1
|
Dai R, Feng T, Ma X, Cao J, Yang K, Fan J. PROTOCOL: Effectiveness of behavioral interventions for smoking cessation among homeless persons: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1416. [PMID: 38882932 PMCID: PMC11177335 DOI: 10.1002/cl2.1416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 05/07/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024]
Abstract
This is the protocol for an updated Campbell systematic review. The objectives are as follows: To evaluate the effect of behavioral interventions on smoking cessation among homeless individuals.
Collapse
Affiliation(s)
- Runjing Dai
- Hospital Infection-Control Department Xi'an Aerospace General Hospital Xi'an Shaanxi P.R. China
- School of Public Health, Center for Laboratory and Simulation Training, Center for Evidence-Based Medicine Gansu University of Chinese Medicine Lanzhou Gansu China
| | - Tiantian Feng
- School of Public Health, Center for Laboratory and Simulation Training, Center for Evidence-Based Medicine Gansu University of Chinese Medicine Lanzhou Gansu China
| | - Xiaoting Ma
- School of Nursing Gansu University of Chinese Medicine Lanzhou Gansu China
| | - Juan Cao
- Department of Public Health Affiliated Hospital of Gansu University of Chinese Medicine Lanzhou China
| | - Kehu Yang
- School of Public Health, Evidence Based Social Science Research Center Lanzhou University Lanzhou China
| | - Jingchun Fan
- School of Public Health, Center for Laboratory and Simulation Training, Center for Evidence-Based Medicine Gansu University of Chinese Medicine Lanzhou Gansu China
| |
Collapse
|
2
|
Brown S, Barman-Adhikari A, Garcia K, Chassman S, Hsu HT, Petering R, Santa Maria D, Narendorf S, Shelton J, Bender K, Ferguson K. Substance use typologies among young people experiencing homelessness in seven cities across the United States: A latent class analysis. Addict Behav 2024; 150:107929. [PMID: 38056194 DOI: 10.1016/j.addbeh.2023.107929] [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: 05/08/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Substance use and other health-risk risk factors, including mental health, trauma, and sexual-risk behaviors, often co-occur among youth experiencing homelessness (YEH). The present study aimed to identify subgroups of YEH based on polysubstance use and the linkages to sociodemographic and health-risk characteristics. METHODS From June 2016 to July 2017, 1,426 YEH (aged 18-26 years) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information via a self-administered electronic survey on substance use, mental health, trauma, sexual risk behaviors, and sociodemographic characteristics. The majority of YEH identified as Black (37.3%), cisgender (92.8%), and heterosexual (69.2%). On average, YEH were 20.9 years (SD = 2.1). This study employed latent class analysis (LCA) to identify subgroups of YEH according to their substance use. Multinomial logistic regression analyses were conducted to identify sociodemographic and health-risk characteristics associated with class-membership. RESULTS Four latent classes of YEH substance use were identified: (1) high polysubstance use; (2) moderate stimulant and high marijuana, alcohol, and prescription drug use; (3) high marijuana, alcohol, and prescription drug use; (4) low/moderate marijuana and alcohol use. Multinomial logistic regression models indicated that geographic location, gender, race/ethnicity, mental health, trauma history, and sexual risk behaviors were significant correlates of substance use class membership among YEH. CONCLUSIONS These findings offer important implications for the prevention and treatment of substance use among YEH. Screening protocols should consider co-occurring risk factors such as traumatic experiences, sexual risk behaviors, and mental health history as indicators of polysubstance use.
Collapse
Affiliation(s)
- Samantha Brown
- School of Social Work, Colorado State University, 450 W Pitkin St, Fort Collins, CO 80521, USA.
| | - Anamika Barman-Adhikari
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO 80208, USA.
| | - Kevin Garcia
- School of Social Work, Colorado State University, 450 W Pitkin St, Fort Collins, CO 80521, USA
| | - Stephanie Chassman
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO 80208, USA.
| | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, 729 Clark Hall, Columbia, MO 65211, USA
| | - Robin Petering
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1150 South Olive Street, 1503-1, Los Angeles, CA 90015, USA
| | - Diane Santa Maria
- Department of Nursing Systems, Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave., Ste. 591, Houston, TX 77030, USA
| | - Sarah Narendorf
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd. #110HA, Houston, TX 77204-4013, USA
| | - Jama Shelton
- Silberman School of Social Work at Hunter College, 2180 Third Ave., New York, NY 10035, USA
| | - Kimberly Bender
- Graduate School of Social Work, University of Denver, 2148 S. High St., Denver, CO 80208, USA.
| | - Kristin Ferguson
- School of Social Work, Arizona State University, 411 N. Central Ave., #865, Phoenix, AZ 85004-0689, USA
| |
Collapse
|
3
|
Nemeth JM, Glasser AM, Macisco J, Hinton A, Wermert A, Patterson JG, Sucaldito A, Gilson C, Kemble H, Garbsch E, Caponi J. Identifying Novel Motivation Phase-Specific Cessation Targets for Youth Experiencing Homelessness in the United States. Nicotine Tob Res 2024; 26:237-244. [PMID: 37725951 PMCID: PMC10803121 DOI: 10.1093/ntr/ntad176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 07/11/2023] [Accepted: 09/18/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Of youth experiencing homelessness (YEH; 14-24 years old), 70%+ smoke combustible, commercial tobacco. Though many have tried to quit, most use ineffective methods. Drop-in centers for YEH are opportune places to link YEH to evidence-based treatment. Using the Phase-Based Model (PBM) for Cessation Research, the aim of this study was to identify "Motivation" phase-specific challenges impacting YEH's willingness to make a quit attempt-the goal of this cessation phase. AIMS AND METHODS Surveys were interview administered with 96 past-week combusted tobacco users accessing drop-in services. Regression models were fit to confirm hypothesized challenges impacting YEH's willingness to quit. RESULTS Moderate nicotine dependence was noted-a key Motivation phase cessation mechanism targeted-and was associated with population challenges including, but not limited to, replacing food with tobacco, accidental oxygen-deprivation events, and smoking to socialize. While 67.1% of participants made a past-year quit attempt, 45.8% expressed 30-day quit interest. Dimensions of coping with housing were associated with quit attempts and quit interest. Quit attempts were also associated with nicotine dependence, working, and smoking to socialize. Whereas, quit interest was associated with less endorsement of smoking to regulate affect and more endorsement to avoid danger. CONCLUSIONS Though common challenges targeted in Motivation phase cessation exist among YEH, other challenges may also need to be addressed to promote quitting. IMPLICATIONS Future research in optimizing evidence-based cessation access for YEH through drop-in centers may consider addressing the challenges of housing, food security, social context, violence, and neurotrauma sequela to bolster YEH willingness to make a quit attempt.
Collapse
Affiliation(s)
- Julianna M Nemeth
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Allison M Glasser
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Institute for Nicotine and Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Joseph Macisco
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Alice Hinton
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Joanne G Patterson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Ana Sucaldito
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Department of Family and Community Medicine and Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Carra Gilson
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Hannah Kemble
- Division of Health Sciences Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
- Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Ellen Garbsch
- Division of Health Sciences Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Jacob Caponi
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Department of Sociology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
4
|
Pedersen ER, DiGuiseppi G, D'Amico EJ, Rodriguez A, Tran DD, Jose R, Tucker JS. Predictors of Housing Trajectories Among Young Adults Experiencing Homelessness in Los Angeles. J Behav Health Serv Res 2024; 51:31-43. [PMID: 37803216 PMCID: PMC10733216 DOI: 10.1007/s11414-023-09863-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/08/2023]
Abstract
Experiencing homelessness during young adulthood is associated with negative health outcomes and understanding housing trajectories of young adults experiencing homelessness may aid in the development of evidence-based public health programs designed to serve this at-risk age group. In the present study, the authors examined baseline predictors of 24-month trajectories of housing stability and unsheltered housing among a sample of 271 young adults aged 18 to 25 recruited from drop-in centers in Los Angeles. In multivariate models, the authors found that identifying as multi-racial/other and better friendship quality at baseline were associated with less steep increases in the likelihood of stable housing over time. Being employed at baseline was associated with a less steep decrease in the probability of being unsheltered over time, while illicit drug use days associated with a steeper decrease in the probability of being unsheltered over time. Continued research is needed to establish important factors determining young adults' long-term housing trajectories in the effort to promote greater access and engagement with housing services.
Collapse
Affiliation(s)
- Eric R Pedersen
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA.
| | - Graham DiGuiseppi
- School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA
- RAND Corporation, 4570 Fifth Ave #600, Pittsburgh, PA, 15213, USA
| | - Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407, USA
| | | | - Denise D Tran
- Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA
| | - Rupa Jose
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407, USA
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407, USA
| |
Collapse
|
5
|
Felner JK, Calzo JP. Housing status as a social determinant of disparities in adolescent smoking, vaping, and dual use of cigarettes and e-cigarettes. Addict Behav 2023; 141:107631. [PMID: 36821879 PMCID: PMC10771816 DOI: 10.1016/j.addbeh.2023.107631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/29/2022] [Accepted: 01/23/2023] [Indexed: 01/27/2023]
Abstract
Little is known about how various housing situations among adolescents may be associated with differential patterns of smoking and vaping-information with practical relevance for tobacco prevention and control efforts. We analyzed disparities by housing status in past 30-day smoking, vaping, and dual use of cigarettes and e-cigarettes/vape products among adolescents participating in the population-based California Healthy Kids Survey (N = 931,355; 2017-2019). Generalized linear mixed models for a categorical outcome quantified differences in prevalence and adjusted odds ratios (AORs) of smoking only, vaping only, and dual use among adolescents in various housing situations relative to their peers living in a home with one or more parents/guardians or other relatives. Our findings suggest adolescents living in a friend's home; adolescents living in a hotel, motel, shelter, car, campground, or other transitional or temporary housing; and adolescents living in a foster home, group care, or waiting placement evidenced pronounced disparities in past 30-day smoking only (AORs: 3.16-3.40, ps < 0.0001) and dual use of cigarettes and e-cigarettes/other nicotine vape products (AOR: 3.73-5.83, ps < 0.0001) relative to their peers living in a home with one or more parents/guardians or other relatives. Vaping only disparities, although significant, were relatively smaller (AORs: 1.53-1.88, ps < 0.0001). These findings emphasize housing as a social determinant of smoking, vaping, and dual use disparities among adolescents and have implications for multilevel preventive intervention development.
Collapse
Affiliation(s)
- Jennifer K Felner
- San Diego State University School of Public Health, San Diego, CA, United States; Institute for Behavioral and Community Health, San Diego, CA, United States.
| | - Jerel P Calzo
- San Diego State University School of Public Health, San Diego, CA, United States; Institute for Behavioral and Community Health, San Diego, CA, United States
| |
Collapse
|
6
|
Rezai R, Hayati Rezvan P, Comulada WS, Lee SJ, Ocasio MA, Swendeman D, Fernández MI. Alcohol Misuse Among Youth Living With and at High Risk for Acquiring HIV During the COVID-19 Stay-at-Home Orders: A Study in Los Angeles and New Orleans. Alcohol Alcohol 2023; 58:238-246. [PMID: 36806545 PMCID: PMC10168714 DOI: 10.1093/alcalc/agad008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND To slow the spread of the COVID-19 virus, governments across the globe instituted stay-at-home orders leading to increased stress and social isolation. Not surprisingly, alcohol sales increased during this period. While most studies primarily focused on alcohol consumption among college students or adults, this study investigates alcohol misuse among marginalized youth in the USA. We examined risk factors associated with hazardous alcohol use and binge drinking including risk behaviors, life stressors and demographic characteristics. METHODS In October 2020, youth living with or at high risk for acquiring human immunodeficiency virus (HIV), participating in community-based research to improve HIV prevention and care, were invited to complete an online survey to assess the impact of the stay-at-home orders on multiple aspects of their daily life. RESULTS Respondents (n = 478) were on average 23 years old; cisgender (84%), not-heterosexual (86.6%), Latino or Black/African American (73%) and assigned male at birth (83%); 52% reported being employed and 14% reported living with HIV. White participants and those who use drugs had higher odds of hazardous alcohol use and binge drinking, compared with other race categories and non-drug users, respectively. CONCLUSION Contrary to findings from adult studies, we did not observe an increase in hazardous or binge drinking among youth at risk for HIV. Hazardous alcohol use and binge drinking was more likely among White participants, those who use drugs and those who were hazardous/binge drinkers prior to the COVID-19 lockdown, which points to the importance of identifying and treating youth who misuse alcohol early to prevent future alcohol misuse.
Collapse
Affiliation(s)
- Roxana Rezai
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
| | - Panteha Hayati Rezvan
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA
| | - Warren Scott Comulada
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA
| | - Sung-Jae Lee
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
- UCLA Nathanson Family Resilience Center, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Manuel A Ocasio
- Department of Pediatrics/Adolescent Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Dallas Swendeman
- Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90024, USA
| | | | | |
Collapse
|
7
|
Ghatak S, Guchhait SK. The perspective of homeless space in the railway stations of India: A critical understanding through inter-personal network analysis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1678-e1689. [PMID: 34596299 DOI: 10.1111/hsc.13594] [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: 10/07/2020] [Revised: 08/11/2021] [Accepted: 09/19/2021] [Indexed: 06/13/2023]
Abstract
There is a global recognition that the homeless in different clusters are isolated social groups. They are highly susceptible to loneliness and related psycho-physical health outcomes owing to their less supportive and fragmented social networks. The conditions are worse in the case of chronic or lifetime homelessness. Beyond this popular notion, other critical perspectives are also there. This paper attempts to analyse the differences in inter-personal social networks between the chronic and the non-chronic homeless groups at a railway junction in India. The data have been collected through structured and semi-structured questionnaires from 28 homeless people (15 chronically and 13 non-chronically homeless) of Burdwan Railway Junction - a vital railway junction of West Bengal, India. The chronically homeless group displays more supportive and compact inter-personal networks in this study than the non-chronic homeless group. Living in the station area for a long time, they have formed a society of their own. Barring some psychological stress and social abuse, the livelihood scenario of these people is relatively stress-free and social networks relations are more intensive and supportive. Considering the outcomes, instead of the housing-first approach of rehabilitation, we favour the development of community shelters with minimum basic amenities close to their present location.
Collapse
Affiliation(s)
- Subhajit Ghatak
- Department of Geography, The University of Burdwan, Burdwan, India
| | | |
Collapse
|
8
|
Patterson JG, Macisco JM, Glasser AM, Wermert A, Nemeth JM. Psychosocial factors influencing smoking relapse among youth experiencing homelessness: A qualitative study. PLoS One 2022; 17:e0270665. [PMID: 35881608 PMCID: PMC9321375 DOI: 10.1371/journal.pone.0270665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES In the United States, up to 70% of youth experiencing homelessness smoke cigarettes. Many are interested in quitting; however, little is known about psychosocial factors influencing smoking relapse in this population. This study, part of a larger project to develop an optimized smoking cessation intervention for youth experiencing homelessness, aimed to describe how psychosocial factors influence smoking relapse in this group. METHODS This study describes the smoking relapse experiences of 26 youth tobacco users, aged 14-24 years, who were recruited from a homeless drop-in center in Ohio. We conducted semi-structured interviews to understand how stress, opportunity, and coping contribute to smoking relapse. RESULTS Five themes emerged from the data: (1) smoking as a lapse in emotional self-regulation in response to stress; (2) smoking as active emotional self-regulation in response to stress; (3) social opportunities facilitate smoking in the context of emotion-focused stress coping; (4) problem-focused stress coping; and (5) opportunity facilitates smoking relapse. CONCLUSIONS Stress was a primary driver of smoking relapse among youth experiencing homelessness, yet social and environmental opportunities to smoke also precipitated relapse. Interventions to improve abstinence among this population should target foundational stressors, coping skills, social supports, and nicotine dependence.
Collapse
Affiliation(s)
- Joanne G. Patterson
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, United States of America
| | - Joseph M. Macisco
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, United States of America
| | - Allison M. Glasser
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, United States of America
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, United States of America
| | - Julianna M. Nemeth
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, Ohio, United States of America
| |
Collapse
|
9
|
Tran DD, Davis JP, Atieh T, Pedersen ER, Tucker JS. Mental health correlates of quitting cigarette smoking in youth experiencing homelessness. Addict Behav 2022; 130:107289. [PMID: 35228020 DOI: 10.1016/j.addbeh.2022.107289] [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: 09/13/2021] [Revised: 02/08/2022] [Accepted: 02/18/2022] [Indexed: 11/24/2022]
Abstract
Smoking prevalence among youth experiencing homelessness (YEH) is three times higher than smoking prevalence among the general population. Many YEH who smoke are interested in quitting smoking, but also report smoking to cope with mental health symptoms. Research on factors that facilitate or impede successful smoking cessation among YEH is limited. This study examined mental health correlates (i.e., anxiety and depression symptoms) of quitting-related factors (i.e., quit attempts, perceived barriers to quitting) and whether smoking to cope moderates these relationships among this vulnerable population. The sample consisted of 77 YEH cigarette smokers between the ages of 18-25 who were interested in quitting. Participants completed a survey assessing various behavioral and cognitive factors related to tobacco use. Analyzing two separate models, hierarchical negative binomial and hierarchical linear regression were used to examine hypothesized correlates of the number of past year quit attempts and perceived barriers to quitting. Smoking to cope moderated the relationships of depression with past year quit attempts and perceived barriers to quitting. Those high in depression and smoking to cope had the fewest number of quit attempts and reported the greatest perceived barriers. Anxiety symptoms were not significantly associated with quit attempts or perceived barriers. Smoking cessation interventions that address using smoking to cope with mental health symptoms may be important for YEH with depression.
Collapse
|
10
|
Kennedy DP, Osilla KC, Tucker JS. Feasibility of a computer-assisted social network motivational interviewing intervention to reduce substance use and increase supportive connections among emerging adults transitioning from homelessness to housing. Addict Sci Clin Pract 2022; 17:26. [PMID: 35505383 PMCID: PMC9066760 DOI: 10.1186/s13722-022-00307-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social networks may play positive and negative roles in the lives of young adults experiencing homelessness (YEH) who are transitioning into housing. Social networks can influence their alcohol and/or other drug (AOD) use, as well as provide immediate and long-term support necessary for a successful transition. METHODS We adapted a four-session computer-assisted motivational interviewing social network intervention (MI-SNI) for YEH transitioning into housing. We iteratively adapted and beta tested the intervention for delivery by case managers at an organization that provides supportive housing to YEH. We conducted a focus group with agency staff (n = 6), role-play exercises with case managers (n = 3), and semi-structured interviews with residents (n = 6). Interview data were thematically analyzed with open coding. This study presents the first adaptation of an innovative social network-based motivational intervention to reduce AOD use and increase stable, prosocial supportive connections via visualizations of the structure and composition of the individual's social network. RESULTS Participants rated sessions as "moderately" to "very" helpful and "good" quality on average. Participants agreed that the sessions were helpful, understandable, and satisfying and would work for new residents. Themes emerged in four broad categories: (1) Acceptability, (2) Positive benefits, (3) Visualization reactions, and (4) MI-SNI interface reactions. For the acceptability category, three sub-themes emerged: (1) understandability, (2) enjoyability and ease of use, (3) and barriers to acceptability. Five sub-themes emerged about the intervention's likelihood to trigger positive benefits: (1) learning/new insights, (2) enhancement to motivation to change, (3) making AOD changes, (4) building social support, and (5) the intervention's usefulness to some but not others. Five sub-themes also emerged from comments about the social network visualizations: (1) general positive comments, (2) understandability, (3) new insights, (4) triggering changes in social support, and (5) triggering changes in AOD use. When discussing the MI-SNI intervention interface beyond the visualizations, discussions emerged in three thematic categories: (1) discussion of name listing, (2) discussion of screen wording, and (3) the use of a computer interface to deliver the intervention. CONCLUSIONS Results suggest that the MI-SNI is acceptable to YEH and can be feasibly delivered by case managers during case management sessions. Trial registration ClinicalTrials.gov Identifier: NCT04637815. Registered November 10, 2020.
Collapse
Affiliation(s)
- David P Kennedy
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - Karen Chan Osilla
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Palo Alto, CA, 94305, USA
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| |
Collapse
|
11
|
Glasser AM, Hinton A, Wermert A, Macisco J, Nemeth JM. Characterizing tobacco and marijuana use among youth combustible tobacco users experiencing homelessness - considering product type, brand, flavor, frequency, and higher-risk use patterns and predictors. BMC Public Health 2022; 22:820. [PMID: 35468777 PMCID: PMC9036780 DOI: 10.1186/s12889-022-13244-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cigarette smoking is three times more prevalent among youth experiencing homelessness compared with the general population. Co-use of tobacco and marijuana is also common. The aim of this study is to characterize tobacco and marijuana use among youth experiencing homelessness who use combustible tobacco in a Midwestern city to inform smoking cessation intervention. METHODS This study included 96 youth (ages 14-24 years; 52% male, 39% female, 5% transgender/non-binary) attending a homeless drop-in center who had used at least one combustible tobacco product in the past week. We assessed past-month use of tobacco products and marijuana, other product use characteristics (e.g., frequency, brand and flavor), and psychosocial predictors of more frequent (i.e., daily) use of combustible tobacco and marijuana. RESULTS Most youth experiencing homelessness with past-week combustible tobacco use had used cigarettes (n = 85, 88.5%), cigars (n = 89, 92.7%), and marijuana (n = 82, 85.4%) in the past month. One-third (n = 34) used electronic vapor products (EVPs), 19.8% (n = 19) smoked hookah, and 11.5% (n = 11) used smokeless tobacco (ST). Most marijuana users co-administered with tobacco (n = 67, 69.8%). Daily combustible tobacco smoking was associated with having a child and smoking out of boredom/habit. Daily marijuana use was associated with using substances to cope with one's housing situation. Newport (n = 66, 72.5%) and Black & Mild (n = 48, 51.1%) were the most popular brands of cigarettes and cigars among ever users. Most non-combustible tobacco ever users reported not having a usual brand (EVPs: n = 51, 73.9%; ST: n = 16, 57.1%). Cigar smokers reported the most varied selection of flavors. CONCLUSIONS Young combustible tobacco users experiencing homelessness engage in high-risk use patterns, including poly-tobacco use, co-use of tobacco with marijuana, and frequent combustible product use. Interventions that consider the full context of tobacco and marijuana use are needed to support smoking cessation in this population.
Collapse
Affiliation(s)
- Allison M. Glasser
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Alice Hinton
- Division of Biostatistics, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Joseph Macisco
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| | - Julianna M. Nemeth
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, 1841 Neil Avenue, Columbus, OH 43210 USA
| |
Collapse
|
12
|
Chassman S, Barman-Adhikari A, Hsu HT, Ferguson KM, Narendorf SC, Maria DS, Shelton J, Petering R, Bender K. Prevalence and Correlates of Illicit Substance Use Among Young Adults Experiencing Homelessness in Seven Cities Across the United States. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426211049355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Young adults experiencing homelessness (YAEH) engage in substantially higher substance use rates than housed young adults. This current study builds on previous research by investigating the prevalence of and salient correlates of illicit substance use across a seven-city sample. Methods This study used the Homeless Youth Risk and Resiliency Survey (HYRRS) dataset, n=1426 Young adults experiencing homelessness to study patterns and correlates of illicit substance use. Results Multivariate logistic regression analyses were used to assess correlates of substance use. Study site, age, gender identity, sexual orientation, history of suicidal ideation, use of specific substances, and trading sex for drugs were associated with five types of illicit substance use (ecstasy, cocaine, crack, methamphetamine, and injection drug use). Conclusion Findings indicate that substance use interventions for YAEH must be multifaceted, addressing illicit and multiple substance use, along with the myriad factors associated with substance use among this at-risk group.
Collapse
Affiliation(s)
| | | | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, Columbia, MO, USA
| | | | - Sarah C. Narendorf
- Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Diane Santa Maria
- Department of Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jama Shelton
- Silberman School of Social Work at Hunter College, New York, NY, USA
| | | | - Kimberly Bender
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| |
Collapse
|
13
|
Gauthier GR, Markowski K, Smith JA, Harcy S, Johnston B. Co-use among confidants: An examination of polysubstance use and personal relationships in southeastern Nebraska. Addict Behav 2022; 124:107116. [PMID: 34562776 PMCID: PMC8542383 DOI: 10.1016/j.addbeh.2021.107116] [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: 03/26/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023]
Abstract
This study examines the relationship between personal networks and polysubstance use among people who use drugs (PWUD) in a medium sized city in the Midwest. A large body of work has demonstrated that personal relationships have an ambivalent association with substance use. On the one hand, a supportive network is associated with safer drug use practices and dramatically improves the outlook for recovery. However, individuals whose personal networks are composed of co-drug use partners are more likely to engage in risky practices. We argue that this notion of "supportive" social contacts and "risky" social contacts is ultimately incomplete: risky behaviors are introduced and further developed in a social context, often with the people who provide emotional support. We argue that personal networks with more multiplex relationships (where co-drug use and confiding fuse) are harmful because they combine norms of trust and reciprocity with drug use. We use data from the Rural Health Cohort (RHC) study to test this idea. The sample consists of 120 adult PWUD in a medium sized city located in southeastern Nebraska who were recruited using respondent-driven sampling. Participants listed up to nine confidants and nine co-drug use partners, indicating any overlap between the two networks. Our results demonstrate that multiplex ties are as strongly associated with polysubstance use as simple co-drug use relationships. As the drug crisis has increasingly shifted to underserved populations outside large urban centers, this paper represents an important advance in our understanding of the current drug crisis.
Collapse
Affiliation(s)
- G. Robin Gauthier
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA,Please address correspondence to Robin Gauthier, Research, Department of Sociology, 719 Oldfather Hall, University of Nebraska-Lincoln NE 68588-0623.
| | - Kelly Markowski
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
| | - Jeffrey A. Smith
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
| | - Sela Harcy
- Department of Sociology, University of Nebraska-Lincoln, Nebraska, USA,Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
| | - Bergen Johnston
- Rural Addiction Research Center, University of Nebraska-Lincoln, Nebraska, USA
| |
Collapse
|
14
|
Lightfoot M, Milburn N, Loeb Stanga L. Addressing Health Disparities in HIV: Introduction to the Special Issue. J Acquir Immune Defic Syndr 2021; 88:S1-S5. [PMID: 34757986 PMCID: PMC8579984 DOI: 10.1097/qai.0000000000002804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Racial and ethnic minority, sexual and gender minority, and low-income people have historically experienced poorer health outcomes and poorer social conditions that lead to poorer health outcomes (social determinants of health) than nonminority people in the United States. To eliminate these health disparities, intentional and targeted interventions that address the needs and preferences of diverse populations are needed. To address disparities, the California HIV/AIDS Research Program focused their funding resources tightly on communities facing elevated HIV incidence or prevalence. This special issue describes interventions that aimed to increase linkage to and engagement in HIV-specific prevention or medical care, each uniquely tailored to the needs of an identified California population with disparate HIV-related health outcomes and each for implementation at a specific stage of the HIV prevention and care continuum.
Collapse
Affiliation(s)
- Marguerita Lightfoot
- UCSF Center for AIDS Research, Center for AIDS Prevention Studies, UCSF Prevention Research Center, University of California, San Francisco, CA
| | - Norweeta Milburn
- UCLA Center for AIDS Research, Center for HIV, Identification, Prevention, and Treatment Services, University of California, Los Angeles, CA; and
| | - Lisa Loeb Stanga
- California HIV/AIDS Research Program, University of California, Office of the President, Oakland, CA
| |
Collapse
|
15
|
Patterson JG, Glasser AM, Macisco JM, Hinton A, Wermert A, Nemeth JM. "I smoked that cigarette, and it calmed me down": A qualitative analysis of intrapersonal, social, and environmental factors influencing decisions to smoke among youth experiencing homelessness. Nicotine Tob Res 2021; 24:250-256. [PMID: 34605550 DOI: 10.1093/ntr/ntab196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 09/27/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Approximately 70% of youth experiencing homelessness smoke cigarettes; many try to quit and are interested in formal smoking cessation programs. The purpose of this study was to describe the intrapersonal, social, and environmental contexts associated with the most recent smoking experience among youth experiencing homelessness and (2) identify differences in contextual factors by age and willingness to quit. METHODS Thirty-six youth experiencing homelessness aged 14-24 years and who reported current smoking were recruited from a drop-in center in a Midwestern city. Semi-structured in-person interviews were analyzed to understand smoking behaviors. RESULTS Two-thirds of participants reported stress and nicotine dependence as primary reasons for smoking, and older youth (aged 18-24 years) reported smoking to de-escalate negative emotions associated with stressful events. For 25% of participants, and especially older youth, smoking was described as part of a routine. Over 80% of participants smoked outside at the homeless drop-in center or the places they lived. Social prompts from drop-in center peers regularly preempted smoking. Younger youth (aged 14-17 years) reported smoking socially while older youth were more likely to smoke alone. CONCLUSIONS For youth experiencing homelessness, smoking is integrated into daily life and is often used to manage stress associated with homelessness and engage socially with homeless peers. Multicomponent interventions to reduce structural stressors specific to homelessness, change social smoking norms (environmental and social context), and address stress management and nicotine dependence (intrapersonal context) are needed to support smoking cessation among youth experiencing homelessness. IMPLICATIONS Youth experiencing homelessness overwhelmingly described how daily stressors associated with homelessness and nicotine dependence preceded recent smoking. Older youth (aged 18-24 years) also reported smoking as "routine", which likely underscores nicotine dependence in this group. Younger youth (aged 14-17 years) described social smoking. Researchers must develop optimized multilevel interventions to support youth experiencing homelessness who want to quit smoking. Interventions directly targeting social determinants of stress (e.g., poverty, housing instability, food insecurity) and linkages to supportive services are needed. Complementary strategies to address stress coping and nicotine dependence (intrapersonal context) and social smoking norms (social and environmental context) are also necessitated.
Collapse
Affiliation(s)
- Joanne G Patterson
- Division of Epidemiology, Ohio State University College of Public Health, Columbus, OH, USA
- Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Allison M Glasser
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, Columbus, OH, USA
| | - Joseph M Macisco
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, Columbus, OH, USA
| | - Alice Hinton
- Division of Biostatistics, Ohio State University College of Public Health, Columbus, OH, USA
| | - Amy Wermert
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, Columbus, OH, USA
| | - Julianna M Nemeth
- Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
- Division of Health Behavior and Health Promotion, Ohio State University College of Public Health, Columbus, OH, USA
| |
Collapse
|
16
|
Johnson ME, Lloyd SL, Bristol SC, Rosel G, Otufowora AA, Epps NN. Runaway History and Past 30-Day Opioid Misuse in Justice-Involved Adolescents. JUVENILE & FAMILY COURT JOURNAL 2021; 72:21-35. [PMID: 34955571 PMCID: PMC8699162 DOI: 10.1111/jfcj.12206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study used a sample from the Florida Department of Juvenile Justice (n= 79,960) to analyze the association between runaway history and past 30-day opioid misuse (OM) among justice involved adolescents. Past 30-day OM was confirmed using a urine analysis. Adolescents who were runaways in their lifetime were twice as likely to misuse opioids, and those who were runaways at the time of arrest were three times as likely to be opioid misusers compared to adolescents who never ran away or been kicked out of a home. These findings emphasize a need for resources that focus on developing strong attachment bonds.
Collapse
Affiliation(s)
- Micah E Johnson
- Department of Mental Health Law and Policy in the College of Behavioral and Community Sciences at the University of South Florida
| | | | - Skye C Bristol
- College of Behavioral and Community Sciences at the University of South Florida
| | | | | | | |
Collapse
|
17
|
Pedersen ER, Linnemayr S, Shadel WG, Zutshi R, DeYoreo M, Cabreros I, Tucker JS. Substance Use and Mental Health Outcomes from a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness. Nicotine Tob Res 2021; 24:130-134. [PMID: 34375409 DOI: 10.1093/ntr/ntab160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/09/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Cigarette smoking and associated high-risk behaviors are prevalent among youth experiencing homelessness (YEH), making appropriately tailored interventions targeting smoking behavior important for this group. We pilot tested a brief text-messaging intervention (TMI) as an adjunct to standard care for YEH who smoke and found promising preliminary effects of the intervention on smoking cessation. The purpose of the present study was to test the TMI's effect on the secondary outcomes of other substance use (including use of other tobacco/nicotine devices) and mental health symptoms. METHODS A total of 77 participants completed the pilot randomized controlled trial, with 40 receiving the TMI (174 automated text messages plus a group smoking counseling session and provision of nicotine patches). They completed an assessment at baseline and another three months later that evaluated use of other tobacco/nicotine devices, alcohol, marijuana, and anxiety and depression symptoms. RESULTS We found that the TMI helped to reduce secondary substance use behaviors and mental health symptoms among the participants; mainly there were medium effects of the intervention on changes in other tobacco/nicotine use, drinking, and anxiety and depression symptoms. The intervention did not have an effect on number of marijuana use days in the past month; however, past 30-day marijuana users who received the intervention benefited by reducing the number of times they used marijuana per day. CONCLUSIONS In addition to helping reduce cigarette smoking, we found that a TMI for YEH was helpful in improving secondary outcomes, suggesting the promise of the TMI on benefiting YEH even beyond targeted smoking behavior. IMPLICATIONS This pilot study demonstrates that by targeting cigarette smoking using a text message-based intervention among youth experiencing homelessness, effects may be seen in other areas of functioning such as other substance use and mental health.
Collapse
Affiliation(s)
- Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, Los Angeles, CA
| | | | | | | | | | | | | |
Collapse
|
18
|
Tucker JS, Linnemayr S, Pedersen ER, Shadel WG, Zutshi R, DeYoreo M, Cabreros I. Pilot Randomized Clinical Trial of a Text Messaging-Based Intervention for Smoking Cessation Among Young People Experiencing Homelessness. Nicotine Tob Res 2021; 23:1691-1698. [PMID: 33852730 DOI: 10.1093/ntr/ntab055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/13/2021] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Smoking rates are alarmingly high among young people experiencing homelessness (YEH), yet there are no evidence-based cessation programs for this population. This paper presents results from a pilot evaluation of a text messaging-based smoking cessation treatment, as an adjunct to brief group cessation counseling, to improve abstinence rates among 18-25 year old smokers experiencing homelessness. The goal of this study was to estimate effect sizes for a larger trial and it was not powered to detect group differences. METHODS YEH smokers who had a working cell phone with them at recruitment were randomized to receive a group counseling session, nicotine patches, and written material on quitting (n=37) or a similar program that also included a 6-week automated text messaging intervention (TMI) to provide ongoing support for quitting (n=40). Smoking outcomes were evaluated through a 90-day follow-up. RESULTS 7-day point prevalence abstinence at 90-day follow-up was higher in the TMI condition than standard condition (17.50% vs. 8.11%, respectively; Cohen's h=.37); however, the 90-day continuous abstinence rate was not statistically different from zero in either condition. Reductions in the number of days smoked in the past 30 days from baseline to follow-up were greater in the TMI condition than the standard condition (-14.24 vs. -8.62, respectively; Cohen's d=.49). CONCLUSIONS Adding a 6-week TMI support to a brief group counseling and pharmacotherapy protocol holds promise for smoking reduction and abstinence among YEH smokers. Results indicate that further development and evaluation of the TMI in this population is warranted. IMPLICATIONS This is the first study to evaluate the feasibility of using a text messaging-based intervention (TMI) for behavior change with 18-25 year olds experiencing homelessness, and more specifically, the first to test a TMI to provide ongoing support for smoking cessation. Small to medium effect sizes for the TMI are promising in terms of implementing a TMI using participants' own cell phones, as well as the efficacy of this approach as an adjunct to standard care (brief group counseling and pharmacotherapy) for smoking cessation among young people experiencing homelessness.
Collapse
Affiliation(s)
| | | | - Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | | | | |
Collapse
|
19
|
Linnemayr S, Zutshi R, Shadel W, Pedersen E, DeYoreo M, Tucker J. Text Messaging Intervention for Young Smokers Experiencing Homelessness: Lessons Learned From a Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e23989. [PMID: 33792551 PMCID: PMC8050749 DOI: 10.2196/23989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/04/2021] [Accepted: 02/23/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Smoking rates are significantly higher among young people experiencing homelessness than in the general population. Despite a willingness to quit, homeless youth have little success in doing so on their own, and existing cessation resources tailored to this population are lacking. Homeless youth generally enjoy the camaraderie and peer support that group-based programs offer, but continuous in-person support during a quit attempt can be prohibitively expensive. OBJECTIVE This study aimed to assess the feasibility and acceptability of an automated text messaging intervention (TMI) as an adjunct to group-based cessation counseling and provision of nicotine patches to help homeless youth quit smoking. This paper outlines the lessons learned from the implementation of the TMI intervention. METHODS Homeless youth smokers aged 18 to 25 years who were interested in quitting (n=77) were recruited from drop-in centers serving homeless youth in the Los Angeles area. In this pilot randomized controlled trial, all participants received a group-based cessation counseling session and nicotine patches, with 52% (40/77) randomly assigned to receive 6 weeks of text messages to provide additional support for their quit attempt. Participants received text messages on their own phone rather than receiving a study-issued phone for the TMI. We analyzed baseline and follow-up survey data as well as back-end data from the messaging platform to gauge the acceptability and feasibility of the TMI among the 40 participants who received it. RESULTS Participants had widespread (smart)phone ownership-16.4% (36/219) were ineligible for study participation because they did not have a phone that could receive text messages. Participants experienced interruptions in their phone use (eg, 44% [16/36] changed phone numbers during the follow-up period) but reported being able to receive the majority of messages. These survey results were corroborated by back-end data (from the program used to administer the TMI) showing a message delivery rate of about 95%. Participant feedback points to the importance of carefully crafting text messages, which led to high (typically above 70%) approval of most text messaging components of the intervention. Qualitative feedback indicated that participants enjoyed the group counseling session that preceded the TMI and suggested including more such group elements into the intervention. CONCLUSIONS The TMI was well accepted and feasible to support smoking cessation among homeless youth. Given high rates of smartphone ownership, the next generation of phone-based smoking cessation interventions for this population should consider using approaches beyond text messages and focus on finding ways to develop effective approaches to include group interaction using remote implementation. Given overall resource constraints and in particular the exigencies of the currently ongoing COVID-19 epidemic, phone-based interventions are a promising approach to support homeless youth, a population urgently in need of effective smoking cessation interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT03874585; https://clinicaltrials.gov/ct2/show/NCT03874585. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13722-020-00187-6.
Collapse
Affiliation(s)
| | | | | | - Eric Pedersen
- University of Southern California, Los Angeles, CA, United States
| | | | - Joan Tucker
- RAND Corporation, Santa Monica, CA, United States
| |
Collapse
|
20
|
Tucker JS, Kennedy DP, Osilla KC, Golinelli D. Motivational network intervention to reduce substance use and increase supportive connections among formerly homeless emerging adults transitioning to housing: study protocol for a pilot randomized controlled trial. Addict Sci Clin Pract 2021; 16:18. [PMID: 33726809 PMCID: PMC7968154 DOI: 10.1186/s13722-021-00227-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies indicate high rates of substance use among youth experiencing homelessness (YEH). Further, the social networks of YEH, although multi-dimensional in composition, are largely comprised of other YEH, substance users, and individuals who do not provide the youth with tangible or emotional support. For YEH who have the opportunity to enter a housing program, helping them to reduce their substance use and strengthen their prosocial supportive connections during this critical transition period may increase their stability and reduce their risk of re-entering homelessness. The goal of this study is to pilot test a brief motivational network intervention (MNI), delivered by case managers, to help former YEH who have recently transitioned to a housing program reduce their substance use and strengthen their prosocial supportive connections. METHODS/DESIGN Up to 60 residents of housing programs in the Los Angeles area will be randomized to receive four sessions of usual case manager support or four sessions of case manager support + MNI. Each MNI session consists of three parts: (1) identifying two goals that are most important for the resident over the next year (e.g., get or keep a job, finish or stay in school, reduce substance use); (2) a network interview with the resident to capture network data pertaining to their interactions in the past 2 weeks; and (3) a discussion between the case manager and the resident of the resulting network visualizations, conducted in a Motivational Interviewing (MI) style, and what role the resident's network may play in reaching their most important goals over the next year. DISCUSSION This study addresses a critical gap by pilot testing a computer-assisted MNI, delivered using MI techniques, that can help case managers work with recent YEH to reduce substance use and increase permanent supportive connections during the critical transitional period from homelessness to housing. Trial registration ClinicalTrials.gov Identifier: NCT04637815. Registered November 10, 2020.
Collapse
Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
| | - David P Kennedy
- RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA
| | | | | |
Collapse
|
21
|
Rhoades H, Hsu HT, Rice E, Harris T, LaMotte-Kerr W, Winetrobe H, Henwood B, Wenzel S. Social Network Change after Moving into Permanent Supportive Housing: Who Stays and Who Goes? NETWORK SCIENCE (CAMBRIDGE UNIVERSITY PRESS) 2021; 9:18-34. [PMID: 34026210 PMCID: PMC8135224 DOI: 10.1017/nws.2020.19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Social relationships are important among persons experiencing homelessness, but there is little research on changes in social networks among persons moving into permanent supportive housing (PSH). Using data collected as part of a longitudinal study of 405 adults (aged 39+) moving into PSH, this study describes network upheaval during this critical time of transition. Interviews conducted prior to and after three months of living in PSH assessed individual-level characteristics (demographics, homelessness history, health and mental health) and included a social network component that assessed network size and composition (demographics, relationship type, social support); interviewers utilized network member characteristics to assess whether network members were new or sustained between baseline and 3 months post-housing. Multilevel logistic regression models assessed what characteristics of network members were associated with being newly-gained or persisting in networks 3 months after moving into PSH. We found that only one-third of social networks were retained during the transition to PSH, and that veterans, African Americans and other persons of racial/ethnic minorities, and those living in scattered-site housing were more likely to experience network disruption. Relatives, romantic partners, and service providers were most likely to be retained after move-in. Some network change was moderated by tie strength, including the retention of street-met persons. Implications are discussed.
Collapse
Affiliation(s)
- Harmony Rhoades
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089
| | - Hsun-Ta Hsu
- University of Missouri, School of Social Work, 709 Clark Hall, Columbia, MO 65211
| | - Eric Rice
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089
| | - Taylor Harris
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089
| | - Wichada LaMotte-Kerr
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089
| | - Hailey Winetrobe
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089
| | - Benjamin Henwood
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089
| | - Suzanne Wenzel
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Montgomery Ross Fisher Building, Los Angeles, CA 90089
| |
Collapse
|
22
|
Zhang S, Wu S, Wu Q, Durkin DW, Marsiglia FF. Adolescent drug use initiation and transition into other drugs: A retrospective longitudinal examination across race/ethnicity. Addict Behav 2021; 113:106679. [PMID: 33032193 DOI: 10.1016/j.addbeh.2020.106679] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Understanding adolescent drug use mechanisms is critical for drug use prevention. Although some theories such as the gateway theory suggest that drug users gradually transition into using more addictive drugs, there is no consensus about such a hypothesis. One important factor that hinders the advancement of knowledge in this area is the scarcity of longitudinal studies examining the type of drugs adolescents initially use and the different pathways adolescents take to transition into using other drugs as they grow older. METHODS Using the pooled sample of adolescent dug users (14-17 years old; n = 10,644) from the National Survey on Drug Use and Health (2015-2018), we constructed longitudinal data on adolescents' illicit drug use history other than the use of tobacco and alcohol based on the age of drug initiation. This allowed us to investigate what drugs were initially used by adolescents, how the use of these drugs may have progressed into a new drug, and whether there were racial/ethnic differences in the initiation and progression. The retrospective longitudinal data analyses applied life table method and Cox regression models. RESULTS Two thirds of the adolescent drug users initiated their drug use trajectories with marijuana, one quarter with inhalants, and the remaining with hallucinogens, prescription drugs, and hard drugs. Adolescent drug users who initiated with different drugs showed unique trajectories to the use of a new drug. By year 8, the probability of using a new drug was about 40% and 70% to 80% for adolescents who initiated with inhalants and other drugs, respectively. The probability of using a new drug for adolescents who initiated with marijuana and inhalants accumulated stably over time, and its difference with that of other drug users diminished over time. The multivariate Cox regression models suggest the observed discrepancies generally held after controlling for covariates. There were also racial/ethnic differences in adolescent drug use initiation and progression, with Black/African American adolescents being the least likely to switch to the use of a new drug. CONCLUSION Adolescents' initial use of marijuana and inhalants may lead to substantial risks of using other drugs over time. It is therefore important to screen adolescent drug use comprehensively and provide early interventions to prevent an escalation to more detrimental drugs. The findings provide new evidence to support aspects of both the gateway and generalized risk drug use theories.
Collapse
|
23
|
Siconolfi D, Tucker JS, Shadel WG, Seelam R, Golinelli D. Health, Homelessness Severity, and Substance Use among Sexual Minority Youth Experiencing Homelessness: A Comparison of Bisexual Versus Gay and Lesbian Youth. JOURNAL OF SEX RESEARCH 2020; 57:933-942. [PMID: 31809204 PMCID: PMC7274857 DOI: 10.1080/00224499.2019.1695723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Lesbian, gay, bisexual, and questioning (LGBQ) youth are overrepresented among youth experiencing homelessness (YEH), and health disparities among LGBQ youth are well-documented. LGBQ youth are typically aggregated as a single sexual minority group; however, research suggests that bisexual youth may have greater mental health, substance use, and physical health risks relative to their gay and lesbian peers. In a probability sample of LGBQ YEH in Los Angeles County (n = 183), we examined subgroup differences in homelessness severity, depression, physical health, and substance use, focusing on differences between bisexual and gay/lesbian youth due to the small subsample of questioning youth. Indicators of homelessness severity were standalone outcomes, and also were integrated as control variables with gender, age, race/ethnicity, and education in multivariable models. Bisexual youth were more likely to have become unaccompanied homeless persons as minors (OR = 4.35, 95% CI 1.85-10.23), and to have not recently utilized emergency shelters or transitional housing at least once in the past month (OR = 6.41; 95% CI 2.41-17.03). Bisexual youth were more likely to have probable depression (OR = 4.06, 95% CI 1.41-11.68). Among sexual minority YEH, bisexual youth may be at elevated risk for depression, in addition to more severe homelessness.
Collapse
Affiliation(s)
| | - Joan S Tucker
- RAND Social and Economic Well-Being, RAND Corporation
| | | | | | | |
Collapse
|
24
|
Tucker JS, D'Amico EJ, Pedersen ER, Rodriguez A, Garvey R. Study protocol for a group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among young adults experiencing homelessness. Addict Sci Clin Pract 2020; 15:26. [PMID: 32723349 PMCID: PMC7390162 DOI: 10.1186/s13722-020-00201-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/17/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Young people experiencing homelessness have alarmingly high rates of alcohol and other drug (AOD) use, which is associated with sexual risk behaviors such as unprotected sex, trading sex, and sex with multiple casual partners. Few risk reduction programs for this population have been developed and rigorously evaluated, particularly those that address both of these interrelated behaviors, use a collaborative and non-judgmental approach, and are feasible to deliver in settings where homeless young people seek services. This paper describes the protocol of a study evaluating a four-session Motivational Interviewing (MI)-based group risk reduction intervention for this population. The protocol has been shown to be efficacious in pilot work over 3 months with 200 homeless young adults [1]. The current study seeks to refine the intervention protocol and evaluate the program on a larger scale. METHODS/DESIGN In a cluster-cross-over randomized controlled trial, 18-25 year olds will receive the AWARE risk reduction program (n = 200) or standard care (n = 200) at one of three drop-in centers serving homeless youth in the Los Angeles area. We will evaluate intervention effects on primary outcomes of AOD use and sexual risk behavior, as well as secondary outcomes of health-related quality of life and social stability, over a 12-month period. DISCUSSION This project has the potential to fill a significant gap in prevention services by demonstrating that a brief intervention, feasible to deliver within settings where young people experiencing homelessness typically seeks services, can significantly reduce the interrelated problems of AOD use and sexual risk behavior. Trial registration ClinicalTrials.gov Identifier: NCT03735784. Registered November 18, 2018, https://clinicaltrials.gov/ct2/show/record/NCT03735784 (retrospectively registered).
Collapse
Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States.
| | - Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States
| | - Eric R Pedersen
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States.,Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, 250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, United States
| | - Anthony Rodriguez
- RAND Corporation, 20 Park Plaza, Suite 920, Boston, MA, 02116, United States
| | - Rick Garvey
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, United States
| |
Collapse
|
25
|
Tyler KA, Olson K. A comparison of frequency of alcohol and marijuana use using short message service surveying and survey questionnaires among homeless youth. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2020; 46:401-407. [PMID: 31794285 DOI: 10.1080/00952990.2019.1680682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/28/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND There are several benefits to using short message service surveying (SMS) to gather data on substance use from homeless youth, including capturing data "in the moment" and verifying the timing of one behavior relative to another. Though SMS is a valuable data collection tool with highly mobile populations that otherwise are difficult to longitudinally sample, the reliability of SMS compared with surveys is largely unknown with homeless youth. Examining the reliability of SMS is important because these data can provide a more nuanced understanding of the relationships between various risk behaviors, which may lead to better intervention strategies with these youth. OBJECTIVES We compared past 30-day survey and SMS data for youth's alcohol and marijuana use. METHODS Interviewed 150 homeless youth (51% female) using surveys and SMS. RESULTS Past 30-day survey and SMS data revealed moderately strong correlations for alcohol (rs = .563) and marijuana (rs = .564). Regression analysis revealed that independent variables were similarly associated with alcohol and marijuana use when comparing survey and SMS data with two exceptions: heterosexual youth reported less alcohol use in SMS data compared to survey data (β = -.212; p < .05 vs. β = -.006; p > .05, respectively) and youth whose parents had alcohol problems reported less marijuana use in survey data compared to SMS data (β = -.277; p < .01 vs. β = -.150; p > .05, respectively). CONCLUSION Findings indicate SMS and surveys are both reliable methods of gathering data from homeless youth on substance use.
Collapse
Affiliation(s)
- Kimberly A Tyler
- Department of Sociology, University of Nebraska-Lincoln , Lincoln, NE, USA
| | - Kristen Olson
- Department of Sociology, University of Nebraska-Lincoln , Lincoln, NE, USA
| |
Collapse
|
26
|
Tyler KA, Olson K, Ray CM. Short Message Service Surveying With Homeless Youth: Findings From a 30-Day Study of Sleeping Arrangements and Well-Being. YOUTH & SOCIETY 2020; 52:850-866. [PMID: 32863452 PMCID: PMC7450936 DOI: 10.1177/0044118x19832167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Little is known about the location and consistency of sleeping arrangements among youth experiencing homelessness (YEH) and how this is linked to their well-being. This study addresses this gap using ecological momentary assessment (EMA) via short message service (SMS) surveying with 150 YEH over 30 days, to examine how various sleeping arrangements are associated with depression, marijuana use, support received, and service utilization. Results revealed that the average number of consecutive days youth stayed at any particular location varied considerably. Youth who stayed more frequently with a friend/partner or in a transitional living facility (TLF) reported fewer days of being depressed, whereas staying with a friend/ partner was associated with using marijuana more frequently. Finally, youth staying with a friend/partner, stranger, or TLF reported using services on fewer days. Because sleeping arrangements change almost daily, on average, this has important public health implications for agencies finding permanent housing for YEH.
Collapse
|
27
|
Moon SH, Kim HR, Kim M. Predictors for Sexual Intercourse Experience among Runaway Female At-Risk Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113913. [PMID: 32492833 PMCID: PMC7311989 DOI: 10.3390/ijerph17113913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 11/16/2022]
Abstract
This study attempted to provide basic data for creating a program to help promote safe sexual behavior among runaway female at-risk adolescents by identifying factors related to the sexual experiences. This study conducted a logistic regression analysis using data regarding 182 female at-risk adolescents, which were sourced from the 2016 survey of Korean adolescents’ contact with media usage and harmful environment. This study showed that adolescents’ age, smoking, and harmful environments are associated with the occurrence of sexual activity among at-risk female adolescents. One significant outcome of this study was the identification of harmful environmental factors and their impact on sexual behavior. Since smoking and sex-related problems among adolescents can act as risk factors for adult sexual health in the future, schools should institute direct and indirect channels for assessing sex-related problems among runaway female at-risk adolescents and establishing proactive and preventive measures for promoting their sexual health. In addition, a social cooperation system should be established in order to assess, and mediate within, the environments around schools in order to minimize adolescents’ exposure to harmful environments.
Collapse
Affiliation(s)
- So-Hyun Moon
- Department of Nursing, College of Medicine, Chosun University, Gwangju 61452, Korea;
| | - Hyung-Ran Kim
- Department of Pediatrics, Kwangju Christian Hospital, Gwangju 61661, Korea;
| | - Miok Kim
- Department of Nursing, College of Nursing, Dankook University, Cheonan 31116, Korea
- Correspondence: ; Tel.: +82-41-550-3888
| |
Collapse
|
28
|
Smoking cessation methods among homeless youth in a Midwestern city. Addict Behav Rep 2020; 11:100276. [PMID: 32426448 PMCID: PMC7225613 DOI: 10.1016/j.abrep.2020.100276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 11/23/2022] Open
Abstract
More than two-third of homeless youth in this study were willing to quit smoking. Evidence-based treatments were being underutilized by homeless youth in this study. Nicotine replacement therapy was mostly perceived negatively, likely due to misuse. Drop-in centers may be an effective location from which to offer cessation services.
Introduction Nearly three times as many homeless youth smoke cigarettes in the United States (US) compared to the general population of youth. Few studies have focused on how to help homeless youth quit smoking. As part of a series of studies to develop a smoking cessation intervention for homeless youth, this study aimed to describe methods used in past quit attempts by homeless youth. Methods Recruited from a drop-in center in the Midwestern US, the analytic sample was comprised of 32 unaccompanied homeless youth aged 14–24 who smoked combustible tobacco at some point in the past week. In-person qualitative interviews were conducted to understand prior quit attempt experiences of homeless youth. Results Twenty-two youth (69%) were willing to quit smoking in the next 30 days. Most previous quit attempts were unassisted (78%). Participants frequently reported engaging in distracting behaviors (e.g., video games) or thoughts (e.g., remaining positive). Nicotine replacement therapy (NRT) was another popular method (38%), but with mostly negative reactions. While less common, vaping and use of cannabis to substitute cigarettes was reported in a notable faction of youth (28%), primarily 18–24 years of age. Conclusions Youth are primarily engaging in non-evidence-based strategies to quit smoking. Existing evidence-based treatments are often underutilized or not used according to instructions, and youth who do use evidence-based treatments do not find them useful. Future research should explore effective cessation treatment among homeless youth that can ideally be provided at shelters and drop-in centers. Implications Existing evidence-based treatments are underutilized by homeless youth in this study. Most homeless youth are willing to quit in the next month and are interested in trying behavioral counseling and monitored use of NRT. Drop-in centers may be an effective location from which to develop and offer targeted smoking cessation interventions for homeless youth.
Collapse
|
29
|
Tucker JS, Shadel WG, Golinelli D, Seelam R, Siconolfi D. Motivation to quit cigarettes and alternative tobacco products: prevalence and correlates among youth experiencing homelessness. J Behav Med 2020; 43:318-328. [PMID: 31396821 PMCID: PMC7971096 DOI: 10.1007/s10865-019-00092-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/04/2019] [Indexed: 10/26/2022]
Abstract
Use of alternative tobacco products, as well as regular cigarettes, is widespread among unaccompanied youth experiencing homelessness. However, little is known about their level of motivation for quitting use of these products, factors associated with motivation to quit, or how these might vary by type of tobacco product. Unaccompanied homeless youth were sampled from 25 street and service sites in Los Angeles County (N = 469). All participants were past month tobacco users who completed a survey on their tobacco-related behaviors and cognitions, including motivation to quit, as well as background characteristics. Among self-reported users of each product, motivation to quit in the next 30 days was highest for regular cigarettes (33%), followed by e-cigarettes/vaporizers (30%), little cigars/cigarillos (25%), cigars (20%), and natural cigarettes (20%). Between 33 and 49% of youth, depending on product, were not thinking about quitting at all. Correlates of lower motivation to quit differed somewhat by product type, with the most consistent being race, more frequent use, lower perceived riskiness of the product, and using the product because of its good taste or smell. Results from this study identify a set of psychosocial and behavioral factors, some that are common across tobacco products and others that are product-specific, that may be particularly important to address in efforts to reduce tobacco use among youth experiencing homelessness. Future regulations on the sale of flavored tobacco products may also serve to increase motivation to quit in this population.
Collapse
Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - William G Shadel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA
| | - Daniela Golinelli
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Daniel Siconolfi
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA
| |
Collapse
|
30
|
Brown SM, Barman-Adhikari A, Combs KM, Rice E. Sociodemographic and substance use characteristics associated with typologies and composition of social support networks among youth experiencing homelessness in Los Angeles, USA. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:533-543. [PMID: 31667942 DOI: 10.1111/hsc.12886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/23/2019] [Accepted: 10/14/2019] [Indexed: 05/28/2023]
Abstract
Youth experiencing homelessness are a vulnerable population with increased behavioural health risks. Social networks are a consistent correlate of youths' substance use behaviours. However, less is known about the reciprocal relationships among these constructs. This study classified youth experiencing homelessness according to their social support network type (e.g. instrumental, emotional, service) and composition (e.g. family, peers, service staff) and linked their membership in these social network classes to sociodemographic and substance use characteristics. Four waves of cross-sectional data were collected between October 2011 and June 2013 from youth experiencing homelessness, ages 14-29, at three drop-in centres in Los Angeles, CA (N = 1,046). This study employed latent class analysis to identify subgroups of youth experiencing homelessness according to the type and composition of their social support networks. Multinomial logistic regression analyses were then conducted to identify the sociodemographic and substance use characteristics associated with social support network class membership. Five latent classes of youths' social support networks were identified: (a) high staff emotional and service support; (b) high home-based peer and family emotional, service and instrumental support; (c) moderate street- and home-based peer emotional support; (d) low or no support and (e) high home-based peer and family emotional and instrumental support. Multinomial logistic regression models indicated that race/ethnicity, gender, sexual orientation, literal homelessness, former foster care experience, depression, heroin and marijuana use were significant correlates of social support network class membership. Results indicate distinct classes of social support networks among youth experiencing homelessness, with certain sociodemographic and substance use characteristics implicated in youths' social networks.
Collapse
Affiliation(s)
- Samantha M Brown
- School of Social Work, Colorado State University, Fort Collins, CO, USA
| | | | - Katie Massey Combs
- Institute of Behavioral Science, University of Colorado at Boulder, Boulder, CO, USA
| | - Eric Rice
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
31
|
Tucker JS, Pedersen ER, Linnemayr S, Shadel WG, DeYoreo M, Zutshi R. A text message intervention for quitting cigarette smoking among young adults experiencing homelessness: study protocol for a pilot randomized controlled trial. Addict Sci Clin Pract 2020; 15:11. [PMID: 32075695 PMCID: PMC7031942 DOI: 10.1186/s13722-020-00187-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/09/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cigarette smoking is much more prevalent among young people experiencing homelessness than in the general population of adolescents and young adults. Although many young homeless smokers are motivated to quit, there are no empirically-evaluated smoking cessation programs for this population. It is important that any such program address the factors known to be associated with quitting-related outcomes among homeless young people, to provide ongoing support in a way that accommodates the mobility of this population, and does not rely on scarce service provider resources for its delivery. The objective of this project is to develop and pilot test a text messaging-based intervention (TMI), as an adjunct to brief cessation counseling and provision of nicotine patches, to help homeless young people who want to quit smoking. METHODS/DESIGN This pilot study will utilize a cluster cross-over randomized controlled design with up to 80 current smokers who desire to quit and are recruited from three drop-in centers serving young people experiencing homelessness in the Los Angeles area. All participants will be provided with a minimum standard of care: a 30-min group-based smoking cessation counseling session and free nicotine replacement. Half of these smokers will then also receive the TMI, as an adjunct to this standard care, which will provide 6 weeks of ongoing support for quitting. This support includes continued and more intensive education regarding nicotine dependence, quitting smoking, and relapse; does not require additional agency resources; can be available "on demand" to users; and includes features to personalize the quitting experience. This study will investigate whether receiving the TMI adjunct to standard smoking cessation care results in greater reductions in cigarette smoking compared to standard care alone over a 3-month period. DISCUSSION This study has the potential to address an important gap in the clinical research literature on cigarette smoking cessation and provide empirical support for using a TMI to provide ongoing assistance and support for quitting among young smokers experiencing homelessness. Trial registration ClinicalTrials.gov Identifier NCT03874585. Registered March 14, 2019, https://clinicaltrials.gov/ct2/show/record/NCT03874585.
Collapse
Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - Eric R Pedersen
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Sebastian Linnemayr
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - William G Shadel
- RAND Corporation, 4570 Fifth Ave, Ste. #600, Pittsburgh, PA, 15213, USA
| | - Maria DeYoreo
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Rushil Zutshi
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| |
Collapse
|
32
|
Tucker JS, Shadel WG, Seelam R, Golinelli D, Siconolfi D. Co-use of tobacco and marijuana among young people experiencing homelessness in Los Angeles County. Drug Alcohol Depend 2020; 207:107809. [PMID: 31846847 PMCID: PMC7075024 DOI: 10.1016/j.drugalcdep.2019.107809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Tobacco and marijuana co-use among young people in the U.S. is a public health concern that deserves greater attention. This study addresses a significant gap in the literature by examining the prevalence and correlates of tobacco and marijuana co-use among young people experiencing homelessness. METHODS The analytic sample consisted of 449 unaccompanied homeless youth (mean age = 22; 72% male) who had used any type of tobacco product in the past 30 days. Participants were recruited from 12 service sites and 13 street sites in Los Angeles County. RESULTS Over 90% of young homeless tobacco users reported past month marijuana and tobacco co-use: 65% reported any co-administration (mixing both substances in a cigarette, joint, blunt, bong, hookah, pipe or bowl) and 27% reported only using them separately. Analysis of covariance tests found that co-administrators reported greater quantity and frequency of tobacco cigarette use, more frequent marijuana use and, in some cases, poorer functioning and more severe homelessness compared to other tobacco users (p < 0.05). Logistic regression analysis indicated that co-administration was less likely among youth who were Black (vs. white) and who perceived it as being the same or more harmful than cigarette smoking, but more likely among youth who reported greater exposure to peers who engaged in co-administration (p < 0.05). CONCLUSIONS Co-administration of tobacco and marijuana is prevalent among young tobacco users experiencing homelessness. Results add to a growing literature on the prevalence and potential risks of co-administration among young people that can inform policies aimed at regulating tobacco and marijuana products.
Collapse
Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States.
| | - William G Shadel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665, United States
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States
| | - Daniela Golinelli
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States
| | - Daniel Siconolfi
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665, United States
| |
Collapse
|
33
|
Patterns of alternative tobacco product use among youth experiencing homelessness. Addict Behav 2019; 99:106088. [PMID: 31445484 DOI: 10.1016/j.addbeh.2019.106088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/06/2019] [Accepted: 08/12/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Identifying distinct patterns of tobacco product use can inform efforts to reduce poly-tobacco use among young people, but little is known regarding patterns of use among youth experiencing homelessness. This study identified patterns of using tobacco/nicotine products among youth experiencing homelessness, and assessed whether certain subgroups of youth were more likely than others to engage in specific patterns of use. METHODS Data were collected from a probability sample of 469 homeless youth who used tobacco in the past month, recruited from 25 service and street sites in Los Angeles County. Participants reported on lifetime and past month use of natural cigarettes, cigars, little cigars/cigarillos, electronic nicotine delivery systems, hookah, and chewing tobacco. Latent class analysis was used to identify patterns of tobacco product use. RESULTS We identified four main classes of use: traditional cigarettes smokers (34.7% of the sample), poly-tobacco experimenters (24.9%), current users of combustible products (natural cigarettes, cigars, little cigars/cigarillos; 27.1%), and current poly-tobacco users (13.1%). Youth who were male, slept outdoors, and screened positive for substance abuse disorder were more than twice as likely as their counterparts to be current poly-tobacco users relative to traditional cigarettes smokers. CONCLUSIONS Rates of poly-tobacco experimentation and current use among youth experiencing homelessness are high. This suggests that efforts to reduce the use of tobacco products in this population should focus on the combined use of these products, and further, that users with the greatest poly-use may have competing unmet needs such as substance use disorders and more severe homelessness.
Collapse
|
34
|
Tyler KA, Ray CM. Risk and Protective Factors for Substance Use Among Youth Experiencing Homelessness. CHILDREN AND YOUTH SERVICES REVIEW 2019; 107:104548. [PMID: 31827311 PMCID: PMC6905194 DOI: 10.1016/j.childyouth.2019.104548] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Though research finds that youth experiencing homelessness (YEH) have high rates of substance use, which can lead to numerous long-term negative health effects, less is known about both risk and protective factors for substance use. Moreover, even less is known about whether these factors differ for lesbian, gay and bisexual (LGB) youth compared to non-LGB youth. In the current study, we compared risk and protective factors for binge drinking, marijuana use, and illicit drug use (i.e. substance use) among heterosexual and sexual minority YEH. METHODS The sample included 322 young people experiencing homelessness in the Midwestern United States and who were between 16 and 26 years of age. Almost one-half of our sample were female (N = 146; 45%) and 68 youth (21%) identified as LGB. RESULTS Youth who experienced more child physical abuse, ran away from home more frequently, and those who had a parent(s) with drug problems were more likely to have reported binge drinking in the past 30 days. Additionally, having parents with drug problems was associated with the use of marijuana and illicit drugs. Conversely, having higher parental monitoring while growing up reduced the likelihood of using marijuana and illicit drugs. Tests for interactions revealed that while self-efficacy had no relationship with the probability of binge drinking for heterosexual youth, as self-efficacy increased, the probability of binge drinking declined drastically for sexual minority youth suggesting this protective mechanism operates differently for these two groups of youth. Additionally, tests of interactions showed that the probability of binge drinking among heterosexual and sexual minority youth also varied by child sexual abuse and street sexual victimization. CONCLUSION Study results have implications for service providers who serve YEH.
Collapse
|
35
|
Tucker JS, Shadel WG, Seelam R, Golinelli D, Siconolfi D. Roll-your-own cigarette smoking among youth experiencing homelessness. Drug Alcohol Depend 2019; 205:107632. [PMID: 31678834 PMCID: PMC6893089 DOI: 10.1016/j.drugalcdep.2019.107632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Roll-your-own (RYO) cigarette smoking is uncommon among young smokers in the U.S. but may be more widespread among those experiencing homelessness as it is a less expensive source of cigarettes. This study examines the prevalence and correlates of RYO use among young cigarette smokers experiencing homelessness. METHODS The analytic sample consisted of 433 unaccompanied homeless youth who reported past month use of factory-manufactured cigarettes. Participants were sampled from 25 street and service sites in Los Angeles County, and completed a survey on their tobacco-related behaviors and cognitions. RESULTS RYO use was reported by 43% of cigarette smokers. Among those who filled RYOs with tobacco, 87% rolled them with used tobacco (typically mixed with new tobacco). Most RYO smokers reported engaging in high-risk smoking practices, such as smoking discarded cigarettes. Although RYO smokers were more likely than other smokers to perceive RYOs as less risky in general, these groups did not differ in the perceived relative harm, expense, and ease of access of RYOs compared to regular cigarettes. Multivariable analyses indicated that RYO use was associated with older age, less perceived riskiness of RYOs, greater exposure to RYO smokers, and stronger future intentions to smoke. CONCLUSION RYOs may encourage continued tobacco use among youth experiencing homelessness and pose additional health risks despite users' beliefs to the contrary. Future research is needed to obtain more detailed information on RYO practices and motivations for use, as well as how to address RYOs in efforts to reduce tobacco use in this population.
Collapse
Affiliation(s)
- Joan S. Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138
| | - William G. Shadel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138
| | - Daniela Golinelli
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138
| | - Daniel Siconolfi
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665
| |
Collapse
|
36
|
Developing a text messaging-based smoking cessation intervention for young smokers experiencing homelessness. J Smok Cessat 2019. [DOI: 10.1017/jsc.2019.24] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AbstractIntroductionCigarette smoking is highly prevalent among young people experiencing homelessness, and many of these smokers are motivated to quit. However, there is a lack of readily available cessation services for this population, which is highly mobile and can be challenging to engage in services.AimsWe describe the development of a smoking cessation text messaging intervention (TMI) for homeless youth who are interested in quitting smoking.MethodsParticipants were 18–25 years old and recruited from drop-in centers serving homeless youth. Three focus groups (N = 18) were conducted with smokers to refine the TMI content, and a separate sample of smokers (N = 8) provided feedback on the TMI after using it for 1 week. Survey data assessed the TMI's acceptability and feasibility.ResultsParticipants generally rated the TMI as helpful and relevant, and nearly all had cell phone plans that included unlimited texting and were able to view TMI content with few difficulties. Qualitative feedback on strengths/limitations of the TMI in terms of content, tone, and delivery parameters was used to finalize the TMI for a future evaluation.ConclusionsResults suggest that a TMI is a feasible and acceptable option for young people experiencing homelessness who are interested in quitting smoking.
Collapse
|
37
|
Shadel WG, Tucker JS, Seelam R, Golinelli D, Siconolfi D. Associations of Tobacco Advertising Appeal With Intentions to Use Alternative Tobacco Products Among Young Tobacco Users Experiencing Homelessness. Am J Health Promot 2019; 34:132-141. [PMID: 31581783 DOI: 10.1177/0890117119878350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE Virtually nothing is known about the potential effects of tobacco advertising on tobacco use among youth experiencing homelessness, a vulnerable population with high tobacco use rates. This study examines associations between the appeal of advertising for 5 classes of tobacco product (electronic cigarettes, hookah, cigars, cigarillos, and smokeless tobacco) and future intentions to use those products again among homeless youth who had indicated any level of lifetime use. DESIGN A cross-sectional design was used. SETTING Settings were 25 service and street sites in Los Angeles County. PARTICIPANTS A probability sample of 469 young tobacco users experiencing homelessness (mean age = 22; 71% male; 29% non-Hispanic White) was recruited. MEASURES Assessments included product-specific tobacco advertising appeal and future intentions to use the product again, as well as a range of covariate controls (eg, demographics, homelessness severity, current tobacco use, general advertising exposure). ANALYSIS Linear regression tested for associations between the appeal of advertising for a specific tobacco product and intentions to use that product again in the future, controlling for myriad covariates. RESULTS Advertising appeal was positively associated with future intentions to use again for electronic cigarettes (P = .006) and hookah (P = .001), but not cigars (P = .486), cigarillos (P = .126), or smokeless tobacco (P = .109). CONCLUSION Results suggest that advertising appeal may increase use of certain tobacco products among youth experiencing homelessness. However, differences in themes emphasized by advertising for specific tobacco products could differentially influence use in this population.
Collapse
|
38
|
Tyler KA, Olson K, Ray CM. Understanding Daily Depression, Drinking, and Marijuana Use among Homeless Youth using Short Message Service Surveying. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019; 28:170-179. [PMID: 33013152 PMCID: PMC7531045 DOI: 10.1080/1067828x.2019.1667286] [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: 10/25/2022]
Abstract
We used short message service surveying (SMS) with 150 homeless youth to examine the time ordering of feeling depressed with drinking alcohol, using marijuana, and using substances with friends. Multilevel binary logistic regression results revealed that youth who were depressed earlier in the day were more likely to drink alcohol later that day. Among depressed youth, heterosexual youth were less likely to drink alcohol than lesbian, gay, and bisexual (LGB) youth. Depressed youth had increased odds of using marijuana by a factor of 1.6, while heterosexual youth, compared to LGB youth, were 80% less likely to use marijuana. Females were 82% less likely and heterosexual youth 75% less likely to use substances with friends compared to males and LGB youth, respectively. These findings improve upon prior retrospective studies by using SMS to understand time ordering between feeling depressed and substance use in the same day.
Collapse
Affiliation(s)
- Kimberly A Tyler
- University of Nebraska-Lincoln, Department of Sociology, Lincoln, NE 68588-0324
| | - Kristen Olson
- University of Nebraska-Lincoln, Department of Sociology, Lincoln, NE 68588-0324
| | - Colleen M Ray
- University of Nebraska-Lincoln, Department of Sociology, Lincoln, NE 68588-0324
| |
Collapse
|
39
|
Desai R, Ruiter RAC, Schepers J, Reddy SP, Mercken LAG. Tackling smoking among out of school youth in South Africa: An analysis of friendship ties. Addict Behav Rep 2019; 10:100214. [PMID: 31517020 PMCID: PMC6728272 DOI: 10.1016/j.abrep.2019.100214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 11/24/2022] Open
Abstract
Background Friendships during adolescence play a significant role in the initiation and maintenance of tobacco use. Smoking behaviour among adolescent friends has not been explored among out of school youth (OSY) in South Africa. Out of school youth (OSY), described as those between 13 and 20 years old, have not completed their schooling and are not currently enrolled in school, are at greater risk for tobacco use. Aim The main aim of this study is to examine whether the smoking behaviour of OSY is associated with that of their OSY friends. Methods Respondent driven sampling was used to recruit OSY and their OSY friends. A mixed effects logistic regression with a random intercept across school-province combinations was used to analyse survey data. Race and gender were also incorporated into the analyses as effect moderators (n = 391). Results Results of this study confirm that cigarette smoking was common among OSY and their OSY friends, with 53.5% of the respondents smoking in the past month (SD = 0.44). When OSY friends were either all non-smokers or half their friends were non-smokers, Coloured (mixed race) OSY were less likely to smoke compared to Black African and Other (mostly Asian descent) OSY. Conclusion Cultural norms and values associated with the different race groups may play a role in the smoking behaviour of out of school youth friends. Understanding this relationship is useful for identifying those OSY that are vulnerable to the behaviours that place them at risk of tobacco related morbidity and mortality. Smoking was common among out of school youth and their out of school youth friends. Racial differences were found in out of school youth smoking and their friends. Cultural norms and values influence smoking behaviour of out of school youth friends.
Collapse
Affiliation(s)
- R Desai
- Department of Work & Social Psychology, Maastricht University, P.O. Box 6200, MD, Maastricht, the Netherlands
| | - R A C Ruiter
- Department of Work & Social Psychology, Maastricht University, P.O. Box 6200, MD, Maastricht, the Netherlands
| | - J Schepers
- Department of Methodology and Statistics, Maastricht University, P.O. Box 6200, MD, Maastricht, the Netherlands
| | - S P Reddy
- Human Sciences Research Council, Social Aspects of Health, Private Bag X9182, Cape Town 8000, South Africa
| | - L A G Mercken
- Department of Health Promotion, Maastricht University and Care and Public Health Research Institute (CAPHRI), P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| |
Collapse
|
40
|
Tucker JS, Shadel WG, Golinelli D, Seelam R, Siconolfi D. Correlates of cigarette and alternative tobacco product use among young tobacco users experiencing homelessness. Addict Behav 2019; 95:145-151. [PMID: 30921625 PMCID: PMC6545131 DOI: 10.1016/j.addbeh.2019.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Most young people experiencing homelessness smoke cigarettes, but little is known about use of alternative tobacco products (ATPs) such as e-cigarettes or other electronic nicotine delivery systems (ENDS) and little cigars/cigarillos (LCCs). This study examines past month use and correlates of cigarettes and ATP among young tobacco users experiencing homelessness. METHODS We surveyed a probability sample of N = 469 unaccompanied homeless 13-25 year olds (mean age = 22; 71% male), who reported past month use of any type of tobacco product, from 25 service and street sites in Los Angeles County. RESULTS Nearly all (90%) participants reported smoking regular cigarettes, and 78% reported using at least one tobacco product other than regular cigarettes. The most commonly used of these other products was natural cigarettes (55%), followed by LCCs (43%), ENDS (34%), cigars (31%), hookah (14%), chewing tobacco (7%), and snus (5%). Multivariable models indicated that correlates of past month use differed by product, but included sociodemographic characteristics, homelessness severity, depression, exposure to other people who used the product, and product perceptions (e.g., relative access, cost, and harm compared to cigarettes). CONCLUSION Use of cigarettes and ATPs are both widespread among young homeless tobacco users, suggesting that efforts to reduce tobacco use in this population should have a broad focus that includes a variety of products. The effectiveness of these efforts may be enhanced by addressing their considerable exposure to other tobacco users, as well as their perceptions of certain products as being less harmful or more cost-effective options than regular cigarettes.
Collapse
Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States of America.
| | - William G Shadel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665, United States of America
| | - Daniela Golinelli
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States of America
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States of America
| | - Daniel Siconolfi
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213-2665, United States of America
| |
Collapse
|
41
|
Barman-Adhikari A, Hsu HT, Brydon D, Petering R, Santa Maria D, Narendorf S, Shelton J, Bender K, Ferguson K. Prevalence and correlates of nonmedical use of prescription drugs (NMUPD) among Young adults experiencing homelessness in seven cities across the United States. Drug Alcohol Depend 2019; 200:153-160. [PMID: 31132682 DOI: 10.1016/j.drugalcdep.2019.03.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/25/2019] [Accepted: 03/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Nonmedical use of prescription drugs (NMUPD) is an urgent public health concern facing the United States. Young adults experiencing homelessness (YEH) are at increased risk of NMUPD; however, community estimates of NMUPD among YEH are sparse. This current study sought to understand patterns and correlates of NMUPD in a geographically heterogeneous sample of YEH recruited from seven cities across the United States. METHODS From June 2016 to July 2017, 1,426 YEH (aged 18-26) were recruited from seven cities (Houston, Los Angeles, Denver, Phoenix, New York City, St. Louis, San Jose). Participants provided information on substance use, mental health, trauma, and sexual-risk behaviors. Multivariable logistic regression was utilized to assess demographic, psychological, and behavioral correlates of self-reported past-month NMUPD and NMUPD types (i.e., prescription stimulant, sedative, and opioids). RESULTS Approximately 20% of participants reported past-month NMUPD. Almost 9% reported misusing prescription opioids, 8.7% misused prescription sedatives, and 6% misused prescription stimulants. Multivariable logistic regressions revealed unmet mental health needs were associated with sedative and stimulant misuse but not opioid misuse. Having suicidal thoughts was associated with opioid misuse but not sedative or stimulant misuse. Although no geographical differences emerged for stimulant and sedative misuse, youth from Denver, Phoenix, and San Jose were more likely to engage in opioid misuse relative to youth in Los Angeles. CONCLUSIONS These findings indicate that interventions designed to address NMUPD need to be multifaceted, designed to address other risk behaviors correlated with NMUPD, and target unmet mental health needs.
Collapse
Affiliation(s)
- Anamika Barman-Adhikari
- Graduate School of Social Work, University of Denver, 2148 S. High St. Denver, CO, 80208, USA.
| | - Hsun-Ta Hsu
- School of Social Work, University of Missouri, 729 Clark Hall, Columbia, MO, 65211, USA.
| | - Daphne Brydon
- Graduate School of Social Work, University of Denver, 2148 S. High St. Denver, CO, 80208, USA.
| | - Robin Petering
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1150 South Olive St. 1503-1, Los Angeles, CA, 90015, USA.
| | - Diane Santa Maria
- Department of Nursing Systems, Cizik School of Nursing, The University of Texas Health Science Center at Houston, 6901 Bertner Ave. Ste. 591, Houston, TX 77030, USA.
| | - Sarah Narendorf
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd. #110HA, Houston, TX, 77204-4013, USA.
| | - Jama Shelton
- Silberman School of Social Work at Hunter College, 2180 Third Ave. New York, NY, 10035, USA.
| | - Kimberly Bender
- Graduate School of Social Work, University of Denver, 2148 S. High St. Denver, CO, 80208, USA.
| | - Kristin Ferguson
- School of Social Work, Arizona State University, 411 N. Central Ave. #865, Phoenix, AZ 85004-0689, USA.
| |
Collapse
|
42
|
Not getting high with a little help from your friends: Social versus drug network correlates of marijuana use among YMSM. Addict Behav 2019; 92:180-185. [PMID: 30641336 DOI: 10.1016/j.addbeh.2019.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/07/2018] [Accepted: 01/04/2019] [Indexed: 11/20/2022]
Abstract
Substantial evidence has documented the importance of social connections in shaping health and drug use behaviors among adolescents and young adults. The current study extends previous research into the associations between network characteristics and drug use behavior among young men who have sex with men (YMSM) by 1) examining multiple network characteristics, 2) simultaneously assessing multiple network types (i.e., social and drug use), and 3) examining change in network characteristics and drug use behavior over time. Data for the current study comes from RADAR, a longitudinal cohort study of YMSM. Latent growth curve models examined the change in frequency of marijuana use across four observations and individual and network correlates of this change including: demographics, drug network size, drug network density, social network size, and social network density. Baseline frequency of marijuana use was positively associated with drug network size and density, while it was inversely related to social network size and density. In addition, increasing frequency of marijuana use was associated with increases in drug network size and density, while it was associated with decreases in social network size. These findings highlight the complexity of multiple network types (e.g., drug and social) and network structures (e.g., size and density) in understanding drug use behavior among YMSM. Furthermore, as changes in drug and social networks may be indicative of changes in marijuana use, peer relationships may be especially important in understanding an individual's trajectories of marijuana use.
Collapse
|
43
|
Abstract
Objectives This study examined perceptions of factors that influence use and non-use of Alternative Tobacco Products (ATPs) among unaccompanied youth experiencing homelessness. Methods Focus groups were conducted with 30 homeless 18-24 year olds (80% men, 50% Hispanic, 30% Black, 17% White, 20% multi-racial/other) recruited from drop-in centers in Los Angeles. Discussion focused on several ATPs (hookah, electronic cigarettes/vaping devices, cigarillos/little cigars, smokeless tobacco, snus, natural cigarettes, clove cigarettes), soliciting participants' experiences using each ATP and motivations for using or not using each ATP. Results Focus group transcripts were subjected to a rigorous coding procedure and 8 themes relating to the reasons that participants may or may not use ATPs emerged. Each ATP was associated with distinctive characteristics that motivated use and non-use. For example, hookah use was viewed positively with positive sensory and social features dominating the discussion, whereas electronic cigarettes were viewed largely negatively (i.e., that they were expensive and harmful to health). Homelessness characterized participants' responses to the extent that cost was a factor in their choice of ATP. Conclusions These data provide important, first look insights into factors that may influence the use and non-use of ATPs among unaccompanied youth experiencing homelessness.
Collapse
|
44
|
Braciszewski JM, Vose-O’Neal A, Gamarel KE, Colby SM. Combustible Cigarette Smoking and Alternative Tobacco Use in a Sample of Youth Transitioning from Foster Care. CHILDREN AND YOUTH SERVICES REVIEW 2019; 96:231-236. [PMID: 31571706 PMCID: PMC6768414 DOI: 10.1016/j.childyouth.2018.11.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Among the struggles faced by youth currently in or recently exiting foster care, tobacco use remains a low priority for practitioners and researchers, alike. Indeed, despite the dramatically altered landscape of tobacco products on the market, there have been no studies evaluating the use of alternative tobacco products among this vulnerable population. The current study aimed to determine the prevalence of lifetime and current combustible and non-combustible tobacco use among youth exiting foster care, and report on the prevalence of nicotine dependence, motivation to quit, and preferred methods of tobacco cessation. Youth aged 18-24 (M = 20.13, SD = 1.16) who were transitioning from foster care (N = 154) completed a survey of tobacco product use adapted from the Population Assessment of Tobacco and Health Baseline Survey. Most participants (76%) reported lifetime use of combustible cigarettes, while almost half (42%) were current combustible cigarette smokers. Current use of electronic cigarettes was comparable to general population rates. Many participants (76%) reported interest in quitting and willingness to try through patches/gum (56%) and technology-based (61%) approaches. Youth exiting foster care are at high risk for smoking and other tobacco product use, as well as dependence, yet are rarely screened for use or advised to quit. As tobacco use remains among the most preventable causes of mortality and morbidity, future work should involve implementation of screening within child welfare and tailoring interventions to the unique needs of this population. The current results underscore a missed opportunity to promote public health in a vulnerable population.
Collapse
Affiliation(s)
- Jordan M. Braciszewski
- Henry Ford Health System, Center for Health Policy & Health Services Research, 1 Ford Place, Detroit, MI, USA 48202
| | - Adam Vose-O’Neal
- Pacific Institute for Research and Evaluation, Decision Sciences Institute, 1005 Main St., Suite 8120, Pawtucket, RI, USA 02860
| | - Kristi E. Gamarel
- University of Michigan, School of Public Health, Department of Health Behavior and Health Education, 3826 SPH I, 1415 Washington Heights, Ann Arbor, MI, USA 48109
| | - Suzanne M. Colby
- Brown University, Center for Alcohol & Addiction Studies, Box G-121S-4, Providence, RI, USA 02912
| |
Collapse
|
45
|
Zhao Q, Kim BKE, Li W, Hsiao HY, Rice E. Incarceration history, social network composition, and substance use among homeless youth in Los Angeles. J Addict Dis 2018; 37:64-76. [PMID: 30592248 DOI: 10.1080/10550887.2018.1545555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Homeless youth in the United States have high rates of substance use. Existing research has identified social network composition and street-associated stressors as contributing factors. Incarceration is a highly prevalent stressor for homeless youth. Its effect on youth's social network composition and substance use, however, has been neglected. Aims: This study investigated the direct and indirect associations between incarceration history and substance use (through social networks) among homeless youth in Los Angeles, California. Methods: A sample of 1047 homeless youths were recruited between 2011 and 2013. Computerized self-administrated surveys and social network interviews were conducted to collect youth's sociodemographic characteristics, incarceration history, social network composition, and substance use. Bootstrapping was used to identify the direct and indirect associations between youth's incarceration history and substance use. Results: Incarceration history was positively associated with youth's cannabis, methamphetamine, and injection drug use. The percentage of cannabis-using peers partially mediated the associations between incarceration history and youth's cannabis, cocaine, and heroin use. The percentage of methamphetamine-using peers partially mediated the associations between incarceration history and youth's methamphetamine, cocaine, and injection drug use. The percentage of heroin-using peers partially mediated the association between incarceration history and youth's heroin use. Moreover, the percentage of peers who inject drugs partially mediated the associations between incarceration history and youth's methamphetamine, heroin, and injection drug use. Discussion: Incarceration history should be taken to a more central place in future research and practice with homeless youth in the United States.
Collapse
Affiliation(s)
- Qianwei Zhao
- a USC Suzanne Dworak-Peck School of Social Work , University of Southern California , Los Angeles , CA , USA
| | - B K Elizabeth Kim
- a USC Suzanne Dworak-Peck School of Social Work , University of Southern California , Los Angeles , CA , USA
| | - Wen Li
- b School of Social Work , Rutgers University , New Brunswick , NJ , USA
| | - Hsin-Yi Hsiao
- a USC Suzanne Dworak-Peck School of Social Work , University of Southern California , Los Angeles , CA , USA
| | - Eric Rice
- a USC Suzanne Dworak-Peck School of Social Work , University of Southern California , Los Angeles , CA , USA
| |
Collapse
|
46
|
Rhoades H, La Motte-Kerr W, Duan L, Woo D, Rice E, Henwood B, Harris T, Wenzel SL. Social networks and substance use after transitioning into permanentsupportive housing. Drug Alcohol Depend 2018; 191:63-69. [PMID: 30086424 PMCID: PMC6224132 DOI: 10.1016/j.drugalcdep.2018.06.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/17/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Substance use disorders are common among persons experiencing homelessness, and research has identified social networks as important correlates of substance use in this population. Permanent supportive housing (PSH), particularly Housing First, which uses a harm reduction model not requiring substance abstinence, is a key solution for ending homelessness. However, conflicting evidence exists regarding the associations between moving into PSH and changes in substance use, and there is limited understanding of how networks may influence such changes. METHODS Using observational, longitudinal data from 421 persons before they moved in and over their first year in PSH (collected as part of a HIV-risk study), this paper assesses substance use change (alcohol, marijuana, and illicit drugs) and associations between perceived network characteristics and individual substance use. RESULTS Substance use remained relatively stable among participants over their first year living in PSH, although illicit substance use reduced somewhat at six months compared to baseline levels (from 18.5%-14.5%) and marijuana use increased slightly at 12 months (from 26.6% at baseline to 32.9%). Substance use among social network members was consistently associated with individual-level substance use, both cross-sectionally and longitudinally. Specific network substance use characteristics, such as proximity, location met, and social support, had differential relationships with particular substance types. CONCLUSIONS These findings provide longitudinal evidence that changes within substance-using social networks are associated with subsequent changes in individual use and underscore the importance of interventions aimed at promoting positive social relationships for formerly homeless persons and improving PSH's social environments.
Collapse
Affiliation(s)
- Harmony Rhoades
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1149 S. Hill Street, Los Angeles, CA, 90015, United States.
| | - Wichada La Motte-Kerr
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1149 S. Hill Street, Los Angeles, CA, 90015, United States
| | - Lei Duan
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1149 S. Hill Street, Los Angeles, CA, 90015, United States
| | - Darlene Woo
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1149 S. Hill Street, Los Angeles, CA, 90015, United States
| | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1149 S. Hill Street, Los Angeles, CA, 90015, United States
| | - Benjamin Henwood
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1149 S. Hill Street, Los Angeles, CA, 90015, United States
| | - Taylor Harris
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 1149 S. Hill Street, Los Angeles, CA, 90015, United States
| | - Suzanne L Wenzel
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 West 34th Street, Los Angeles, CA, 90089, United States
| |
Collapse
|
47
|
Noh D. The Effect of a Resilience Enhancement Programme for Female Runaway Youths: A Quasi-Experimental Study. Issues Ment Health Nurs 2018; 39:764-772. [PMID: 30239243 DOI: 10.1080/01612840.2018.1462871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The effects of a resilience enhancement programme on resilience, depression, anxiety, and problem drinking among female runaway youths living in shelters were evaluated. Participants were 32 youths (16 experimental and 16 control participants), assessed at pre-test, post-test, and one-month follow-up. The programme incorporated five protective factors associated with resilience: self-esteem, self-regulation, relational skills, problem-solving skills, and goal-setting skills. There were significant group-by-time interaction effects for resilience, anxiety, and problem drinking at one-month follow-up. The preliminary results suggest that providing female runaway youths with this programme focusing on protective factors may enhance resilience and mitigate anxiety, and problem drinking.
Collapse
Affiliation(s)
- Dabok Noh
- a College of Nursing, Eulji University , Seongnam , South Korea
| |
Collapse
|
48
|
Yang C, Yang J, Davey-Rothwell M, Latkin C. Social network perspective on alcohol consumption among African American women: a longitudinal analysis. ETHNICITY & HEALTH 2018; 23:503-510. [PMID: 28277027 PMCID: PMC5550363 DOI: 10.1080/13557858.2017.1290215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of the study was to examine alcohol use in African American women's social networks. DESIGN This was a longitudinal study of African American women and their social networks in Baltimore, MD. Data were collected through face-to-face interviews at a community-based research clinic. Alcohol consumption frequency was assessed by a single question 'How often do you drink alcohol?' with a four-point ordinal rating scale 'never,' 'monthly or less,' '2-4 times a month' and '>2 times a week.' A longitudinal ordinal logistic model was conducted to use 317 African American women's alcohol consumption frequency as a predictor of their social networks' alcohol consumption frequency. RESULTS Results show that African American women's alcohol consumption frequency was a statistically significant predictor of their social network members' alcohol consumption frequency. CONCLUSION Findings suggest the merit of social network-based approaches to address alcohol use among urban minority populations.
Collapse
Affiliation(s)
- Cui Yang
- a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Jingyan Yang
- b Department of Epidemiology, Mailman School of Public Health , Columbia University , New York , USA
| | - Melissa Davey-Rothwell
- a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Carl Latkin
- a Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| |
Collapse
|
49
|
Harris T, Dunton G, Henwood B, Rhoades H, Rice E, Wenzel S. Los Angeles Housing Models and Neighborhoods' Role in Supportive Housing Residents' Social Integration. HOUSING STUDIES 2018; 34:609-635. [PMID: 31371845 PMCID: PMC6675468 DOI: 10.1080/02673037.2018.1462308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 03/28/2018] [Indexed: 05/11/2023]
Affiliation(s)
- Taylor Harris
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34th St, Los Angeles, CA 90089
| | - Genevieve Dunton
- University of Southern California, Keck School of Medicine, Institute for Health Promotion & Disease Prevention, 2001 N. Soto Street, Los Angeles, CA 90032
| | - Benjamin Henwood
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34th St, Los Angeles, CA 90089
| | - Harmony Rhoades
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34th St, Los Angeles, CA 90089
| | - Eric Rice
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34th St, Los Angeles, CA 90089
| | - Suzanne Wenzel
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34th St, Los Angeles, CA 90089
| |
Collapse
|
50
|
Pedersen ER, Tucker JS, Klein DJ, Parast L. Perceived Need and Receipt of Behavioral Health Services at Drop-In Centers among Homeless Youth. Health Serv Res 2018; 53:4609-4628. [PMID: 29862501 DOI: 10.1111/1475-6773.12990] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Homeless youth are a population in need of housing assistance and case management, as well as services to address behavioral health problems. This study examines youth's perceived need for and receipt of services through drop-in centers. DATA SOURCE Surveys of 273 homeless youth. STUDY DESIGN Cross-sectional. EXTRACTION METHODS Descriptive analyses with bivariate and multivariable regression models. PRINCIPAL FINDINGS About one-third to half of the sample met criteria for behavioral health problems, yet half or less of those meeting criteria reported a need for services targeting the problems. Most youth who perceived a need for services received relevant services through a drop-in center, with the exception of care for substance use problems. Youth with behavioral health problems were more likely to perceive a need for services related to housing and case management than those addressing behavioral health problems more directly. Multivariable regression analyses indicated that the factors most strongly associated with perceived need for services were not behavioral health problems, but rather race/ethnicity, traveler status, trouble meeting basic needs, delinquency, abuse/victimization experiences, and trading sex. CONCLUSIONS Findings can help to develop outreach and intervention efforts to reach homeless youth and help promote the use of behavioral health services.
Collapse
|