemore SE, Rise J, Clausen T, Høie M. Predicting patient post-detoxification engagement in 12-step groups with an extended version of the theory of planned behavior. Addict Sci Clin Pract 2015; 10:15. [PMID: 26092327 PMCID: PMC4636789 DOI: 10.1186/s13722-015-0036-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 06/16/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Individuals with substance use disorders can receive important abstinence-specific support in 12-step groups (TSGs). However, our understanding of key factors that influence TSG participation remains limited. This study used an extended version of the theory of planned behavior (TPB) to enhance the understanding of TSG affiliation. METHODS Data were retrieved from a controlled trial of a 12-step facilitation intervention conducted on an inpatient detoxification ward in Norway (N = 140). Surveys at baseline included a TPB questionnaire. The behavioral target was to attend at least two TSG meetings per month in the 6-month follow-up period. Structural equation modeling was used to analyze the predictors of behavior at follow-up. RESULTS We found that attitudes, the moral norm, and perceived behavior control accounted for 81 % of the variance in the intention to participate regularly in TSGs after treatment. Subjective norms did not significantly influence the intention to participate. Moreover, the intention to participate significantly predicted behavior (β = 0.42, p < 0.001). In contrast to theory, there was a substantial, model-independent pathway from past to later behavior (β = 0.22, p = 0.047). The model explained 46 % (p < 0.001) of the variance in behavior. Attending ≥ 12 TSG meetings in the follow-up period was associated with a high percentage of abstinent days at follow-up (β = 0.38, p = 0.023). CONCLUSIONS The present TPB questionnaire worked well for assessing patient intentions to attend a TSG. Treatment providers should encourage patient intentions to participate in TSGs post-detoxification.
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Affiliation(s)
- John-Kåre Vederhus
- Addiction Unit, Sørlandet Hospital HF, PO Box 4164, 604, Kristiansand, Norway.
| | | | - Jostein Rise
- Norwegian Institute for Alcohol and Drug Research, Oslo, Norway.
| | - Thomas Clausen
- Addiction Unit, Sørlandet Hospital HF, PO Box 4164, 604, Kristiansand, Norway.
- Norwegian Center for Addiction Research, University of Oslo, Oslo, Norway.
- Fulbright Scholar (2014-15), Alcohol Research Group, Emeryville, CA, USA.
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Stevens E, Jason LA, Ram D, Light J. Investigating Social Support and Network Relationships in Substance Use Disorder Recovery. Subst Abus 2014; 36:396-9. [PMID: 25259558 DOI: 10.1080/08897077.2014.965870] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Social support and characteristics of one's social network have been shown to be beneficial for abstinence and substance use disorder recovery. The current study explores how specific sources of social support relate to general feelings of social support and abstinence-specific self-efficacy. METHODS Data were collected from 31 of 33 individuals residing in 5 recovery houses. Participants were asked to complete social support and social network measures, along with measures assessing abstinence from substance use, abstinence self-efficacy, and involvement in 12-step groups. RESULTS A significant positive relationship was found between general social support and abstinence-specific self-efficacy. General social support was also significantly associated with the specific social support measures of sense of community and Alcoholics Anonymous (AA) affiliation. Social network size predicted abstinence-related factors such as AA affiliation and perceived stress. CONCLUSIONS These results provide insight regarding individual feelings of social support and abstinence-specific self-efficacy by showing that one's social network-level characteristics are related to one's perceptions of social support. We also found preliminary evidence that individual Oxford Houses influence one's feelings of social support.
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Affiliation(s)
- Ed Stevens
- a Center for Community Research , DePaul University , Chicago , Illinois , USA
| | - Leonard A Jason
- a Center for Community Research , DePaul University , Chicago , Illinois , USA
| | - Daphna Ram
- a Center for Community Research , DePaul University , Chicago , Illinois , USA
| | - John Light
- b Oregon Research Institute , Portland , Oregon , USA
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Zemore SE, Ajzen I. Predicting substance abuse treatment completion using a new scale based on the theory of planned behavior. J Subst Abuse Treat 2014; 46:174-82. [PMID: 23953167 PMCID: PMC3840042 DOI: 10.1016/j.jsat.2013.06.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 06/15/2013] [Accepted: 06/27/2013] [Indexed: 11/17/2022]
Abstract
We examined whether a 9-item scale based on the theory of planned behavior (TPB) predicted substance abuse treatment completion. Data were collected at a public, outpatient program among clients initiating treatment (N=200). Baseline surveys included measures of treatment-related attitudes, norms, perceived control, and intention; discharge status was collected from program records. As expected, TPB attitude and control components independently predicted intention (model R-squared=.56), and intention was positively associated with treatment completion even including clinical and demographic covariates (model R-squared=.24). TPB components were generally associated with the alternative readiness scales as expected, and the TPB remained predictive at higher levels of coercion. Meanwhile, none of the standard measures of readiness (e.g., the URICA and TREAT) or treatment coercion were positively associated with treatment participation. Results suggest promise for application of the TPB to treatment completion and support use of the intention component as a screener, though some refinements are suggested.
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Affiliation(s)
- Sarah E. Zemore
- Scientist Alcohol Research Group, 6475 Christie Ave., Suite 400, Emeryville, CA 94608-1010, Tel: (510) 597-3440
| | - Icek Ajzen
- Professor Emeritus, University of Massachusetts, Amherst, Department of Psychology, 441 Tobin Hall, Amherst, MA 01003, Tel: (413) 545-0509
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