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Paquette C, Vierling A, Kane L, Abrego PL, Benson K, Jordan E, Baucom D, Zule W, Daughters S. Harm reduction-focused behavioral activation for people who inject drugs: Mixed methods outcomes from a pilot open trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024:209490. [PMID: 39179209 DOI: 10.1016/j.josat.2024.209490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/22/2024] [Accepted: 08/13/2024] [Indexed: 08/26/2024]
Abstract
INTRODUCTION People who inject drugs (PWID) experience high rates of mental health problems and drug-related harms. Harm reduction-focused interventions aim to reduce harms associated with drug use and are an important approach for engaging people who are not seeking traditional abstinence-focused treatment. Yet, few studies to date have examined the effectiveness of harm reduction psychosocial treatment for drug use. We evaluated the outcomes of a harm reduction-focused behavioral activation (BA) intervention from pretreatment to a 1-month follow-up. METHODS A total of N = 23 PWID (65.2 % White; 52.2 % women; mean age 35.4 ± 7.8 years) were recruited from syringe services programs and n = 19 received the intervention via teletherapy. Assessment of study outcome measures occurred at pre- and posttreatment and a one-month follow-up. RESULTS Results reflected post-intervention increases in behavioral activation and readiness to change drug use, as well as decreases in substance use, depression, and HIV risk behaviors. There were mixed outcomes on substance-related problems with increases at follow-up, possibly reflecting increased problem recognition. CONCLUSIONS These results suggest initial promise for the harm reduction-focused treatment. Additional research with randomized designs and larger sample sizes is needed, and more intensive treatment may be required to support sustained treatment gains in this population.
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Affiliation(s)
- Catherine Paquette
- Duke University School of Medicine Department of Population Health Sciences, Durham, North Carolina, United States.
| | | | - Louisa Kane
- University of North Carolina at Chapel Hill, United States
| | | | | | | | - Donald Baucom
- University of North Carolina at Chapel Hill, United States
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Shen MR, Owusu-Boaitey K, Holsen LM, Suzuki J. The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients: A Scoping Review. J Addict Med 2024:01271255-990000000-00351. [PMID: 39092831 DOI: 10.1097/adm.0000000000001347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
ABSTRACT Substance use disorder (SUD) continues to be a leading cause of morbidity and mortality with limited treatments. There is interest in expanding the use of GLP-1 agonists in treating SUD. However, evidence for safety and efficacy in humans is limited. This review aims to bridge the existing knowledge gap by establishing a baseline of literature in this area to inform future trials and clinical practice. Our inclusion criteria were English peer-reviewed manuscripts reporting on use of GLP-1, GIP, and/or glucagon receptor agonists in treatment of SUDs, excluding case studies. The literature search was performed in accordance to PRISMA guidelines. Five studies were included in this review examining the use of this medication in tobacco use disorder, alcohol use disorder, and cocaine use disorder. No studies regarding substance withdrawal syndrome were identified. The included studies varied widely in terms of patient selection, dose/formulation of GLP-1 agonists, and follow-up. The results of this scoping review are mixed, with 3 studies demonstrating positive results and 2 studies finding no efficacy of this medication on SUD outcomes. It is premature to prescribe this medication off-label to patients. Further research is needed to determine the efficacy of GLP-1 agonists in treating SUD.
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Affiliation(s)
- Mary R Shen
- From the Department of Psychiatry, Brigham and Women's Hospital, Boston, MA (MRS, KO-B, JS); Harvard Medical School, Boston, MA (MRS, KO-B, LMH, JS); and Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA (LMH)
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Thorpe HHA, Fontanillas P, Meredith JJ, Jennings MV, Cupertino RB, Pakala S, Elson SL, Khokhar JY, Davis LK, Johnson EC, Palmer AA, Sanchez-Roige S. Genome-wide association studies of lifetime and frequency cannabis use in 131,895 individuals. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.14.24308946. [PMID: 38947071 PMCID: PMC11213095 DOI: 10.1101/2024.06.14.24308946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Cannabis is one of the most widely used drugs globally. Decriminalization of cannabis is further increasing cannabis consumption. We performed genome-wide association studies (GWASs) of lifetime (N=131,895) and frequency (N=73,374) of cannabis use. Lifetime cannabis use GWAS identified two loci, one near CADM2 (rs11922956, p=2.40E-11) and another near GRM3 (rs12673181, p=6.90E-09). Frequency of use GWAS identified one locus near CADM2 (rs4856591, p=8.10E-09; r2 =0.76 with rs11922956). Both traits were heritable and genetically correlated with previous GWASs of lifetime use and cannabis use disorder (CUD), as well as other substance use and cognitive traits. Polygenic scores (PGSs) for lifetime and frequency of cannabis use associated cannabis use phenotypes in AllofUs participants. Phenome-wide association study of lifetime cannabis use PGS in a hospital cohort replicated associations with substance use and mood disorders, and uncovered associations with celiac and infectious diseases. This work demonstrates the value of GWASs of CUD transition risk factors.
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Affiliation(s)
- Hayley H A Thorpe
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | | | - John J Meredith
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Mariela V Jennings
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Renata B Cupertino
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Shreya Pakala
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | | | - Jibran Y Khokhar
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Lea K Davis
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO USA
| | - Abraham A Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Sandra Sanchez-Roige
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA
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Habtemariam S, Hery CM, Zhang X, Yu M, Mays D, Adeyanju T, Bernardo B, Paskett ED. Association between sociodemographics and change in alcohol or tobacco use behaviors during the COVID-19 pandemic. PLoS One 2024; 19:e0304111. [PMID: 38820378 PMCID: PMC11142573 DOI: 10.1371/journal.pone.0304111] [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: 12/06/2023] [Accepted: 05/06/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE To examine the association between various sociodemographic factors with alcohol and tobacco use behaviors during the COVID-19 pandemic. METHODS Participants from Ohio and Indiana were asked to participate in the 'Impact of COVID-19 on the Cancer Continuum Consortium' study (N = 32,989) from June-November 2020. Those who completed the survey and responded to key study questions were included (n = 5,374). Participants were asked about the frequency and type of alcohol and tobacco product used. Multivariable logistic regression was conducted to determine factors associated with the impact of COVID-19 on change in alcohol and/or tobacco use. RESULTS Mean age was 57 years old, 68% were female, 90% non-Hispanic white, 75% married, and 31% lived in rural counties. Out of 5,374 participants, 53% used alcohol-only (n = 2,833), 5% used tobacco-only (n = 255), 7% used both alcohol and tobacco (n = 395), and 35% used neither alcohol nor tobacco (n = 1,891). Urban county of residence (vs. rural) was associated with an increase in alcohol-use (p = 0.0001), change in alcohol products (p = 0.023), and an increase in tobacco use (p = 0.05). Among alcohol-only users, those who were younger (OR = 0.97), female (OR = 1.58), married (OR = 1.69), of high socioeconomic status (OR = 1.99), residing in urban counties (OR = 1.65), and had elevated financial (OR = 1.06) and employment concerns (OR = 1.28) were significantly more likely to report increased alcohol-use. Similarly, among tobacco users, those who were younger (OR = 0.97), female (OR = 2.79), married (OR = 2.16) or divorced (OR = 2.83), and had higher levels of neighborhood disadvantage (OR = 2.19) were significantly more likely to report increased tobacco-use. CONCLUSIONS Findings suggest targeted intervention and prevention strategies for young, female participants with elevated financial and employment concerns during the COVID-19 pandemic are necessary to mitigate risks associated with higher odds of alcohol and tobacco use. Our findings on alcohol and tobacco use may be a result of the unique social and economic influence of the pandemic on women.
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Affiliation(s)
- Selam Habtemariam
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | - Chloe M. Hery
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Xiaochen Zhang
- Fred Hutch Cancer Center, Seattle, Washington, United States of America
| | - Mengda Yu
- Division of Biostatistics, The Ohio State University, Columbus, Ohio, United States of America
| | - Darren Mays
- The Ohio State University, Columbus, Ohio, United States of America
| | - Toyin Adeyanju
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
| | | | - Electra D. Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, United States of America
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
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Pasqualoni S, Bai Y, Curl A, Rettew J, Kimball L, Devadanam V, Yousef H, Hudziak J, Copeland WE. The substance use behaviors change of first-year college students before and during COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-8. [PMID: 38227917 DOI: 10.1080/07448481.2023.2299419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 12/10/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE This article tests the substance use behaviors of college students before and during COVID-19 pandemic. METHODS In-depth assessment and nightly survey data was used from a longitudinal study (n = 675) which examined student substance use during the 2019-2020 academic year, both before and during the onset of the COVID-19 pandemic. Changes in beer/wine, tobacco, liquor, and marijuana use before versus during the pandemic, in addition to the interaction of COVID-19, were tested with gender and subjective social status. RESULTS Marijuana use significantly decreased from a weekly prevalence of 9.9% before COVID-19 to 6.4% during COVID-19 (p = 0.002). A similar decrease was seen in liquor use (10.6% before COVID to 6.4% during COVID, p = 0.01). There was no significant change observed for beer/wine use or for tobacco use. CONCLUSION In the wake of the COVID-19 pandemic, liquor, and marijuana use decreased for college students, while other substance use stayed the same.
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Affiliation(s)
| | - Yang Bai
- University of Utah, Salt Lake City, Utah, USA
| | - Azilee Curl
- University of Vermont, Burlington, Vermont, USA
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Minhas AMK, Kewcharoen J, Hall ME, Warraich HJ, Greene SJ, Shapiro MD, Michos ED, Sauer AJ, Abramov D. Temporal Trends in Substance Use and Cardiovascular Disease-Related Mortality in the United States. J Am Heart Assoc 2024; 13:e030969. [PMID: 38197601 PMCID: PMC10926834 DOI: 10.1161/jaha.123.030969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/25/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND There are limited data on substance use (SU) and cardiovascular disease (CVD)-related mortality trends in the United States. We aimed to evaluate SU+CVD-related deaths in the United States using the Centers for Disease Control and Prevention Wide-Ranging, Online Data for Epidemiologic Research database. METHODS AND RESULTS The Multiple Cause-of-Death Public Use record death certificates were used to identify deaths related to both SU and CVD. Crude, age-adjusted mortality rates, annual percent change, and average annual percent changes with a 95% CI were analyzed. Between 1999 and 2019, there were 636 572 SU+CVD-related deaths (75.6% men, 70.6% non-Hispanic White individuals, 65% related to alcohol). Age-adjusted mortality rates per 100 000 population were pronounced in men (22.5 [95% CI, 22.6-22.6]), American Indian or Alaska Native individuals (37.7 [95% CI, 37.0-38.4]), nonmetropolitan/rural areas (15.2 [95% CI, 15.1-15.3]), and alcohol-related death (9.09 [95% CI, 9.07 to 9.12]). The overall SU+CVD-related age-adjusted mortality rates increased from 9.9 (95% CI, 9.8-10.1) in 1999 to 21.4 (95% CI, 21.2-21.6) in 2019 with an average annual percent change of 4.0 (95% CI, 3.7-4.3). Increases in SU+CVD-related average annual percent change were noted across all subgroups and were pronounced among women (4.8% [95% CI, 4.5-5.1]), American Indian or Alaska Native individuals, younger individuals, nonmetropolitan areas, and cannabis and psychostimulant users. CONCLUSIONS There was a prominent increase in SU+CVD-related mortality in the United States between 1999 and 2019. Women, non-Hispanic American Indian or Alaska Native individuals, younger individuals, nonmetropolitan area residents, and users of cannabis and psychostimulants had pronounced increases in SU+CVD mortality.
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Affiliation(s)
| | - Jakrin Kewcharoen
- Division of CardiologyLoma Linda University Medical CenterLoma LindaCA
| | - Michael E. Hall
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMS
| | | | | | - Michael D. Shapiro
- Cardiovascular MedicineWake Forest University School of MedicineWinston SalemNC
| | - Erin D. Michos
- Division of CardiologyJohns Hopkins School of MedicineBaltimoreMD
| | | | - Dmitry Abramov
- Division of CardiologyLoma Linda University Medical CenterLoma LindaCA
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Tan X, Zhang H, Ren X. The effects of neighborhood socioeconomic status on ADL/IADL among Chinese older adults-neighborhood environments as mediators. Front Public Health 2024; 11:1202806. [PMID: 38298263 PMCID: PMC10828966 DOI: 10.3389/fpubh.2023.1202806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 12/20/2023] [Indexed: 02/02/2024] Open
Abstract
Background There have been few consistencies in the effects and pathways of neighborhood socioeconomic status (SES) on functional limitations. This study aimed to investigate whether neighborhood socioeconomic status influences ADL/IADL in older residents in China through the neighborhood built environment and social environment. Methods Activities of daily living/IADL were assessed in a sample of 5,887 Chinese individuals aged 60 or older, utilizing data obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS 2011). Neighborhood SES was measured by the neighborhood per-capita net income. Neighborhood built environment was measured by the security resources, motion resources, living resources, service resources for older adults, and medical resources of neighborhood. Neighborhood social environment was measured by the organizations, unemployment subsidies, minimum living allowance, subsidies to persons older than 65, and pensions to persons older than 80 of the neighborhood. The two-level logistical regression model and multilevel structural equation model (MSEM) were used. Results The rate of ADL/IADL loss among Chinese older adults aged 60 and above in 2011 were 32.17 and 36.87%, respectively. Neighborhood SES was significantly associated with ADL/IADL in older adults. Compared with the respondents living in communities with lower SES, those living in communities with higher SES possessed better ADL (β = -0.33, p < 0.05) and IADL (β = -0.36, p < 0.05) status. The path of neighborhood socioeconomic status on ADL was completely mediated by the neighborhood built environment (β = -0.110, p < 0.05) and neighborhood social environment (β = -0.091, p < 0.05). Additionally, the effect of neighborhood socioeconomic status on IADL was fully mediated by the neighborhood built environment (β = -0.082, p < 0.05) and neighborhood social environment (β = -0.077, p < 0.05). Conclusion Neighborhood SES was significantly correlated with ADL/IADL through the neighborhood environment. Improving the ADL/IADL status of older adults residing in low socioeconomic neighborhoods requires enhancing the built and social environment by provisioning additional neighborhood resources.
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Affiliation(s)
- Xiaoshuang Tan
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Hong Zhang
- Integrated Care Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohui Ren
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Rogers RT, Tran H, Belnap SC, Starosciak AK. Cerebrovascular Events and Hospital Discharge Outcomes Associated With Drug Use: A Retrospective Case-Matched Study. Cureus 2023; 15:e50190. [PMID: 38192948 PMCID: PMC10771966 DOI: 10.7759/cureus.50190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Individuals using cocaine, methamphetamines, cannabis, and other mood-altering drugs (MADs) have been reported to have greater stroke risk when compared to individuals who do not use these drugs. Yet, the impact that MAD use has on stroke outcomes has not been adequately explored, with existing research not agreeing on the extent to which the use of these drugs influences stroke outcomes. This study aimed to determine the impact that the use of common MADs has on stroke outcome factors such as length of stay (LOS), discharge modified Rankin Scale (mRS), and discharge disposition. Methods A retrospective case-matched study was conducted with two adult cohorts treated for cerebrovascular accidents: those who use MADs and those who do not use MADs prior to their stroke. Subjects identified for the users of MADs cohort were matched at a 1:1 ratio to those who do not use MADs (control cohort) by age, sex, and stroke type (e.g., hemorrhagic or ischemic). Logistic regression was used to calculate odds ratios for functional outcomes for stroke patients with and without prior MAD use. Results Active users of MADs had an increased overall risk of poor stroke outcome, i.e., increased length of stay, discharge disposition other than to home or to rehabilitation, discharge modified Rankin scale (mRS) 3-6 after controlling for stroke severity from initial National Institutes of Health Stroke Scale (NIHSS) (X2{9}=21.68, p<0.01, Cox adjusted R2=0.31). This finding was driven predominately by increased hospital LOS (p=0.006) among the MAD cohort, whereas discharge mRS 3-6 (p=0.24) and discharge disposition to care facility (p=0.27) and expired (p=0.26) did not vary significantly between groups. Conclusion Our study suggests that patients who had actively used MADs prior to their stroke may be at risk of poorer stroke outcomes, namely an increased LOS. Future research should be conducted to further elucidate which factors, such as individual drugs, amount of drug, acute or recreational use versus chronic or long-term use, and route of administration, for instance, specifically contribute to a longer LOS so that they may be targeted for mitigation.
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Affiliation(s)
- Richard T Rogers
- Neurology, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Ha Tran
- Pediatrics, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
- Pediatrics, Children's National Hospital, Washington, D.C., USA
| | - Starlie C Belnap
- Miami Neuroscience Institute, Baptist Health South Florida, Miami, USA
| | - Amy K Starosciak
- Translational Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
- Center for Research, Baptist Health South Florida, Coral Gables, USA
- Miami Neuroscience Institute, Baptist Health South Florida, Miami, USA
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Fataar F, Driezen P, Owusu-Bempah A, Hammond D. Patterns of problematic cannabis use in Canada pre- and post-legalisation: Differences by neighbourhood deprivation, individual socioeconomic factors and race/ethnicity. Drug Alcohol Rev 2023; 42:1534-1546. [PMID: 37137866 DOI: 10.1111/dar.13677] [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: 10/13/2022] [Revised: 04/13/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023]
Abstract
INTRODUCTION The legalisation of cannabis in Canada in 2018, and subsequent increase in prevalence of use, has generated interest in understanding potential changes in problematic patterns of use, including by socio-demographic factors such as race/ethnicity and neighbourhood deprivation level. METHODS This study used repeat cross-sectional data from three waves of the International Cannabis Policy Study web-based survey. Data were collected from respondents aged 16-65 prior to cannabis legalisation in 2018 (n = 8704), and post-legalisation in 2019 (n = 12,236) and 2020 (n = 12,815). Respondents' postal codes were linked to the INSPQ neighbourhood deprivation index. Multinomial regression models examined differences in problematic use by socio-demographic and socio-economic factors and over time. RESULTS No evidence of a change in the proportion of those aged 16-65 in Canada whose cannabis use would be classified as 'high risk' was noted from before cannabis legalisation (2018 = 1.5%) to 12 or 24 months after legalisation (2019 = 1.5%, 2020 = 1.6%; F = 0.17, p = 0.96). Problematic use differed by socio-demographic factors. For example, consumers from the most materially deprived neighbourhoods were more likely to experience 'moderate' vs 'low risk' compared to those living outside deprived neighbourhoods (p < 0.01 for all). Results were mixed for race/ethnicity and comparisons for high risk were limited by small sample sizes for some groups. Differences across subgroups were consistent from 2018 to 2020. DISCUSSION AND CONCLUSIONS The risk of problematic cannabis use does not appear to have increased in the 2 years following cannabis legalisation in Canada. Disparities in problematic use persisted, with some racial minority and marginalised groups experiencing higher risk.
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Affiliation(s)
- Fathima Fataar
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Pete Driezen
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | | | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Xia Y, Rebello V, Bodison SC, Jonker D, Steigelmann B, Donald KA, Charles W, Stein DJ, Ipser J, Ahmadi H, Kan E, Sowell ER, Narr KL, Joshi SH, Odendaal HJ, Uban KA. Contextualizing the impact of prenatal alcohol and tobacco exposure on neurodevelopment in a South African birth cohort: an analysis from the socioecological perspective. Front Integr Neurosci 2023; 17:1104788. [PMID: 37534335 PMCID: PMC10390790 DOI: 10.3389/fnint.2023.1104788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 06/19/2023] [Indexed: 08/04/2023] Open
Abstract
Background Alcohol and tobacco are known teratogens. Historically, more severe prenatal alcohol exposure (PAE) and prenatal tobacco exposure (PTE) have been examined as the principal predictor of neurodevelopmental alterations, with little incorporation of lower doses or ecological contextual factors that can also impact neurodevelopment, such as socioeconomic resources (SER) or adverse childhood experiences (ACEs). Here, a novel analytical approach informed by a socio-ecological perspective was used to examine the associations between SER, PAE and/or PTE, and ACEs, and their effects on neurodevelopment. Methods N = 313 mother-child dyads were recruited from a prospective birth cohort with maternal report of PAE and PTE, and cross-sectional structural brain neuroimaging of child acquired via 3T scanner at ages 8-11 years. In utero SER was measured by maternal education, household income, and home utility availability. The child's ACEs were measured by self-report assisted by the researcher. PAE was grouped into early exposure (<12 weeks), continued exposure (>=12 weeks), and no exposure controls. PTE was grouped into exposed and non-exposed controls. Results Greater access to SER during pregnancy was associated with fewer ACEs (maternal education: β = -0.293,p = 0.01; phone access: β = -0.968,p = 0.05). PTE partially mediated the association between SER and ACEs, where greater SER reduced the likelihood of PTE, which was positively associated with ACEs (β = 1.110,p = 0.01). SER was associated with alterations in superior frontal (β = -1336.036, q = 0.046), lateral orbitofrontal (β = -513.865, q = 0.046), caudal anterior cingulate volumes (β = -222.982, q = 0.046), with access to phone negatively associated with all three brain volumes. Access to water was positively associated with superior frontal volume (β=1569.527, q = 0.013). PTE was associated with smaller volumes of lateral orbitofrontal (β = -331.000, q = 0.033) and nucleus accumbens regions (β = -34.800, q = 0.033). Conclusion Research on neurodevelopment following community-levels of PAE and PTE should more regularly consider the ecological context to accelerate understanding of teratogenic outcomes. Further research is needed to replicate this novel conceptual approach with varying PAE and PTE patterns, to disentangle the interplay between dose, community-level and individual-level risk factors on neurodevelopment.
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Affiliation(s)
- Yingjing Xia
- Public Health, University of California, Irvine, Irvine, CA, United States
| | - Vida Rebello
- Public Health, University of California, Irvine, Irvine, CA, United States
| | - Stefanie C. Bodison
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Deborah Jonker
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Kirsten A. Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Weslin Charles
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, Cape Town, South Africa
| | - Jonathan Ipser
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Hedyeh Ahmadi
- University Statistical Consulting, LLC, Irvine, CA, United States
| | - Eric Kan
- Department of Pediatrics, Keck School of Medicine, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, United States
| | - Elizabeth R. Sowell
- Department of Pediatrics, Keck School of Medicine, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, United States
| | - Katherine L. Narr
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Shantanu H. Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Hein J. Odendaal
- Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa
| | - Kristina A. Uban
- Public Health, University of California, Irvine, Irvine, CA, United States
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Floyd LJ, Brown K. Perceived neighborhood disorder as a moderator of the relationship between marijuana use and disinhibition in a sample of emerging adult African American females. J Ethn Subst Abuse 2023:1-15. [PMID: 37270673 PMCID: PMC10694336 DOI: 10.1080/15332640.2023.2195691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Disinhibition is associated with myriad risk-taking behaviors and adverse outcomes. Both marijuana use and poor neighborhood conditions have been associated with disinhibition. However, the extent to which neighborhood disorder interacts with marijuana use to influence disinhibition has not been studied, extensively. A better understanding of these relationships has implications for designing more effective tailored place-based interventions that aim to reduce risk taking behaviors and related adverse social and health outcomes associated with marijuana use. Thus, the purpose of this study was to examine the interactive effects of perceived neighborhood disorder and marijuana use on disinhibition. The sample included 120 African American female residents of disadvantaged neighborhoods (Mage = 23.6 ± 3.46). We employed hierarchical linear regression analysis to examine the interactive effects of marijuana use and perceived neighborhood disorder on disinhibition, while controlling for age and education. The interaction term was marginally significant (b = 5.66; t(109) = 1.72, p = .08). Next, the conditional effects were explored. Results indicated the association of marijuana use with disinhibition was stronger for females in the higher neighborhood disorder group, compared to those in the lower neighborhood disorder group (10.40 and 4.51, respectively). Our findings support the need for more research on the potential of neighborhood disorder to amplify the effects of marijuana use on disinhibition and related neurobehavioral traits. The identification of contextual moderators and high-risk sub-groups will aid in the design of more tailored place-based interventions that aim to reduce risk-taking behavior among those most vulnerable.
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12
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Martínez-Loredo V. Critical appraisal of the discussion on delay discounting by Bailey et al. and Stein et al.: A scientific proposal for a reinforcer pathology theory 3.0. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2022.101006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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13
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Walia H, Tucker LYS, Manickam RN, Kene MV, Sharp AL, Berdahl CT, Hirschtritt ME. Patient and Visit Characteristics Associated With Physical Restraint Use in the Emergency Department. Perm J 2023; 27:94-102. [PMID: 36464780 PMCID: PMC10013723 DOI: 10.7812/tpp/22.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Objective Physical restraints are used in emergency departments (EDs) to address behavioral emergencies in situations in which less restrictive methods have failed. The objective of this study was to evaluate for associations between patient/visit characteristics and physical restraint use. Study Design This study was designed as a cross-sectional, retrospective study of all encounters at Kaiser Permanente Northern California EDs from January 1, 2016, to December 31, 2019, to evaluate differences in patient and visit characteristics between visits involving physical restraint use and those without. Methods Using electronic health record data, this study identified physical restraint use among ED encounters and extracted demographic, clinical, and facility characteristics. The authors calculated odds ratios for physical restraint placement, adjusting for patient and visit characteristics and accounting for within-patient clustering. Results Among 4,410,816 encounters (representing 1,791,673 patients), 6369 encounters (0.1%) involved physical restraint use among 5,554 patients (0.3%). Variables associated with the lowest odds of physical restraint included female sex, presentation to the ED in more recent years, and presence of intentional self-harm/suicidal ideation. Variables associated with the highest odds of physical restraint included higher visit acuity and weekend presentations to the ED. Discussion This study, which leveraged a large, diverse patient sample generalizable to the Northern California population, found several patient and visit characteristics associated with physical restraint use in the ED. Conclusion Results of this study may help identify patient groups and situational factors that are most likely to lead to physical restraint use and structural factors contributing to disparities in care, thereby informing interventions to reduce physical restraint use when possible.
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Affiliation(s)
- Harbir Walia
- Department of Psychiatry, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Lue-Yen S Tucker
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Raj N Manickam
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Mamata V Kene
- Department of Emergency Medicine, Kaiser Permanente Fremont Medical Center, Greater Southern Alameda Area, Fremont, CA, USA
| | - Adam L Sharp
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.,Department of Clinical Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA
| | - Carl T Berdahl
- Departments of Medicine and Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Matthew E Hirschtritt
- Department of Psychiatry, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.,Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.,Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
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14
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Stewart K, Kendler KS, Westholm A, Ohlsson H, Sundquist J, Sundquist K. Spatiotemporal patterns of drug use disorder in Sweden assessed using population-based registries. BMC Public Health 2023; 23:266. [PMID: 36750781 PMCID: PMC9906828 DOI: 10.1186/s12889-023-15149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 01/27/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Drug Use Disorder (DUD) is a major contributor to world-wide morbidity and mortality. The extensive national registers in Sweden provide the basis for a study of spatial and temporal patterns of DUD onset and recurrence in Sweden from 2001-2015. METHODS To identify patterns of DUD over space, time and gender for Swedish individuals aged 15-35, space-time clustering using SaTScan was applied. We used yearly information on residential locations in Demographic Statistical Areas (DeSO) for all of Sweden. The clustering analysis used a Poisson probability model and a null hypothesis that the expected number of cases in each DeSO was proportional to the population size of DeSOs. As SaTScan results can be unstable, steps were taken to determine stable clusters and to refine and optimize cluster size. Results for each gender-register combination were compared to the results of spatial clustering using Gi* statistics. The space-time scanning model was also run with an adjustment for neighborhood socioeconomic status to determine DUD prevalence as it relates to education, income, unemployment and receipt of social welfare. RESULTS DUD prevalence increased over time. Males yielded more significant clusters than females for both criminal and medical registers. Female DUD prevalence rates increased over time, especially after 2012. Higher correlations in DUD rates existed across the two registers than across gender. Male clusters were present from 2004 onwards while female-criminal clusters appeared after 2007, and female-medical clusters not until 2010. By 2013, clusters existed for all gender-register combinations. Male-criminal clusters were concentrated in Stockholm, Göteborg and Malmö as were male and female-medical clusters. Neighborhood SES was more highly related to the distribution of criminal than medical DUD clusters. A persistent gap in core clusters was identified in Stockholm in an area with notably high SES. CONCLUSIONS Persistent hotspots of DUD in Sweden were confirmed as well as new and emerging hotspots, especially in Stockholm, Göteborg and Malmö. Higher correlations existed in DUD rates across registers than across gender. The findings are useful for monitoring the current drug problem and for identifying drivers underlying patterns of spread and important causal pathways to DUD.
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Affiliation(s)
- Kathleen Stewart
- Center for Geospatial Information Science, Department of Geographical Sciences, University of Maryland, College Park, MD, 20742, USA
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Anton Westholm
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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15
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Shirley K, O’Neil M, Boyd S, Loftis JM. Differences in rates of impairment in adults who use methamphetamine using two sets of demographically corrected norms. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-9. [PMID: 36668907 PMCID: PMC10356906 DOI: 10.1080/23279095.2022.2164197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Neuropsychologists can expect to meet with increasing rates of patients who use methamphetamine (MA), as MA use is on the rise, often comorbid with other substance use disorders, and frequently accompanied by changes in cognitive functioning. To detect impairment, neuropsychologists must apply the appropriate normative data according to important demographic factors such as age, sex, and education. This study involved 241 adults with and without MA dependence who were administered the Neuropsychological Assessment Battery. Given the high rates of polysubstance use among adults who use MA, we included adults with mono-dependence and poly-dependence on MA and at least one other substance. We compared the rates of adults with and without previous MA dependence classified as impaired on neurocognitive testing when using norms corrected for age, education, and sex versus norms corrected only for age. Norms corrected for age, education, and sex resulted in less frequent identification of impairment compared to norms corrected only for age, but both sets of norms appeared sufficient and similar enough to warrant their use with this population. It may be appropriate to explore the possible implications of discrepancies between education-corrected and non-education corrected sets of scores when assessing impairment in individuals who use MA.
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Affiliation(s)
- Kate Shirley
- Research & Development Service, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Maya O’Neil
- Research & Development Service, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, OR, USA
- Mental Health & Clinical Neurosciences Division, VA Portland Health Care System, Portland, OR, USA
| | - Stephen Boyd
- Department of Anesthesiology and Perioperative Medicine, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Jennifer M. Loftis
- Research & Development Service, VA Portland Health Care System, Portland, OR, USA
- Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland, OR, USA
- Department of Behavioral Neuroscience, School of Medicine, Oregon Health & Science University, Portland, OR, USA
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16
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Guindon GE, Montreuil A, Driezen P, Stahlbaum R, Giolat D, Baskerville NB. Do cigarette prices near secondary schools vary by area-level socioeconomic status? Findings from a field study in Ontario and Québec, Canada. Health Place 2023; 79:102936. [PMID: 36493496 DOI: 10.1016/j.healthplace.2022.102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/18/2022] [Accepted: 11/03/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To examine, in the context of youth smoking, whether cigarette prices near secondary schools varied by area-level socioeconomic status in Southwestern and Central Ontario, and the greater Montréal region. METHODS We collected cigarette prices four times between 2016 and 2019 from stores near secondary schools and used mixed-effects and ordinary least squares regressions. RESULTS We found consistent evidence that cigarette prices near secondary schools were lower in neighbourhoods with lower area-level household income, and that differences were large enough to be meaningful. In Ontario and Québec, our results indicate a Can$0.26 [0.04, 0.47] to Can$0.51 [0.33, 0.69] and Can$0.10 [-0.04, 0.24] to Can$0.37 [0.22, 0.52] difference in prices for a pack of 25 cigarettes between neighbourhoods with a median household income standard deviation below/above the provincial median, respectively. CONCLUSION Policy changes that limit area-level cigarette price differences without lowering cigarette prices may reduce inequities in youth smoking.
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Affiliation(s)
- G Emmanuel Guindon
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Economics, McMaster University, Hamilton, ON, Canada.
| | - Annie Montreuil
- Institut national de santé publique du Québec, Montréal, QC, Canada; Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada; School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Ryan Stahlbaum
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Didier Giolat
- Institut national de santé publique du Québec, Montréal, QC, Canada
| | - N Bruce Baskerville
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada; Canadian Institutes of Health Research, Ottawa, ON, Canada
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17
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Mahoney E, Karriker-Jaffe KJ, Mericle AA, Patterson D, Polcin DL, Subbaraman M, Witbrodt J. Do neighborhood characteristics of sober living houses impact recovery outcomes? A multilevel analysis of observational data from Los Angeles County. Health Place 2023; 79:102951. [PMID: 36535073 PMCID: PMC9928842 DOI: 10.1016/j.healthplace.2022.102951] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To identify neighborhood factors associated with recovery outcomes for sober living house (SLH) residents. METHODS Six-month longitudinal data for new SLH residents (n = 557) was linked with census tract data, services available, alcohol outlets, and Walk Scores® (0-100 score indicating access to neighborhood resources) for 48 SLHs in 44 neighborhoods in Los Angeles County. RESULTS Non-significant neighborhood characteristics in separate regressions for all outcomes were residents' ratings of perceived risk, percentage of residences with access to a car, percentage of homes over $500,000, percentage of renter-occupied units, percentage with income less than $25,000, percentage that were non-white, the density of substance inpatient within 10 miles, and transit scores from Walk Score®. Multilevel regressions found outpatient substance abuse treatment and density of AA groups were positively associated with more abstinent days. No neighborhood variables were associated with psychiatric symptoms. Higher perceived neighborhood cohesion, lower crime ratings, and better transportation ratings were associated with higher recovery capital. CONCLUSION Greater neighborhood densities of substance abuse services and AA groups may help residents achieve more days abstinent. While residents may achieve better substance use outcomes even with negative perceptions of the neighborhood, positive perceptions of the neighborhoods may help them acquire more recovery capital.
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Affiliation(s)
- Elizabeth Mahoney
- Behavioral Health and Recovery Studies, Public Health Institute, Oakland, CA, USA.
| | | | - Amy A Mericle
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Deidre Patterson
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
| | - Douglas L Polcin
- Behavioral Health and Recovery Studies, Public Health Institute, Oakland, CA, USA
| | - Meenakshi Subbaraman
- Behavioral Health and Recovery Studies, Public Health Institute, Oakland, CA, USA
| | - Jane Witbrodt
- Alcohol Research Group, Public Health Institute, Emeryville, CA, USA
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18
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Haeny AM, Gibbons FX, Fleischli ME, Gerrard M, Lopez J, Beach SRH. Racial centrality mediates the association between adolescent racial discrimination and adult cigarette smoking outcomes among Black Americans. Soc Sci Med 2023; 316:115225. [PMID: 35931591 PMCID: PMC10163899 DOI: 10.1016/j.socscimed.2022.115225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/01/2022] [Accepted: 07/15/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The objective of this study was to investigate racial centrality as a mediator of the association between Black adolescents' racial discrimination experiences and their cigarette use in early adulthood. METHODS The data were drawn from the Family and Community Health Study, which is a longitudinal study of Black American families that began in 1996. Families with a child in 5th grade who identified as Black or African American were recruited from Iowa and Georgia. At baseline, there were 838 Black American children. Hierarchical regressions and bootstrap tests of the indirect effects were used to investigate whether racial centrality at Wave 5 (mean age = 21.6 years) mediated the association between adolescent discrimination at Waves 1-4 (mean ages = 10.5-18.8 years) and adult cigarette use at wave 6 (mean age = 23.5 years). RESULTS Bivariate associations indicated racial discrimination was significantly associated positively with racial centrality and adult use of cigarettes. Racial centrality indirectly affected the association between racial discrimination and cigarette use such that greater racial centrality was associated with less cigarette use. Further, racial centrality predicted cessation among those who had smoked. Finally, racial centrality was higher among those who never smoked and those who had smoked and quit, relative to those who currently smoke. CONCLUSIONS These findings suggest that having strong Black racial centrality is a mediator that reduces the risk of cigarette use among young adults who experience racial discrimination in adolescence. In addition, racial centrality also predicts smoking cessation among young Black Americans who smoke. Translational implications of these findings are discussed.
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19
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Pinheiro LC, Groner L, Soroka O, Prosper AE, Jack K, Tamimi RM, Safford M, Phillips E. Analysis of Eligibility for Lung Cancer Screening by Race After 2021 Changes to US Preventive Services Task Force Screening Guidelines. JAMA Netw Open 2022; 5:e2229741. [PMID: 36053535 PMCID: PMC9440399 DOI: 10.1001/jamanetworkopen.2022.29741] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
IMPORTANCE Lung cancer incidence and mortality have disproportionate consequences for racial and ethnic minority populations. The extent to which the 2021 changes to the US Preventive Services Task Force (USPSTF) screening guidelines have reduced the racial disparity gap in lung cancer screening eligibility is not known. OBJECTIVE To assess the consequences of the changes in USPSTF low-dose computed tomography eligibility criteria for lung cancer screening between 2013 and 2021 among Black and White community-dwelling adults. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed data from the Reasons for Geographic and Racial Differences in Stroke study, a prospective longitudinal cohort study of community-dwelling Black and White adults 45 years and older who were initially recruited across the US between January 2003 and October 2007, with ongoing follow-up. All participants who would have been potentially eligible for lung cancer screening based on the 2021 USPSTF guidelines (N = 14 285) were included. Follow-up data for the current cohort study were collected and analyzed between January 2013 and December 2017, with final analysis performed in 2021. EXPOSURES Self-reported Black vs White race. PRIMARY OUTCOMES AND MEASURES Differences in the proportion of Black vs White participants eligible for lung cancer screening according to 2013 and 2021 guidelines were assessed using modified Poisson models with robust SEs. Associations between important covariates (demographic characteristics and social factors associated with health), including interaction and dissimilarity indices (2 measures of residential segregation), and differences in screening eligibility were also examined. RESULTS Among 14 285 participants (mean [SD] age, 64.7 [7.5] years; 7675 men [53.7%]), 5787 (40.5%) self-identified as Black and 8498 (59.5%) as White. Based on the 2013 USPSTF guidelines, 1109 of 5787 Black participants (19.2%) and 2313 of 8498 White participants (27.2%) were eligible for lung cancer screening (difference, -8.06 percentage points; 95% CI, -9.44 to -6.67 percentage points). Based on the 2021 guidelines, 1667 of 5787 Black participants (28.8%) and 2940 of 8498 White participants (34.6%) were eligible for screening (difference, -5.73 percentage points; 95% CI, -7.28 to -4.19 percentage points). After adjustment for differences in individual characteristics and residential segregation, the 2013 difference in screening eligibility among Black vs White participants was -12.66 percentage points (95% CI, -14.71 to -10.61 percentage points), and the 2021 difference was -12.15 percentage points (95% CI, -14.37 to -9.93 percentage points). CONCLUSIONS AND RELEVANCE In this study, 2021 changes to the USPSTF lung cancer screening guidelines were associated with reductions in but not elimination of existing eligibility disparities in lung cancer screening among Black and White adults. These findings suggest that accounting for factors beyond age and pack-years of smoking is needed when tailoring guidelines to improve screening eligibility among groups at high risk of lung cancer.
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Affiliation(s)
- Laura C. Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Lauren Groner
- Department of Radiology, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
| | - Orysya Soroka
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
| | - Ashley E. Prosper
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles
| | - Kellie Jack
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
| | - Rulla M. Tamimi
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
| | - Monika Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
| | - Erica Phillips
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
- Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York–Presbyterian Hospital, New York
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20
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Poudel R, Tobia MJ, Riedel MC, Salo T, Flannery JS, Hill-Bowen LD, Dick AS, Laird AR, Parra CM, Sutherland MT. Risky decision-making strategies mediate the relationship between amygdala activity and real-world financial savings among individuals from lower income households: A pilot study. Behav Brain Res 2022; 428:113867. [PMID: 35385783 PMCID: PMC10739684 DOI: 10.1016/j.bbr.2022.113867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 03/06/2022] [Accepted: 03/28/2022] [Indexed: 11/19/2022]
Abstract
Lower financial savings among individuals experiencing adverse social determinants of health (SDoH) increases vulnerabilities during times of crisis. SDoH including low socioeconomic status (low-SES) influence cognitive abilities as well as health and life outcomes that may perpetuate poverty and disparities. Despite evidence suggesting a role for financial growth in minimizing SDoH-related disparities and vulnerabilities, neurobiological mechanisms linked with financial behavior remain to be elucidated. As such, we examined the relationships between brain activity during decision-making (DM), laboratory-based task performance, and money savings behavior. Participants (N = 24, 14 females) from low-SES households (income<$20,000/year) underwent fMRI scanning while performing the Balloon Analogue Risk Task (BART), a DM paradigm probing risky- and strategic-DM processes. Participants also completed self-report instruments characterizing relevant personality characteristics and then engaged in a community outreach financial program where amount of money saved was tracked over a 6-month period. Regarding BART-related brain activity, we observed expected activity in regions implicated in reward and emotional processing including the amygdala. Regarding brain-behavior relationships, we found that laboratory-based BART performance mediated the impact of amygdala activity on real-world behavior. That is, elevated amygdala activity was linked with BART strategic-DM which, in turn, was linked with more money saved after 6 months. In exploratory analyses, this mediation was moderated by emotion-related personality characteristics such that, only individuals reporting lower alexithymia demonstrated a relationship between amygdala activity and savings. These outcomes suggest that DM-related amygdala activity and/or emotion-related personality characteristics may provide utility as an endophenotypic marker of individual's financial savings behavior.
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Affiliation(s)
- Ranjita Poudel
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael J Tobia
- Department of Physics, Florida International University, Miami, FL, United States
| | - Michael C Riedel
- Department of Physics, Florida International University, Miami, FL, United States
| | - Taylor Salo
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Jessica S Flannery
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Lauren D Hill-Bowen
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Anthony S Dick
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, FL, United States
| | - Carlos M Parra
- College of Business, Florida International University, Miami, FL, United States
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, Miami, FL, United States.
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21
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Efrati Y, Spada MM. Self-perceived substance and behavioral addictions among Jewish Israeli adolescents during the COVID-19 pandemic. Addict Behav Rep 2022; 15:100431. [PMID: 35647261 PMCID: PMC9133580 DOI: 10.1016/j.abrep.2022.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022] Open
Abstract
This study examined self-perceived substance and behavioral addictions among Israeli adolescents during the COVID-19 pandemic across different sociodemographic categories. The sample comprised 2,074 adolescents (40% males, 60% females) aged 12-19 years who completed the survey anonymously and with parental consent. We examined what is the prevalence of self-perceived substance and behavioral addictions in this population in the COVID-19 pandemic context. Participants reported self-perceived addictions to social networks (70%), shopping (46%), binge eating (34%), gaming (30%), sex-related behavior (15%), psychoactive substance (31%, including alcohol, tobacco, cannabis, and/or cocaine), and gambling (3%). Moreover, differences were found to be directly related to age, biological sex, religiosity, socioeconomic status, and immigration status. From a lay epidemiological perspective, the current research expands our knowledge about self-perceived addiction among adolescents during the COVID-19 pandemic, offering better understanding of the likelihood probability factors for self-perceived addiction among adolescents and its related negative outcomes, including increased risk factors for later adult life.
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Affiliation(s)
- Yaniv Efrati
- Bar-Ilan University, Faculty of Education, Ramat Gan, Israel
| | - Marcantonio M. Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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22
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al’Absi M, DeAngelis B, Fiecas M, Budney A, Allen S. Effects of regular cannabis and nicotine use on acute stress responses: chronic nicotine, but not cannabis use, is associated with blunted adrenocortical and cardiovascular responses to stress. Psychopharmacology (Berl) 2022; 239:1551-1561. [PMID: 35275227 PMCID: PMC9248975 DOI: 10.1007/s00213-022-06087-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 02/09/2022] [Indexed: 11/24/2022]
Abstract
RATIONALE Cannabis is one of the most prevalent substances used by tobacco smokers and, in light of the growing list of states and territories legalizing cannabis, it is expected that co-use of cannabis and nicotine will escalate significantly and will lead to continuing challenges with tobacco use. OBJECTIVES This study was conducted to examine the interactive effects of chronic cannabis and nicotine use on adrenocortical, cardiovascular, and psychological responses to stress and to explore sex differences in these effects. METHODS Participants (N = 231) included cannabis-only users, nicotine-only users, co-users of both substances, and a non/light-user comparison group. After attending a medical screening session, participants completed a laboratory stress session during which they completed measures of subjective states, cardiovascular responses, and salivary cortisol during baseline (rest) and after exposure to acute stress challenges. RESULTS Nicotine use, but not cannabis use, was associated with blunted cortisol and cardiovascular responses to stress across both men and women. Men exhibited larger cortisol responses to stress than women. Co-users had significantly larger stress-related increases in cannabis craving than cannabis-only users. Cannabis users reported smaller increases in anxiety during stress than cannabis non/light-users, and both male nicotine-only users and male cannabis-only users experienced significantly smaller increases in stress than their non/light-user control counterparts. CONCLUSIONS This study replicates and extends earlier research on the impacts of sex and nicotine use on stress responses, and it provides novel findings suggesting that when co-used with nicotine, cannabis use may not confer additional alterations to physiological nor subjective responses to stress. Co-use, however, was associated with enhanced stress-related craving for cannabis.
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Affiliation(s)
- Mustafa al’Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA
| | - Briana DeAngelis
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA
| | - Mark Fiecas
- School of Public Health, Division of Biostatistics, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | | | - Sharon Allen
- Department of Family Medicine and Community Health, University of Minnesota, Twin Cities, Minneapolis, MN, USA
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Kupka P, Petruželka B, Walach V. Illicit drug use and exposure in disadvantaged neighborhoods in Czechia: policy representations and evidence. J Ethn Subst Abuse 2022; 21:662-686. [PMID: 32701039 DOI: 10.1080/15332640.2020.1793866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examines the lifetime prevalence of illicit drug use and illicit drug exposure in disadvantaged ("Roma") and more affluent neighborhoods in Czechia. The results of a survey among populations of both types of neighborhoods suggest no statistically significant difference between the two in terms of the overall lifetime prevalence of illicit drug use; however, lifetime prevalence of methamphetamine use proved higher in disadvantaged neighborhoods. The population of disadvantaged neighborhoods has also lower chances to use LSD during their lifetime. Further differences were identified in drug exposure, with the population of more affluent neighborhoods being more frequently exposed to illicit drugs than the population of disadvantaged neighborhoods. The predictors of drug use and drug exposure were partially different for both populations. In the disadvantaged population, drug use was revealed, among other predictors, to be associated with housing conditions.
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Affiliation(s)
- Petr Kupka
- University of West Bohemia, Pilsen, Czechia
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24
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Pasman JA, Demange PA, Guloksuz S, Willemsen AHM, Abdellaoui A, Ten Have M, Hottenga JJ, Boomsma DI, de Geus E, Bartels M, de Graaf R, Verweij KJH, Smit DJ, Nivard M, Vink JM. Genetic Risk for Smoking: Disentangling Interplay Between Genes and Socioeconomic Status. Behav Genet 2022; 52:92-107. [PMID: 34855049 PMCID: PMC8860781 DOI: 10.1007/s10519-021-10094-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/10/2021] [Indexed: 11/15/2022]
Abstract
This study aims to disentangle the contribution of genetic liability, educational attainment (EA), and their overlap and interaction in lifetime smoking. We conducted genome-wide association studies (GWASs) in UK Biobank (N = 394,718) to (i) capture variants for lifetime smoking, (ii) variants for EA, and (iii) variants that contribute to lifetime smoking independently from EA ('smoking-without-EA'). Based on the GWASs, three polygenic scores (PGSs) were created for individuals from the Netherlands Twin Register (NTR, N = 17,805) and the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2, N = 3090). We tested gene-environment (G × E) interactions between each PGS, neighborhood socioeconomic status (SES) and EA on lifetime smoking. To assess if the PGS effects were specific to smoking or had broader implications, we repeated the analyses with measures of mental health. After subtracting EA effects from the smoking GWAS, the SNP-based heritability decreased from 9.2 to 7.2%. The genetic correlation between smoking and SES characteristics was reduced, whereas overlap with smoking traits was less affected by subtracting EA. The PGSs for smoking, EA, and smoking-without-EA all predicted smoking. For mental health, only the PGS for EA was a reliable predictor. There were suggestions for G × E for some relationships, but there were no clear patterns per PGS type. This study showed that the genetic architecture of smoking has an EA component in addition to other, possibly more direct components. PGSs based on EA and smoking-without-EA had distinct predictive profiles. This study shows how disentangling different models of genetic liability and interplay can contribute to our understanding of the etiology of smoking.
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Affiliation(s)
- Joëlle A Pasman
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, PO Box 281, 171 77, Stockholm, Sweden.
| | - Perline A Demange
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Research Institute LEARN!, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - A H M Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Margreet Ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Eco de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Meike Bartels
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ron de Graaf
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Karin J H Verweij
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Dirk J Smit
- Department of Psychiatry, Amsterdam UMC, Amsterdam Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Michel Nivard
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jacqueline M Vink
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
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25
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Brgdar A, Gharbin J, Elawad A, Yi J, Sanchez J, Bishaw A, Taha ME, Ameyaw EE, Allen N, Prafulla M. Effects of Substance Use Disorder on In-Hospital Outcomes of Young Patients Presenting With a Cardiovascular Event: A Nationwide Analysis. Cureus 2022; 14:e22737. [PMID: 35386479 PMCID: PMC8969757 DOI: 10.7759/cureus.22737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/20/2022] Open
Abstract
Background Substance use is widely prevalent among young adults and is associated with increased cardiovascular morbidity and mortality such as sudden cardiac arrest, acute coronary syndrome, arrhythmias, and cardiomyopathy. However, they are limited studies analyzing the impact of substance use disorder on in-hospital outcomes among young patients with cardiovascular events. Methods All patients aged 18-39 years admitted primarily for major cardiovascular events including acute myocardial infarction (AMI), arrhythmia, cardiac arrest, acute ischemic stroke, and venous thromboembolic events in 2019 were identified in the National Inpatient Sample database. They were then categorized into those with and without concomitant substance use disorder (SUD). The primary outcome was in-hospital mortality. Unadjusted and adjusted analysis was performed on appropriate variables of interest. Results Of 57,985 hospitalizations with cardiac events, 12,115 (20%) of young adults had concomitant SUD. SUD was significantly associated with cardiac arrest (OR 3.3; CI 2.4-4.4), atrial fibrillation (OR 1.5; CI 1.3-1.7), AMI (OR 1.3; CI 1.2-1.6), heart failure (OR 2.6; CI 2.4-3.0) (all p<0.05) despite a lower prevalence of traditional cardiovascular risk factors than non-users. Logistic regression showed acute kidney injury (aOR 1.5; CI 1.3-1.8; p<0.001) and inpatient mortality (aOR 1.6; CI 1.2-2.2; p<0.001) were also significantly higher in young patients presenting with cardiac events and concomitant SUD. There was no difference in the length of stay or incidence of gastrointestinal bleed between the two groups. Conclusion In young patients presenting with a cardiovascular event, concurrent substance use disorder was associated with increased in-hospital mortality despite significantly lower comorbidities.
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Bernhardt C, King C. Neighborhood disadvantage and prescription drug misuse in low-income urban mothers. Drug Alcohol Depend 2022; 231:109245. [PMID: 34998251 DOI: 10.1016/j.drugalcdep.2021.109245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/04/2021] [Accepted: 12/06/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prescription drug misuse remains a persistent problem in the United States. Residents living in disadvantaged neighborhoods are at greater risk of substance abuse such as alcohol, tobacco, or drugs. However, whether neighborhood disadvantage affects prescription drug misuse remains underexplored. METHODS This study uses data on 3444 mothers from the Fragile Families and Child Wellbeing Study to examine the role of neighborhood disadvantage in prescription drug misuse. In addition, we examine whether social support and neighborhood collective efficacy (social cohesion and social control) explain this relationship. The analysis uses multivariate logistic regression and delineated between the following neighborhoods: affluent (3% poverty), low poverty (3-10%), moderate poverty (10-20%), and high poverty neighborhoods (20% or more). RESULTS Mothers living in moderately poor neighborhoods were more than twice as likely (odds = 2.17, 95% CI: 1.43-3.27) to misuse prescription drugs than mothers living in neighborhoods with high poverty. Mothers living in neighborhoods with high poverty did not have a statistically significant difference in prescription drug misuse than those living in affluent or low poverty neighborhoods. Social support and neighborhood collective efficacy did not explain these associations. The association between moderate poverty and prescription drug misuse was mostly direct and there was no indirect association. CONCLUSION The study highlights the higher risk of prescription drug misuse among mothers living in neighborhoods with moderate poverty. Interventions aimed at reducing opioid misuse should focus on demographic groups that are more vulnerable such as low-income mothers living in disadvantaged neighborhoods.
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Affiliation(s)
| | - Christian King
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA.
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McCarty D, Shanahan M. Theory-Informed Clinical Practice: How Physical Therapists Can Use Fundamental Interventions to Address Social Determinants of Health. Phys Ther 2021; 101:6308777. [PMID: 34174078 DOI: 10.1093/ptj/pzab158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/14/2021] [Accepted: 04/25/2021] [Indexed: 11/14/2022]
Abstract
UNLABELLED The American Physical Therapy Association's Vision Statement for the profession is guided by principles of innovation, access, equity, and advocacy, and calls on physical therapists to stretch their influence beyond the walls of the clinic and the individuals they treat. Access and equity are problems that span multiple health care professions and entities; yet, addressing social determinants of health is a paradigm shift that clinicians need continued support to achieve. This article has 2 objectives: (1) to define the Fundamental Cause Theory and the Socioecological Model within the context of physical therapy in order to promote best clinical practice, and (2) to apply the concept of "fundamental interventions" in clinical practice to mitigate the negative impact of downstream effects of social determinants of health across levels of the Socioecological Model-individual, interpersonal, institutional, community, and societal. This theoretical lens provides the conceptual framework necessary for physical therapists to think creatively about ways to change their practice in their own contexts to impact the life of individual patients and transform the movement health of society. IMPACT As health care providers, physical therapists have a responsibility to make every effort to meet the needs of their patients and optimize movement health in society; yet significant structural and systemic barriers often prevent patients from reaching their fullest potential. Clinicians can no longer subscribe to a narrow scope of practice focused on individual attainment of therapy goals. This Perspective discusses Fundamental Cause Theory and the Socioecological Model theoretical frameworks that can help physical therapists develop, test, and implement functional interventions to address the needs of society as a whole.
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Affiliation(s)
- Dana McCarty
- Division of Physical Therapy, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meghan Shanahan
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Zhen-Duan J, Fukuda M, DeJonckheere M, Falgas-Bagué I, Miyawaki S, Khazi P, Alegría M. Ensuring access to high-quality substance use disorder treatment for Medicaid enrollees: A qualitative study of diverse stakeholders' perspectives. J Subst Abuse Treat 2021; 129:108511. [PMID: 34176694 PMCID: PMC8380648 DOI: 10.1016/j.jsat.2021.108511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/01/2021] [Accepted: 05/26/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Medicaid programs are vital to ensure low-income individuals have access to substance use disorder (SUD) treatment. However, shifts in Medicaid policies may alter coverage and SUD care for this population, who already face difficulties receiving high-quality SUD treatment. Using a policy implementation research approach, we sought to identify barriers and facilitators when transitioning from Medicaid fee-for-service to managed care plan structures and opportunities for improving SUD care in New York State (NYS). METHOD Study staff conducted semistructured, in-depth qualitative interviews (N = 40 total) with diverse stakeholders involved with different aspects of SUD treatment in NYS, including policy leaders (n = 13), clinicians (n = 12), Medicaid managed care plan administrators (n = 5), and patients (n = 10). RESULTS Findings from thematic analysis centered on three themes: 1) while transitions to managed care have benefited clinicians, certain policies affect patients' Medicaid enrollment and quality of care; 2) stakeholders perceived individuals with dual diagnoses, older adults, and linguistic minorities to be at higher risk for inadequate care; and 3) current quality metrics may not adequately capture treatment quality. CONCLUSION Policy changes should focus on promoting increased collaboration among stakeholders, expanding Medicaid coverage, and reducing stigma. Resources should be diverted to facilitate psychiatric care for patients with dual diagnoses and to build workforce capacity to adequately meet the needs of older adults and linguistic minorities. Opportunities for NYS Medicaid include adapting performance metrics to capture meaningful patient outcomes and link reimbursements to improvements in patients' quality of life.
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Affiliation(s)
- Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
| | - Marie Fukuda
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Irene Falgas-Bagué
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven Miyawaki
- Department of Sociology, Bowdoin College, Brunswick, ME, USA
| | - Parwana Khazi
- Department of Public Health, Santa Clara University, Santa Clara, CA, USA
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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29
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Genetic correlates of socio-economic status influence the pattern of shared heritability across mental health traits. Nat Hum Behav 2021. [PMID: 33686200 DOI: 10.1038/s41562-021-01053-4.genetic] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Epidemiological studies show high comorbidity between different mental health problems, indicating that individuals with a diagnosis of one disorder are more likely to develop other mental health problems. Genetic studies reveal substantial sharing of genetic factors across mental health traits. However, mental health is also genetically correlated with socio-economic status (SES), and it is therefore important to investigate and disentangle the genetic relationship between mental health and SES. We used summary statistics from large genome-wide association studies (average N ~ 160,000) to estimate the genetic overlap across nine psychiatric disorders and seven substance use traits and explored the genetic influence of three different indicators of SES. Using genomic structural equation modelling, we show significant changes in patterns of genetic correlations after partialling out SES-associated genetic variation. Our approach allows the separation of disease-specific genetic variation and genetic variation shared with SES, thereby improving our understanding of the genetic architecture of mental health.
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30
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Marees AT, Smit DJ, Abdellaoui A, Nivard MG, van den Brink W, Denys D, Galama TJ, Verweij KJ, Derks EM. Genetic correlates of socio-economic status influence the pattern of shared heritability across mental health traits. Nat Hum Behav 2021; 5:1065-1073. [PMID: 33686200 PMCID: PMC8376746 DOI: 10.1038/s41562-021-01053-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 01/13/2021] [Indexed: 01/31/2023]
Abstract
Epidemiological studies show high comorbidity between different mental health problems, indicating that individuals with a diagnosis of one disorder are more likely to develop other mental health problems. Genetic studies reveal substantial sharing of genetic factors across mental health traits. However, mental health is also genetically correlated with socio-economic status (SES), and it is therefore important to investigate and disentangle the genetic relationship between mental health and SES. We used summary statistics from large genome-wide association studies (average N ~ 160,000) to estimate the genetic overlap across nine psychiatric disorders and seven substance use traits and explored the genetic influence of three different indicators of SES. Using genomic structural equation modelling, we show significant changes in patterns of genetic correlations after partialling out SES-associated genetic variation. Our approach allows the separation of disease-specific genetic variation and genetic variation shared with SES, thereby improving our understanding of the genetic architecture of mental health.
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Affiliation(s)
- Andries T. Marees
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands,QIMR Berghofer, Translational Neurogenomics group, Brisbane, Queensland, Australia,Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, the Netherlands,Correspondence: Andries T. Marees () Eske M. Derks ()
| | - Dirk J.A. Smit
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Michel G. Nivard
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Titus J. Galama
- Department of Economics, School of Business and Economics, VU University Amsterdam, Amsterdam, the Netherlands,University of Southern California, Dornsife Center for Economic and Social Research (CESR), Los Angeles, CA, USA,Erasmus School of Economics, Erasmus University, Rotterdam, The Netherlands
| | - Karin J.H. Verweij
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Eske M. Derks
- QIMR Berghofer, Translational Neurogenomics group, Brisbane, Queensland, Australia,Correspondence: Andries T. Marees () Eske M. Derks ()
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31
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Blondino CT, Clifford JS, Lu J, Prom-Wormley EC. The association between internalizing and externalizing severity with current use of cigarettes, e-cigarettes, and alcohol in adults: Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. Addict Behav 2021; 119:106890. [PMID: 33901812 PMCID: PMC9294613 DOI: 10.1016/j.addbeh.2021.106890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/26/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Concurrent tobacco/alcohol use is common in adults, and associated with the severity of symptoms experienced by those with mental health disorders. However, few studies have explored this relationship across different combinations of tobacco products [i.e., conventional cigarette (CC) and electronic cigarette (EC)] and alcohol. METHODS Data from the Wave 1 (2013-2014) Population Assessment of Tobacco and Health study were used. A total of 15,947 adults aged 18 years or older with complete study information were included. Multinomial logistic regression analyses were performed to determine the relationship between lifetime internalizing/externalizing severity and past 30-day use of tobacco and alcohol, adjusting for nicotine dependence (ND), sex, age, race, education, and income. RESULTS Internalizing severity was more strongly associated with CC and alcohol use (moderate AOR = 1.47, 95% CI = 1.22-1.77; high AOR = 1.29, 95% CI = 1.03-1.61) as well as alcohol-exclusive use (moderate AOR = 1.58, 95% CI = 1.27-1.96; high AOR = 1.31, 95% CI = 1.05-1.64) while externalizing severity was more strongly associated with EC and alcohol use (high AOR = 2.97, 95% CI = 1.84-4.81, moderate AOR = 2.29, 95% CI = 1.53-3.43) when accounting for ND compared to none. The relationship between externalizing severity with EC use was dependent on alcohol being used with EC. CONCLUSIONS The associations between psychopathology (internalizing vs. externalizing severity) varies by different combinations of alcohol, CC, and EC. Further, these relationships may be mediated through ND. Future investigations into the comorbidity between mental disorder symptoms with tobacco and alcohol use should consider use of specific substances as well as their combination.
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Affiliation(s)
- Courtney T Blondino
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA.
| | - James S Clifford
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA
| | - Juan Lu
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA
| | - Elizabeth C Prom-Wormley
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA
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32
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Bensley KMK, Kerr WC, Barnett SB, Mulia N. Postmortem screening of opioids, benzodiazepines, and alcohol among rural and urban suicide decedents. J Rural Health 2021; 38:77-86. [PMID: 33817837 DOI: 10.1111/jrh.12574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE Fatal suicides involving opioids are increasingly common, particularly in rural areas. As co-use of opioids with other substances contributes significantly to mortality risk, we examined whether positive screens for opioids with other substances is more prevalent among rural versus urban suicide deaths, as this could have implications for public health strategies to reduce overdose suicides. METHODS Data from all states reporting opioid-related overdose suicides in the National Violent Death Reporting System from 2012 to 2015 were used. Relative risk ratios were obtained using multinomial logistic regression, comparing opioid-only to (1) opioid and alcohol, (2) opioid and benzodiazepines, and (3) opioid, alcohol, and benzodiazepines suicides across rurality. Models were fit using robust standard errors and fixed effects for year of death, adjusting for individual, county, and state-level covariates. FINDINGS There were 3,781 opioid-overdose suicide decedents (42% female) tested for all 3 substances during the study period. Unadjusted prevalence of positive screens in decedents varied across rurality (P = .022). Urban decedents were more likely to test positive for opioids alone, while rural decedents were more to likely test positive for opioids and benzodiazepines. CONCLUSIONS Rural suicides are associated with increased opioid and benzodiazepine positive screens. These findings suggest the need for rural-focused interventions to support appropriate co-prescribing, better health education for providers about risks associated with drug mixing, and more linkages with mental health services.
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Affiliation(s)
- Kara Marie Kubiak Bensley
- School of Public Health, University of California, Berkeley, California, USA.,Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Sarah Beth Barnett
- School of Public Health, University of California, Berkeley, California, USA.,Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Nina Mulia
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
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Holmes LM, Thrul J, Warren NK, Ling PM. Local variation in cannabis use patterns among young adults in the San Francisco Bay Area. Spat Spatiotemporal Epidemiol 2021; 37:100418. [PMID: 33980412 DOI: 10.1016/j.sste.2021.100418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 02/25/2021] [Accepted: 03/15/2021] [Indexed: 11/15/2022]
Abstract
This study evaluated whether neighborhood-level disorder, social cohesion, and perceived safety, were associated with days of cannabis use in the prior month in a representative sample of young adults in Alameda and San Francisco Counties in California (N = 1272). We used multiscale geographically weighted regression, modeled by county, to measure associations between cannabis use days and neighborhood attributes, adjusting for sociodemographic characteristics and self-rated health. Positive associations were found between number of cannabis use days and neighborhood disorder, and greater perceived safety. Higher levels of social cohesion predicted fewer cannabis use days. Racial/ethnic, sex and, socioeconomic compositions of participants residing in areas with significant neighborhood-level associations varied substantially, suggesting that risk factors for young adult cannabis use may be highly localized. Public health efforts in cannabis education and intervention should be tailored to fit the culture and composition of local neighborhoods.
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Affiliation(s)
- Louisa M Holmes
- Department of Geography & Social Science Research Institute, Pennsylvania State University, 302 Walker Building, University Park, PA 16802, United States.
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Baltimore, MD 21205, United States
| | - Natalie K Warren
- School of Public Health, University of California, Berkeley, 50 University Hall #7360, Berkeley, CA 94720, United States
| | - Pamela M Ling
- Center for Tobacco Control & Research Education, Department of General Internal Medicine, University of California San Francisco, 530 Parnassus Avenue, San Francisco, CA 94143, United States
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Kelly BC, Vuolo M. Developing explanatory models for life course shifts in the burden of substance use to inform future policy and practice. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103182. [PMID: 33685803 DOI: 10.1016/j.drugpo.2021.103182] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/23/2020] [Accepted: 02/17/2021] [Indexed: 01/10/2023]
Abstract
Past approaches to policy and practice for substance use have focused heavily on young people, but recent trends indicate this approach may not be where the future lies. The crises with escalating overdose mortality in several countries, particularly overdoses related to opioids, have drawn attention to life course shifts in the burdens of substance use. Overdose mortality rates for individuals in midlife have considerably outpaced those of adolescents and individuals in early adulthood. These diverging life course trends are occurring not only in the United States, but in other countries with growing overdose problems as well. The future of effective policy and practice depend upon evidence and analyses that adapt to emerging data on shifting life course trends in drug related mortality. Within this manuscript, we consider a range of theoretical possibilities on the divergence of midlife drug mortality trends from those of young people for the purpose of outlining an agenda for future research and practice. Specifically, we consider the following theoretical approaches to move research forward in this area: Changes in Medical Context hypothesis; Emergent Comorbidities hypothesis; Cohort hypothesis; Generational Forgetting hypothesis; Legal Regulation hypothesis; Strength of Life Course Bonds hypothesis; Deepening Inequality hypothesis; Measurement Reliability hypothesis. These theoretical frameworks attend specifically to the overdose crisis but extend to other aspects of substance use. Beyond setting an agenda for research by providing empirically verifiable hypotheses, this manuscript also identifies future directions in policy and practice that are attentive to life course trends.
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Affiliation(s)
- Brian C Kelly
- Department of Sociology, Purdue University, 700 W State St, West Lafayette, IN, 47907, USA
| | - Mike Vuolo
- Department of Sociology, The Ohio State University, 238 Townshend Hall, 1885 Neil Avenue Mall, Columbus, OH 43210, USA.
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Doshi R, Dave M, Majmundar M, Kumar A, Adalja D, Shariff M, Desai R, Ziaeian B, Vallabhajosyula S. National rates and trends of tobacco and substance use disorders among atrial fibrillation hospitalizations. Heart Lung 2021; 50:244-251. [PMID: 33359929 PMCID: PMC8310779 DOI: 10.1016/j.hrtlng.2020.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Atrial Fibrillation (AF) has been associated with various behavioral risk factors such as tobacco, alcohol, and/or substances abuse. OBJECTIVE The main objective is to describe the national trends and burden of tobacco and substance abuse in AF hospitalizations. Also, this study identifies potential population who are more vulnerable to these substance abuse among AF hospitalizations. METHODS The National Inpatient Sample database from 2007 to 2015 was utilized and the hospitalizations with AF were identified using the international classification of disease, Ninth Revision, Clinical Modification code. They were stratified into without abuse, tobacco use disorder (TUD), substance use disorder (SUD), alcohol use disorder (AUD) and drug use disorder (DUD). RESULTS Of 3,631,507 AF hospitalizations, 852,110 (23.46%) had TUD, 1,851,170 (5.1%) had SUD, 155,681 (4.29%) had AUD and 42,667 (1.17%) had DUD. The prevalence of TUD, SUD, AUD, and DUD was substantially increased across all age groups, races, and gender during the study period. Female sex was associated with lower odds TUD, SUD, AUD, and DUD. Among AF hospitalizations, the black race was associated with higher odds of SUD, and DUD. The younger age group (18-35 years), male, Medicare/Medicaid as primary insurance, and lower socioeconomic status were associated with increased risk of both TUD and SUDs. CONCLUSION TUD and SUD among AF hospitalizations in the United States mainly affects males, younger individuals, white more than black, and those of lower socioeconomic status which demands for the development of preventive strategies to address multilevel influences.
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Affiliation(s)
- Rajkumar Doshi
- Department of Internal Medicine, University of Nevada Reno School of Medicine, , 1155 Mill St, W-11, Reno, NV 89502, USA.
| | - Mihir Dave
- Department of Internal Medicine, University of Nevada Reno School of Medicine, , 1155 Mill St, W-11, Reno, NV 89502, USA
| | - Monil Majmundar
- Department of Internal Medicine, Metropolitan Medical Center, New York, NY, USA
| | - Ashish Kumar
- Department of Critical Care Medicine, St John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Devina Adalja
- Department of Medicine, GMERS Gotri Medical College, Vadodara, Gujarat, India
| | - Mariam Shariff
- Department of Critical Care Medicine, St John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Rupak Desai
- Department of Cardiology, Atlanta VA Medical Center, Decatur, GA, United States
| | - Boback Ziaeian
- Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA; Division of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Saraschandra Vallabhajosyula
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Center for Clinical and Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, MN, USA
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36
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Knaappila N, Marttunen M, Fröjd S, Lindberg N, Kaltiala R. Changes in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. J Cannabis Res 2020; 2:44. [PMID: 33526131 PMCID: PMC7819333 DOI: 10.1186/s42238-020-00052-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine trends in cannabis use according to socioeconomic status among Finnish adolescents from 2000 to 2015. METHODS A population-based school survey was conducted biennially among 14-16-year-old Finns between 2000 and 2015 (n = 761,278). Distributions for any and frequent cannabis use over time according to socioeconomic adversities were calculated using crosstabs and chi-square test. Associations between any and frequent cannabis use, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95% confidence intervals. RESULTS At the overall level, the prevalences of lifetime and frequent cannabis use varied only slightly between 2000 and 2015. Cannabis use was associated with socioeconomic adversities (parental unemployment in the past year, low parental education, and not living with both parents). The differences in any and frequent cannabis use between socioeconomic groups increased significantly over the study period. CONCLUSIONS Although the overall changes in the prevalence of adolescent cannabis use were modest, cannabis use increased markedly among adolescents with the most socioeconomic adversities. Socioeconomic adversities should be considered in the prevention of adolescent cannabis use.
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Affiliation(s)
- Noora Knaappila
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Mauri Marttunen
- Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, PO Box 22, FI-00014 Helsinki, Finland
| | - Sari Fröjd
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Nina Lindberg
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, PO Box 590, 00029 HUS, Helsinki, Finland
| | - Riittakerttu Kaltiala
- Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
- Vanha Vaasa Hospital, Vierinkiventie 1, 65380 Vaasa, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, 33380 Pitkäniemi, Finland
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37
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Zhang‐James Y, Chen Q, Kuja‐Halkola R, Lichtenstein P, Larsson H, Faraone SV. Machine-Learning prediction of comorbid substance use disorders in ADHD youth using Swedish registry data. J Child Psychol Psychiatry 2020; 61:1370-1379. [PMID: 32237241 PMCID: PMC7754321 DOI: 10.1111/jcpp.13226] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 01/03/2020] [Accepted: 01/28/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Children with attention-deficit/hyperactivity disorder (ADHD) have a high risk for substance use disorders (SUDs). Early identification of at-risk youth would help allocate scarce resources for prevention programs. METHODS Psychiatric and somatic diagnoses, family history of these disorders, measures of socioeconomic distress, and information about birth complications were obtained from the national registers in Sweden for 19,787 children with ADHD born between 1989 and 1993. We trained (a) a cross-sectional random forest (RF) model using data available by age 17 to predict SUD diagnosis between ages 18 and 19; and (b) a longitudinal recurrent neural network (RNN) model with the Long Short-Term Memory (LSTM) architecture to predict new diagnoses at each age. RESULTS The area under the receiver operating characteristic curve (AUC) was 0.73(95%CI 0.70-0.76) for the random forest model (RF). Removing prior diagnosis from the predictors, the RF model was still able to achieve significant AUCs when predicting all SUD diagnoses (0.69, 95%CI 0.66-0.72) or new diagnoses (0.67, 95%CI: 0.64, 0.71) during age 18-19. For the model predicting new diagnoses, model calibration was good with a low Brier score of 0.086. Longitudinal LSTM model was able to predict later SUD risks at as early as 2 years age, 10 years before the earliest diagnosis. The average AUC from longitudinal models predicting new diagnoses 1, 2, 5 and 10 years in the future was 0.63. CONCLUSIONS Population registry data can be used to predict at-risk comorbid SUDs in individuals with ADHD. Such predictions can be made many years prior to age of the onset, and their SUD risks can be monitored using longitudinal models over years during child development. Nevertheless, more work is needed to create prediction models based on electronic health records or linked population registers that are sufficiently accurate for use in the clinic.
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Affiliation(s)
- Yanli Zhang‐James
- Department of Psychiatry and Behavioral SciencesSUNY Upstate Medical UniversitySyracuseNYUSA
| | - Qi Chen
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Ralf Kuja‐Halkola
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Henrik Larsson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
- School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Stephen V. Faraone
- Department of Psychiatry and Behavioral SciencesSUNY Upstate Medical UniversitySyracuseNYUSA
- Department of Neuroscience and PhysiologySUNY Upstate Medical UniversitySyracuseNYUSA
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38
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Trucco EM. A review of psychosocial factors linked to adolescent substance use. Pharmacol Biochem Behav 2020; 196:172969. [PMID: 32565241 PMCID: PMC7415605 DOI: 10.1016/j.pbb.2020.172969] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/23/2020] [Accepted: 06/14/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Informed by ecological theories and models of influence, this review discusses various psychosocial risk and protective factors that contribute to adolescent substance use behavior. Given typical patterns of substance use initiation during this developmental period, an emphasis is placed on alcohol, cigarette, and marijuana use. FINDINGS Consistent with bioecological theories, peers and parents tend to have the strongest effect on adolescent substance use behavior. Influences can be both direct, such as offers and availability to use substances, as well as indirect influences, such as the perception of substance use approval. Schools and neighborhoods also contribute to adolescent substance use behavior, but this effect is often less direct. Moreover, the effect of neighborhoods on adolescent behavior reflects both structural components (e.g., neighborhood racial composition, teacher-student ratios) in addition to social process (e.g., neighborhood social cohesion, school connectedness). A review of parallel studies conducted with animals is also provided. SUMMARY Adolescent substance use behavior does not occur in a vacuum. Investigations must encompass the relevant social ecologies that affect adolescent behavior, including family, peer, school, and neighborhood contexts to provide a more complete understanding of substance use etiology.
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Affiliation(s)
- Elisa M Trucco
- Florida International University, Psychology Department, Center for Children and Families, 11200 SW 8th Street, AHC-1, Miami, FL 33199, United States of America.
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39
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Guindon GE, Fatima T, Abbat B, Bhons P, Garasia S. Area-level differences in the prices of tobacco and electronic nicotine delivery systems - A systematic review. Health Place 2020; 65:102395. [PMID: 32858241 DOI: 10.1016/j.healthplace.2020.102395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/30/2020] [Accepted: 07/09/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To examine associations between area-level characteristics (socioeconomic status, racial or ethnic characteristics, age, and any other characteristics that may be associated with vulnerability) and the prices of tobacco products and electronic nicotine delivery systems (ENDS). DATA SOURCES We searched MEDLINE, EconLit and Scopus, unpublished and grey literature, hand-searched four specialty journals, examined references of relevant studies, and contacted key informants. STUDY SELECTION We considered all studies that quantitatively examined area-level variations in the prices of tobacco products and ENDS. We included all studies that examined any area-level measures regardless of the geographic location, language or time of publication. At least two reviewers independently screened the articles. We identified 20 studies. DATA EXTRACTION At least two reviewers independently extracted the characteristics, methods, and main results and assessed the quality of each included study. DATA SYNTHESIS Overall, cigarette prices were found to be lower in lower socioeconomic status neighbourhoods, and in neighbourhoods with a higher percentage of youth, and Blacks or African Americans. We identified too few studies that examined price differences for cigarillos, chewing tobacco, roll-your-own, and ENDS to reach any conclusions. CONCLUSIONS Our findings are in keeping with tobacco industry documents that detailed how manufacturers used race, class, and geography to target vulnerable populations and suggest that regulations that can limit industry price manipulation such as minimum, maximum, and uniform prices, and high specific excise taxes should be considered. More frequent and systematic monitoring of tobacco prices and ENDS is warranted.
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Affiliation(s)
- G Emmanuel Guindon
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada; Department of Economics, McMaster University, Hamilton, ON, Canada.
| | - Tooba Fatima
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Bipandeep Abbat
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Prabhnoor Bhons
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Sophiya Garasia
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
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40
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Floyd LJ. Perceived neighborhood disorder and frequency of marijuana use among emerging adult African American females. J Ethn Subst Abuse 2020; 21:570-584. [PMID: 32697628 DOI: 10.1080/15332640.2020.1793862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Emerging adult African American females are at increased risk for cannabis use disorders. Ecological models suggest that African Americans' increased risk for substance use disorders and associated adverse outcomes may result from chronic exposure to contextual disadvantages, such as living in economically deprived and disorganized communities. However levels of vulnerability for developing cannabis use disorders vary, even among residents of disadvantaged neighborhoods. Therefore, studies focused on within group differences are necessary. This study examined the relationship between frequency of marijuana use and perceived neighborhood disorder. The sample included 117 African American emerging adult females (Mage = 23.6 ± 3.4). After providing informed consent, participants completed a semi-structured interview that included the Neighborhood Environment Scale and a self-report measure of marijuana use. Additionally, participants provided a urine sample that was tested for the presence of psychoactive drugs. 46% tested positive for marijuana and 45% reported using marijuana in the past 30 days. 27% reported frequent/heavy use. Results from multinomial logistic regression analysis indicated a significant relationship between perceived neighborhood disorder and heavy marijuana use (AOR = 3.3; 95% CI = 1.06 - 10.29). Findings suggest African American emerging adult female residents of economically disadvantaged neighborhoods who appraise their environments as disorganized may be at heighten risk for problematic marijuana use and should be targeted for intervention. Moreover, the findings support the need for multi-systems interventions. As policy makers consider the legalization of marijuana, it is important that differences in marijuana use behaviors and negative outcomes across groups and contexts are taken into consideration.
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41
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Biglan A, Elfner K, Garbacz SA, Komro K, Prinz RJ, Weist MD, Wilson DK, Zarling A. A Strategic Plan for Strengthening America's Families: A Brief from the Coalition of Behavioral Science Organizations. Clin Child Fam Psychol Rev 2020; 23:153-175. [PMID: 32347415 PMCID: PMC7186188 DOI: 10.1007/s10567-020-00318-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Despite significant progress in research on the treatment and prevention of psychological, behavioral, and health problems, the translation of this knowledge into population-wide benefit remains limited. This paper reviews the state of America's children and families, highlighting the influence of stressful contextual and social conditions on child and family well-being and the concentration of disadvantage in numerous neighborhoods and communities throughout the nation. It then briefly reviews the progress that has been made in pinpointing policies that can reduce stressful contextual conditions such as poverty, discrimination, and the marketing of unhealthful foods and substances. It also describes numerous family and school interventions that have proven benefit in preventing psychological and behavioral problems as diverse as tobacco, alcohol, and other drug use; depression; antisocial behavior; academic failure; obesity prevention; and early childbearing. We argue that progress in translating existing knowledge into widespread benefit will require a nationwide effort to intervene comprehensively in neighborhoods and communities of concentrated disadvantage. We present a strategic plan for how such an effort could be organized. The first step in this organizing would be the creation of a broad and diverse coalition of organizations concerned with advancing public health and well-being. Such a coalition could increase public support both for the policies needed to focus on these disadvantaged areas and the research needed to incrementally improve our ability to help these areas.
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Affiliation(s)
| | - Karen Elfner
- Department of Child & Family Studies, University of South Florida, Tampa, FL, USA
| | | | - Kelli Komro
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ronald J Prinz
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Mark D Weist
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Dawn K Wilson
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Amie Zarling
- Human Development & Family Studies, Iowa State University, Ames, IA, USA
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42
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Cao Y, Stewart K, Factor J, Billing A, Massey E, Artigiani E, Wagner M, Dezman Z, Wish E. Using socially-sensed data to infer ZIP level characteristics for the spatiotemporal analysis of drug-related health problems in Maryland. Health Place 2020; 63:102345. [PMID: 32543431 DOI: 10.1016/j.healthplace.2020.102345] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 04/02/2020] [Accepted: 04/14/2020] [Indexed: 01/07/2023]
Abstract
This research investigated how socially sensed data can be used to detect ZIP level characteristics that are associated with spatial and temporal patterns of Emergency Department patients with a chief complaint and/or diagnosis of overdose or drug-related health problems for four hospitals in Baltimore and Anne Arundel County, MD during 2016-2018. Dynamic characteristics were identified using socially-sensed data (i.e., geo-tagged Twitter data) at ZIP code level over varying temporal resolutions. Data about three place-based variables including comments and concerns about crime, drug use, and negative or depressed sentiments, were extracted from tweets, along with data from four socio-environmental variables from the American Community Survey were collected to explore socio-environmental characteristics during the same period. Our study showed a statistically significant increase in adjusted rates of Emergency Department (ED) visits occurred between June and November 2017 for patients residing in ZIP codes in western Baltimore and northeastern Anne Arundel County. During this period, the three topics extracted from Twitter data were highly correlated with the ZIP codes where the patients were residing. Exploring the dynamic spatial associations between socio-environmental variables and ED visits for acute overdose assists local health officials in optimizing interventions for vulnerable locations.
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Affiliation(s)
- Yanjia Cao
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Kathleen Stewart
- Center for Geospatial Information Science, Department of Geographical Sciences, University of Maryland, College Park, MD, USA
| | - Julie Factor
- Center for Substance Abuse Research, University of Maryland, College Park, MD, USA
| | - Amy Billing
- Center for Substance Abuse Research, University of Maryland, College Park, MD, USA
| | - Ebonie Massey
- Center for Substance Abuse Research, University of Maryland, College Park, MD, USA
| | - Eleanor Artigiani
- Center for Substance Abuse Research, University of Maryland, College Park, MD, USA
| | - Michael Wagner
- Center for Substance Abuse Research, University of Maryland, College Park, MD, USA
| | - Zachary Dezman
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Eric Wish
- Center for Substance Abuse Research, University of Maryland, College Park, MD, USA
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Kassanits J, Bobak TJ, Stevens E, Guerrero M, Light J, Jason LA. The relationship of Oxford Houses across heterogeneous house and setting characteristics. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2020; 90:324-327. [PMID: 31916801 DOI: 10.1037/ort0000437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Oxford Houses (OH) are democratically run, self-funded, substance-use recovery homes that operate across the United States and internationally. Previous research shows the OHs are present in diverse neighborhoods. The current study examined the neighborhoods of 42 OHs located in Oregon, Texas, and North Carolina to better quantify and understand house and neighborhood characteristics that are related to relapse rates. Independent variables were participants' length of stay in OH, wages earned from employment, and income/education neighborhood characteristics. Neighborhood characteristics were related to relapse rates, with higher relapse rates occurring in neighborhoods with lower income and education levels. This finding supports the OH organization's premise that while OHs may work across community settings, they perform better in neighborhoods with higher average income and education levels. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Ted J Bobak
- Center for Community Research, DePaul University
| | - Ed Stevens
- Center for Community Research, DePaul University
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44
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Keller-Hamilton B, Ferketich AK, Berman M, Conrad E, Roberts ME. Cigarette Prices in Rural and Urban Ohio: Effects of Census Tract Demographics. Health Promot Pract 2020; 21:37S-43S. [PMID: 31908190 DOI: 10.1177/1524839919881141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The prevalence of smoking among rural Americans and Americans of lower socioeconomic status (SES) remains higher than among their urban and higher SES counterparts. Potential factors contributing to these disparities are area-based differences in the retail environment and tobacco control policies. We describe the association between neighborhood demographics and cigarette prices in rural and urban areas. Prices of one pack of Marlboro Reds, Newport menthols, and the cheapest cigarettes in the store were recorded from a stratified random sample of tobacco retailers in urban (N = 104) and rural (N = 109) Ohio in 2016. Associations between prices and census tract demographics (SES and race) were modeled separately in each region, controlling for store type. In the rural region, as the census tract income increased, the price of Marlboro and Newport cigarettes decreased, and the price of the cheapest pack of cigarettes increased. In the urban region, as the census tract income and percentage of White non-Hispanic people increased, the price of Marlboro decreased; there were no associations between census tract characteristics and the price of Newports or the cheapest cigarettes. Results describe a complex association between cigarette brand, prices, and area characteristics, where the cheapest brands of cigarettes can be obtained for the lowest prices in lower SES rural areas. Tobacco control policies that raise the price of cheap cigarettes, particularly minimum price laws, have the potential to reduce SES-related smoking disparities in both rural and urban populations.
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45
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Lung Y, Chang SS, Hsu CY, Wu SC, Chen CY, Chen WJ. Residential Socioeconomic Environments and Areca Nut Use in Taiwan: A Comparison with Alcohol and Tobacco Use in Multilevel Analysis. Subst Use Misuse 2020; 55:2025-2034. [PMID: 32654584 DOI: 10.1080/10826084.2020.1788089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
While the association between residential socioeconomic environments and the use of globally common substances such as alcohol and tobacco has been well documented in Western countries, it remains little known about regionally important substances, such as areca nut in Asia. Objective: This study was aimed to develop residential environmental indicators in the context of Taiwan and examine their associations with areca nut use, in comparison to alcohol and tobacco use. Methods: Data were drawn from 13,392 adults across 168 townships in the 2014 National Survey on Substance Use in Taiwan. Residential socioeconomic environment variables were derived from the census and analyzed using factor analysis. Multilevel logistic regression models were used to examine the association of individual- and residential-level factors with the use of areca nut (use/nonuse), alcohol (harmful use, low-risk use, or nonuse), and tobacco (nicotine dependence, regular active use, or nonuse). Results: A three-factor structure of socioeconomic environments derived from 16 residential-level variables consisted of Rural Disadvantage, Affluence, and Family Fragmentation. Multilevel analyses showed that areca nut use was associated with both individual-level (male sex, age group 35-44 years, being divorced/widowed/separated, low educational attainment, and the occupational group of labors) and residential-level (Rural Disadvantaged and Family Fragmented) variables; such a profile was most similar to that of nicotine dependence. Conclusions: A three-factor structure could be derived for the residential-level socioeconomic environments in the Taiwanese context. Rural Disadvantaged and Family Fragmented were associated with areca nut use, which have implications for interventions targeted at the community level.
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Affiliation(s)
- Yu Lung
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chia-Yueh Hsu
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shang-Chi Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chuan-Yu Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan
| | - Wei J Chen
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan.,Department of Psychiatry, College of Medicine, and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
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46
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Huang H, Cano MÁ, Trepka MJ, Sheehan DM, Sanchez M, Rojas P, De La Rosa M. Neighborhood and health-related outcomes: a study of adult Latinas of Caribbean and South and Central American descent in Miami. JOURNAL OF ETHNIC & CULTURAL DIVERSITY IN SOCIAL WORK 2019; 30:341-363. [PMID: 38094978 PMCID: PMC10718566 DOI: 10.1080/15313204.2019.1703127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
The present study investigated neighborhood effects on substance use, mental and medical health, and health-care access. We used data collected from a sample of adult Latinas of Caribbean and South and Central American descent in 2011. The findings indicate that for adult Latinas, concentrated disadvantage in neighborhoods is associated with increased risk of alcohol misuse and inability to obtain prescription drugs due to lack of money, while Hispanic/immigrant concentration in neighborhoods is associated with fewer mental disorder symptoms. Individual age, criminal justice involvement, religious involvement, intimate partner violence, and employment are also associated with one or more health-related outcomes. We provided practice implications for macro and micro social work practice. Future research is needed to examine the mechanism underlying the negative association between neighborhood Hispanic/immigrant concentration and mental disorder symptoms.
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Affiliation(s)
- Hui Huang
- Center for Research on US Latino HIV/AIDS and Drug Abuse, School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Miguel Ángel Cano
- Center for Research on US Latino HIV/AIDS and Drug Abuse, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mary Jo Trepka
- Center for Research on US Latino HIV/AIDS and Drug Abuse, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Diana M. Sheehan
- Center for Research on US Latino HIV/AIDS and Drug Abuse, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mariana Sanchez
- Center for Research on US Latino HIV/AIDS and Drug Abuse, Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Patria Rojas
- Center for Research on US Latino HIV/AIDS and Drug Abuse, Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mario De La Rosa
- Center for Research on US Latino HIV/AIDS and Drug Abuse, School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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Lauckner C, Desrosiers A, Muilenburg J, Killanin A, Genter E, Kershaw T. Social media photos of substance use and their relationship to attitudes and behaviors among ethnic and racial minority emerging adult men living in low-income areas. J Adolesc 2019; 77:152-162. [PMID: 31731226 DOI: 10.1016/j.adolescence.2019.10.013] [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: 09/27/2018] [Revised: 10/24/2019] [Accepted: 10/30/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Emerging adult minority males have inequitable negative consequences from substance abuse. They are also frequent users of social media, logging into popular sites up to 25 times per week on average, so there may be opportunities to use these technologies for better understanding and preventing substance use behaviors. Through mobile phone monitoring, this study examined how social media sites are used to post substance use-related images and how posting such images is related to behaviors and attitudes. It also explored how self-presentation of masculinity norms, such as coolness and toughness, was related to posting of substance use-related photos. METHODS Instagram and/or Twitter posts of 65 minority males aged 18-25 living in low-income areas were monitored for three months using phone tracking software. Over 2200 posted images were content analyzed to determine if they were related to alcohol or marijuana and if they displayed masculinity norms. Behavioral interviewing was also used to examine alcohol and marijuana attitudes, use, and problematic use. Analyses utilized t-tests and multiple and logistic regression. RESULTS Many participants posted at least one substance use-related photo and a strong majority were exposed to such images through their network. Individuals who posted substance use-related images had more "followers." Posting substance-use related photos was related to marijuana use attitudes, behaviors, and problem behaviors, as well as depictions of toughness in photos. CONCLUSIONS Social media monitoring has potential for use in identifying individuals at-risk for substance abuse and those who may be perpetuating unhealthy substance use norms.
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Affiliation(s)
- Carolyn Lauckner
- Department of Health Promotion and Behavior, University of Georgia, 128 Wright Hall, 100 Foster Rd., Athens, GA, 30606, USA.
| | - Alethea Desrosiers
- Boston College School of Social Work, 140 Commonwealth Ave, McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Jessica Muilenburg
- Department of Health Promotion and Behavior, University of Georgia, 128 Wright Hall, 100 Foster Rd., Athens, GA, 30606, USA
| | - Abraham Killanin
- Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Elizabeth Genter
- Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
| | - Trace Kershaw
- Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
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Solomon CA, Laditka SB, Forthofer M, Racine EF. Black-white disparities in alcohol consumption trends among women in the United States, 1990-2015. J Ethn Subst Abuse 2019; 20:625-646. [PMID: 31709927 DOI: 10.1080/15332640.2019.1685049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Alcohol consumption has more adverse consequences among African American women than among white women. Yet little is known about trends in alcohol consumption among African American women. Using the National Survey on Drug Use and Health, we examined trends in alcohol consumption among African American (n = 4,079) and white (n = 17,512) women, 1990-2015. We calculated population prevalence and used the Cochrane-Armitage test to examine trends, controlling for sociodemographic factors. In adjusted analyses, binge consumption increased for African American and white women; not consuming alcohol decreased among African Americans (all p < 0.05). Results highlight the need for culturally sensitive prevention and intervention strategies.
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Affiliation(s)
| | - Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Melinda Forthofer
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Elizabeth F Racine
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina
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Othman S, Cohn JE, Toscano M, Shokri T, Zwillenberg S. Substance Use and Maxillofacial Trauma: A Comprehensive Patient Profile. J Oral Maxillofac Surg 2019; 78:235-240. [PMID: 31783005 DOI: 10.1016/j.joms.2019.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/14/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Maxillofacial trauma confers an increased risk of long-term clinical sequelae with a substantial economic burden on the health care system. Substance use has long been correlated with an increased risk of trauma, yet to date, a comprehensive profile of substance users incurring facial fractures has not been established. We aimed to establish patterns and trends of substance use and specific substances in the setting of maxillofacial trauma. PATIENTS AND METHODS A retrospective chart review was conducted at our institution examining patients with maxillofacial fractures from 2016 to 2017. Information on age, gender, race, urine drug screen status, setting of presentation, mechanism of injury, trauma history, and injury severity was collected and examined for associations with particular substances. RESULTS We included 388 patients for analysis. Patients with positive urine drug screen results were significantly more likely to be men, present in an urban setting, incur poly-facial trauma, and have a history of facial trauma. In addition, alcohol use correlated significantly with injury severity in the context of polytrauma. Living in an urban setting and using phencyclidine were both significantly associated with a history of maxillofacial trauma. CONCLUSIONS Patients with comorbid maxillofacial trauma and substance use exhibit particular patterns in presentation and history. Establishing a profile for these patients allows for the development of prevention and rehabilitation programs.
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Affiliation(s)
- Sammy Othman
- Medical Student, Drexel University College of Medicine, Philadelphia, PA.
| | - Jason E Cohn
- Resident, Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Michael Toscano
- Medical Student, New York Institute of Technology College of Osteopathic Medicine, Glen Head, NY
| | - Tom Shokri
- Resident, Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, Hershey, PA
| | - Seth Zwillenberg
- Professor, Department of Otolaryngology-Head and Neck Surgery, Einstein Medical Center, Philadelphia, PA
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