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Jamison RN, Edwards RR, Brown R, Barrett BP, Burzinski CA, Lennon RP, Nakamura Y, Schiefelbein T, Garland EL, Zgierska AE. Risk Factors for Self-Harm Ideation Among Persons Treated With Opioids for Chronic Low Back Pain. Clin J Pain 2023; 39:643-653. [PMID: 37712325 PMCID: PMC10695275 DOI: 10.1097/ajp.0000000000001161] [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: 03/11/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES Chronic pain is a significant health concern that adversely affects all aspects of life, including emotional well-being. Opioids are prescribed for the management of refractory, severe chronic pain, although they have been associated with adverse effects, including addiction and overdose. The aim of this study was to examine factors that predict thoughts of self-harm among adults with chronic pain who are prescribed opioids. MATERIALS AND METHODS Seven hundred sixty-five (N=765) persons with opioid-treated chronic lower back pain completed the Current Opioid Misuse Measure (COMM) and other validated questionnaires as part of a larger study. Response to 1 question from the COMM ("How often have you seriously thought about hurting yourself?") was used to assess suicide risk on a 5-point scale (0=never; 4=very often). RESULTS Participants were categorized into 3 groups according to their responses to the self-harm question: never (N=628; 82.1%), seldom or sometimes (N=74; 9.7%), and often or very often (N=63; 8.2%). Multivariate adjusted odds ratio (aOR) analyses indicated that reports of alcohol or drug overuse within the past month (aOR=1.41,[95% CI 1.11-1.78]), posttraumatic stress (PTSD; aOR=1.24,[1.07 to 1.44]), pain catastrophizing (aOR=1.03,[1.01 to 1.05]), not loving oneself (aOR=0.99,[.98-1.00]) and poor perceived mental health (aOR=0.94,[.92 to 97]) were most associated with thoughts of self-harm. Importantly, the ideation frequency of self-harm was highest among individuals treated with higher daily doses of opioids. DISCUSSION These results support the need for continued monitoring of adults treated with opioids for chronic pain, particularly among those on high-dose opioids who present with increased negative affect and concerns of substance misuse.
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Affiliation(s)
- Robert N. Jamison
- Harvard Medical School, Brigham and Women’s Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry, 850 Boylston Street, Chestnut Hill, MA 02467
| | - Robert R. Edwards
- Harvard Medical School, Brigham and Women’s Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry, 850 Boylston Street, Chestnut Hill, MA 02467
| | - Roger Brown
- University of Wisconsin-Madison, School of Medicine and Public Health, and University of Wisconsin-Madison, School of Nursing, 1100 Delaplaine Court, Madison, WI 53715
| | - Bruce P. Barrett
- University of Wisconsin-Madison, School of Medicine and Public Health, and University of Wisconsin-Madison, School of Nursing, 1100 Delaplaine Court, Madison, WI 53715
| | - Cindy A. Burzinski
- University of Wisconsin-Madison, School of Medicine and Public Health, and University of Wisconsin-Madison, School of Nursing, 1100 Delaplaine Court, Madison, WI 53715
| | - Robert P. Lennon
- Pennsylvania State University College of Medicine, Department of Family and Community Medicine, 90 Hope Drive, Hershey, PA 17033
| | - Yoshio Nakamura
- University of Utah School of Medicine, Department of Anesthesiology, Division of Pain Medicine, Pain Research Center, 615 Arapeen Drive, Suite 200, Salt Lake City, UT 84108
| | - Tony Schiefelbein
- Pennsylvania State University College of Medicine, Department of Family and Community Medicine, 90 Hope Drive, Hershey, PA 17033
| | - Eric L. Garland
- University of Utah, Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, 395 1500 E, Salt Lake City, UT 84112
| | - Aleksandra E. Zgierska
- Pennsylvania State University College of Medicine, Department of Family and Community Medicine, 90 Hope Drive, Hershey, PA 17033
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Ugarte DA, Cumberland WG, Singh P, Saadat S, Garett R, Young SD. A HOPE Online Community Peer Support Intervention for Help Seeking: A Randomized Controlled Trial. Psychiatr Serv 2023; 74:648-651. [PMID: 36377369 PMCID: PMC10205089 DOI: 10.1176/appi.ps.202000817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A 6-week study was conducted to test the effectiveness of the Harnessing Online Peer Education (HOPE) intervention on anxiety, help seeking (requests for electronic resources [e-resources] on anxiety reduction), and online engagement. METHODS Three hundred participants with moderate to severe anxiety (i.e., seven-item Generalized Anxiety Disorder scale [GAD-7] scores ≥10) were randomly assigned to social media (i.e., Facebook) groups with or without peer leaders. The study was conducted from April 5 to May 17, 2020. GAD-7 scores, e-resource requests, and online engagement were measured at baseline and at weeks 2, 4, and 6. RESULTS GAD-7 scores improved in both intervention and control groups, with no difference between conditions. Participants in the intervention group were more likely than those in the control group to request e-resources (OR=10.27, 95% CI=4.52-23.35) and engage online (OR=2.84, 95% CI=1.70-4.76). CONCLUSIONS The HOPE intervention effectively promoted mental health help-seeking behavior and online engagement.
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Affiliation(s)
- Dominic Arjuna Ugarte
- Department of Emergency Medicine (Ugarte, Saadat, Young) and Department of Informatics (Singh, Young), University of California, Irvine, Irvine; Department of Biostatistics, University of California, Los Angeles, Los Angeles (Cumberland); ElevateU, Irvine (Garett)
| | - William G Cumberland
- Department of Emergency Medicine (Ugarte, Saadat, Young) and Department of Informatics (Singh, Young), University of California, Irvine, Irvine; Department of Biostatistics, University of California, Los Angeles, Los Angeles (Cumberland); ElevateU, Irvine (Garett)
| | - Parvati Singh
- Department of Emergency Medicine (Ugarte, Saadat, Young) and Department of Informatics (Singh, Young), University of California, Irvine, Irvine; Department of Biostatistics, University of California, Los Angeles, Los Angeles (Cumberland); ElevateU, Irvine (Garett)
| | - Soheil Saadat
- Department of Emergency Medicine (Ugarte, Saadat, Young) and Department of Informatics (Singh, Young), University of California, Irvine, Irvine; Department of Biostatistics, University of California, Los Angeles, Los Angeles (Cumberland); ElevateU, Irvine (Garett)
| | - Renee Garett
- Department of Emergency Medicine (Ugarte, Saadat, Young) and Department of Informatics (Singh, Young), University of California, Irvine, Irvine; Department of Biostatistics, University of California, Los Angeles, Los Angeles (Cumberland); ElevateU, Irvine (Garett)
| | - Sean D Young
- Department of Emergency Medicine (Ugarte, Saadat, Young) and Department of Informatics (Singh, Young), University of California, Irvine, Irvine; Department of Biostatistics, University of California, Los Angeles, Los Angeles (Cumberland); ElevateU, Irvine (Garett)
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Garett R, Cumberland WG, Chakravarthy B, Springer S, Young SD. A Qualitative Exploration of the Potential Role of Using Online Social Media Support Communities to Increase Initiation of Medications for Opioid Use Disorder (MOUD). JOURNAL OF SUBSTANCE USE 2023; 28:880-886. [PMID: 38274090 PMCID: PMC10810551 DOI: 10.1080/14659891.2022.2098846] [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] [Received: 02/07/2022] [Accepted: 07/04/2022] [Indexed: 01/11/2023]
Abstract
Objectives This study sought to explore the potential role of peer-led online communities to increase use of medications for opioid use disorder. Methods From January through March 2020, participants with opioid use disorder and their family members/friends were recruited from paid Facebook ads; public health key stakeholders were recruited from referrals from the study team and opioid experts. Thirty participants from California were interviewed; 23 persons reporting opioid misuse, 3 family members/friends of persons misusing opioids, and 4 public health key stakeholders. We conducted semi-structured interviews asking about preferences, barriers and facilitators of treatment options for opioid use disorder, and perspectives around the use of digital/online communities. The categories of participants interviewed were each asked slightly different questions depending upon their role. Results Results suggest that participants who misuse opioids (1) may prefer to engage in online communities rather than in-person meetings to discuss their opioid use, (2) generally prefer to receive opioid-related information from other patients with opioid use disorder and/or those in recovery rather than from health providers or other individuals, and (3) thought that an online community could be beneficial for helping address their opioid use. Conclusion Results suggest an openness and interest in a peer-led online community to discuss opioid use and treatment among people who misuse opioids.
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Affiliation(s)
| | - William G. Cumberland
- Department of Biostatistics, University of California, Los Angeles, Los Angeles, USA
| | | | - Sandra Springer
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, Yale University, New Haven, USA
| | - Sean D. Young
- Department of Emergency Medicine, University of California, Irvine, Irvine, USA
- University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine, Irvine, USA
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Garett R, Young SD. Role of Peer Coaches in Digital Interventions for MOUD Initiation and Maintenance. Community Ment Health J 2023; 59:9-13. [PMID: 35909202 PMCID: PMC10993297 DOI: 10.1007/s10597-022-01008-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/02/2022] [Indexed: 01/07/2023]
Abstract
Millions of Americans suffer from opioid use disorder (OUD) in the United States, resulting in thousands of deaths. The ongoing opioid crisis necessitates novel approaches to reduce the morbidity and mortality associated with misusing opioids. Studies using peer support models show success in engaging persons living with OUD in initiating treatment and decreasing relapse. Although most studies have focused on patients in clinical settings, community studies integrating peer community leaders also show promise. This viewpoint paper explores the use of peer coaches in online interventions in the community setting.
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Affiliation(s)
- Renee Garett
- ElevateU, Irvine, CA, USA.
- Department of Informatics, University of California Institute for Prediction Technology, Irvine, CA, USA.
| | - Sean D Young
- Department of Emergency Medicine, University of California, Irvine, CA, USA
- Department of Informatics, University of California Institute for Prediction Technology, Irvine, CA, USA
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Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1264. [PMID: 36909883 PMCID: PMC9316011 DOI: 10.1002/cl2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and cost-effectiveness of the use of peer support in health and social care. Search Methods We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies. Selection Criteria Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role. Data Collection and Analysis Data were extracted on the type of peer support intervention and outcomes assessed in included studies. Standardised tools were used to assess study quality for all studies: assessing the methodological quality of systematic reviews 2 for systematic reviews; Cochrane risk of bias tool for randomised controlled trials; and consensus health economic criteria list for economic evaluations. Main Results We included 91 studies: 32 systematic reviews; 52 randomised controlled trials; and 7 economic evaluations. Whilst most included systematic reviews and economic evaluations were assessed to be of low or medium quality, the majority of randomised controlled trials were of higher quality. There were concentrations of evidence relating to different types of peer support, including education, psychological support, self-care/self-management and social support. Populations with long-term health conditions were most commonly studied. The majority of studies measured health-related indicators as outcomes; few studies assessed cost-effectiveness. Studies were unevenly distributed geographically, with most being conducted in the USA. Several gaps were evident regarding the delivery of peer support, particularly the integration of peers and professionals in delivering support and interventions of longer duration. Authors' Conclusions Although there is evidence available to inform the commissioning and delivery of peer support in health and social care, there are also clear gaps that need to be addressed to further support provision, particularly regarding cost-effectiveness. The effectiveness of peer support in different countries, with varying health and social care systems, is a priority for future research, as is the integration of peers with professionals in delivering peer support.
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Affiliation(s)
- Anna Price
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Siân de Bell
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
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6
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Bonar EE, Bauermeister JA, Blow FC, Bohnert ASB, Bourque C, Coughlin LN, Davis AK, Florimbio AR, Goldstick JE, Wisnieski DM, Young SD, Walton MA. A randomized controlled trial of social media interventions for risky drinking among adolescents and emerging adults. Drug Alcohol Depend 2022; 237:109532. [PMID: 35759874 PMCID: PMC9745675 DOI: 10.1016/j.drugalcdep.2022.109532] [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: 03/24/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Alcohol use among adolescents and emerging adults is an important public health issue requiring prevention approaches. Herein, we describe outcomes from a randomized controlled trial testing the efficacy of group-based social media interventions targeting risky drinking among youth. PROCEDURES Using social media advertisements to screen potential participants, we recruited 955 youth (ages 16-24) reporting recent risky drinking. After completing a baseline assessment, participants were randomized to 8-week secret Facebook group conditions: Social Media Intervention + Incentives for engagement, Social Media Intervention only, and attention-placebo control. Electronic coaches trained in motivational interviewing facilitated interaction in intervention groups. Primary outcomes include past 3-month alcohol use and consequences over 3-, 6-, and 12-month follow-ups. Secondary outcomes include other drug use, consequences, and impaired driving. We also measured intervention engagement and acceptability. RESULTS The interventions were well-received, with significantly greater acceptability ratings and engagement in the SMI+I condition relative to other groups. In adjusted analyses, there were no significant differences between interventions and control on alcohol-related outcomes, with all groups showing reductions. Regarding secondary outcomes (70.4% used other drugs), compared to control, the incentivized group reduced other drug use, consequences, and cannabis-impaired driving; the non-incentivized group did not significantly differ from the control condition. CONCLUSIONS Among this predominantly poly-substance using sample, findings were mixed, with significant effects of the incentivized social media intervention on drug (but not alcohol) outcomes. Future studies are needed to further refine social media-delivered interventions to reduce alcohol and other drug use. TRIAL REGISTRATION ClinicalTrials.gov NCT02809586; University of Michigan HUM#00102242.
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Affiliation(s)
- Erin E. Bonar
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
| | - José A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104
| | - Frederic C. Blow
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Veterans Health Administration, Center for Clinical Management Research, North Campus Research Complex, 2800 Plymouth Rd Bldg 16, Ann Arbor, MI 48109, USA
| | - Amy S. B. Bohnert
- Veterans Health Administration, Center for Clinical Management Research, North Campus Research Complex, 2800 Plymouth Rd Bldg 16, Ann Arbor, MI 48109, USA,Department of Anesthesiology, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Carrie Bourque
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Lara N. Coughlin
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
| | - Alan K. Davis
- Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, 1947 College Rd, Columbus, OH 43210 USA,Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Autumn Rae Florimbio
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Jason E. Goldstick
- Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA,Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd Bldg 10-G080, Ann Arbor, MI 48109, USA,Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48105
| | - Diane M. Wisnieski
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Sean D. Young
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California Irvine, Irvine, CA 92697,Department of Emergency Medicine, University of California Irvine, Irvine, CA 92697
| | - Maureen A. Walton
- Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Addiction Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA,Injury Prevention Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
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Garett RR, Yang J, Zhang Q, Young SD. An online advertising intervention to increase adherence to stay-at-home-orders during the COVID-19 pandemic: An efficacy trial monitoring individual-level mobility data. INTERNATIONAL JOURNAL OF APPLIED EARTH OBSERVATION AND GEOINFORMATION : ITC JOURNAL 2022; 108:102752. [PMID: 35463944 PMCID: PMC8942718 DOI: 10.1016/j.jag.2022.102752] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/17/2022] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic has led public health departments to issue several orders and recommendations to reduce COVID-19-related morbidity and mortality. However, for various reasons, including lack of ability to sufficiently monitor and influence behavior change, adherence to these health orders and recommendations has been suboptimal. Starting April 29, 2020, during the initial stay-at-home orders issued by various state governors, we conducted an intervention that sent online website and mobile application advertisements to people's mobile phones to encourage them to adhere to stay-at-home orders. Adherence to stay-at-home orders was monitored using individual-level cell phone mobility data, from April 29, 2020 through May 10, 2020. Mobile devices across 5 regions in the United States were randomly-assigned to either receive advertisements from our research team advising them to stay at home to stay safe (intervention group) or standard advertisements from other advertisers (control group). Compared to control group devices that received only standard corporate advertisements (i.e., did not receive public health advertisements to stay at home), the (intervention group) devices that received public health advertisements to stay at home demonstrated objectively-measured increased adherence to stay at home (i.e., smaller radius of gyration, average travel distance, and larger stay-at-home ratios). Results suggest that 1) it is feasible to use mobility data to assess efficacy of an online advertising intervention, and 2) online advertisements are a potentially effective method for increasing adherence to government/public health stay-at-home orders.
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Affiliation(s)
| | - Jiannan Yang
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Qingpeng Zhang
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Sean D Young
- Department of Emergency Medicine, University of California, Irvine, CA, USA
- University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine
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Piszczek CC, Foley CE, Farag S, Northup M, Overcarsh P, Wiedrick J, Yunker AC, Ecker AM. Social media utilization, preferences, and patterns of behavior in patients with gynecologic pelvic pain. Am J Obstet Gynecol 2022; 226:547.e1-547.e14. [PMID: 34752735 DOI: 10.1016/j.ajog.2021.10.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Social media is increasingly becoming a health resource for people suffering from complex and debilitating health conditions. A comprehensive understanding of how and why social media and the Internet are used among patients with chronic gynecologic pain will allow for the intentional development and incorporation of web-based tools into patient care plans. OBJECTIVE This study aimed to determine whether gynecologic patients with pain are more likely to use social media and the Internet to understand and manage their condition than those without pain. The survey was designed to explore how gynecologic patients with and without pain use and interact with social media and other web-based health resources and the clinical, personal, and demographic factors influencing these behaviors. STUDY DESIGN Patients presenting with a new complaint to a gynecologist at 1 of 6 Fellowship in Minimally Invasive Gynecologic Surgery-affiliated hospital systems were screened, consented, and assigned to pain and no-pain groups. Participants were surveyed about social media and Internet use, symptoms, bother, physician selection, motivation, trust, and demographic information. Survey responses were compared using the Fisher exact tests, odds ratios, and risk ratios from standard tabular analysis, univariate or multivariate tests of means, and regression analyses, as appropriate. RESULTS Of 517 participants included in the study, 475 (92%) completed the survey, 328 (69.1%) with pain and 147 (30.9%) without pain. Study participants in the pain group reported more than double the odds of using social media than those without pain (37.8% vs 19.7%; odds ratio, 2.47; 95% confidence interval, 1.54-3.96) and triple the odds of using the Internet (88.4% vs 69.4%; odds ratio, 3.37; 95% confidence, 2.04-5.56) to understand or manage their condition. Participants with pain were more likely than those without pain to engage in social media at a higher level (3.5 vs 1.7 on a scale of 0 to 10; P<.0001), be motivated by interpersonal elements of online engagement (Hotelling's T2=37.3; P<.0001), prefer an interactive component to their online health resource (35.6% vs 24.3%; risk ratio, 1.46; 95% confidence interval, 1.00-2.20; P=.0433), be influenced by others in their choice of a gynecologist (0.37 vs 0.32 on a scale of 0 to 1; P=.009), use social media as a coping tool (38.3% vs 17%; P=.0001), trust information found on social media (31.4% vs 16.7%; P=.0033), and trust other women with the same condition, informal health resources, and personal sources more and doctors and formal health resources less (P=.0083). Participants in both groups reported higher levels of social media engagement with higher levels of symptom bother (28% increase in engagement with every doubling of bother level (P<.0001). CONCLUSION Patients with gynecologic pain were more likely than those without pain to use social media and the Internet to understand and manage their condition. Patients with pain engaged in and trusted social media at a higher level, with engagement rising directly with bother level.
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Affiliation(s)
| | - Christine E Foley
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Sara Farag
- Division of Minimally Invasive Gynecologic Surgery, Department of Gynecology and Women's Health, Cleveland Clinic Florida, Weston, FL
| | - Megan Northup
- Department of Obstetrics and Gynecology, Scripps Clinic Medical Group, San Diego, CA
| | - Patricia Overcarsh
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN
| | - Jack Wiedrick
- Biostatistics and Design Program, OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR
| | - Amanda C Yunker
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN
| | - Amanda M Ecker
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
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Abstract
Background: Deaths due to opioid overdose continue to rise in the United States. Despite availability of effective treatment for opioid use disorder, uptake is low among those who misuse opioids. Methods: This paper explores the role of misconception, stigma, and misinformation in influencing decisions to initiate medications for opioid use disorder among patients and providers. Conclusion: Misinformation about opioids has been prevalent among future healthcare providers and first responders as well as pharmaceutical companies, which may have implications for treatment. Among individuals with opioid use disorder, treatment uptake and adherence have been negatively affected by misconceptions about treatment efficacy and side effects, as well as stigma. We discuss the role of social media, education, and the community, in mitigating misinformation and addressing misconceptions about opioids and treatment options.
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Affiliation(s)
| | - Sean D Young
- Department of Emergency Medicine, University of California, Irvine, California, USA
- University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine, California, USA
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10
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Staton M, Dickson MF, Pike E, Surratt H, Young S. An Exploratory Examination of Social Media Use and Risky Sexual Practices: A Profile of Women in Rural Appalachia Who Use Drugs. AIDS Behav 2022; 26:2548-2558. [PMID: 35103889 PMCID: PMC8805664 DOI: 10.1007/s10461-022-03605-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 11/21/2022]
Abstract
HIV/HCV risk behavior among women who use drugs is often exacerbated within high risk networks. The use of social media platforms such as Facebook to identify sex partners within these high-risk networks has not been examined among rural Appalachian women who use drugs. This paper provides an exploratory examination of Facebook use to identify sex partners among rural Appalachian women who use drugs, as well as associated risky sexual practices. Rural Appalachian women were randomly selected from two rural jails, consented, screened for eligibility (including drug use), and interviewed prior to jail release. Findings indicated that using Facebook to meet sex partners was associated with exchanging sex for drugs or money and having a male casual partner during the same time frame. These study findings suggest that the use of social media for high-risk sexual practices may provide a valuable platform for intervention delivery, particularly in resource-deprived areas where formal prevention and treatment services are limited.
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Affiliation(s)
- Michele Staton
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA. .,Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Dr., Lexington, KY, 40536, USA.
| | - Megan F. Dickson
- grid.266539.d0000 0004 1936 8438Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY USA ,grid.266539.d0000 0004 1936 8438Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Dr., Lexington, KY 40536 USA
| | - Erika Pike
- grid.266539.d0000 0004 1936 8438Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Dr., Lexington, KY 40536 USA
| | - Hilary Surratt
- grid.266539.d0000 0004 1936 8438Department of Behavioral Science, University of Kentucky College of Medicine, 1100 Veterans Dr., Lexington, KY 40536 USA
| | - Sean Young
- grid.266093.80000 0001 0668 7243Department of Emergency Medicine, School of Medicine, University of California, Irvine, Irvine, USA ,grid.266093.80000 0001 0668 7243Department of Informatics, School of Information and Computer Sciences, University of California, Irvine, Irvine, USA
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11
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Garett R, Young SD. The Impact of Misinformation and Health Literacy on HIV Prevention and Service Usage. J Assoc Nurses AIDS Care 2022; 33:e1-e5. [PMID: 34939991 PMCID: PMC10993296 DOI: 10.1097/jnc.0000000000000298] [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] [Indexed: 11/26/2022]
Abstract
There are an increasing number of online resources people can use to gain access to information, including for health-related issues, such as for HIV prevention. Trend data show that the way individuals obtain news and information has changed from years past. Health literacy, therefore, is an important skill to ensure adequate understanding of the data available about HIV in the media and online. Unfortunately, the proliferation of misinformation is ubiquitous and may have deleterious effects on individual health behavior, and consequently, the public’s health. This commentary focuses on sources of online misinformation as it relates to HIV and how misinformation impacts seeking health services.
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Affiliation(s)
- Renee Garett
- Renee Garett, MSW, LCSW, is the Founding Director, ElevateU, Irvine, California, USA. Sean D. Young, PhD, MS, is an Associate Professor, Department of Emergency Medicine, and Executive Director, University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine, California, USA
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12
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Garett R, Young SD. Potential Effects of Digital Inequality on Treatment Seeking for Opioid Use Disorder. Int J Ment Health Addict 2021; 21:890-895. [PMID: 34466133 PMCID: PMC8395375 DOI: 10.1007/s11469-021-00629-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/02/2022] Open
Abstract
Despite the availability of effective treatment, medications for opioid use disorder are underutilized due to a variety of practical, political, and psychological reasons. Digital inequalities, such as limited access to technology, skills to leverage the technology for desirable outcomes, and social resources, may be contributing to negative health outcomes. In addition, broader health literacy plays an integral part in the capacity of individuals to appraise opioid medication-related online information. This paper explores the role of digital inequalities in the uptake of treatment for opioid use disorder. Given the shift toward telemedicine and online counseling for substance use treatment as a consequence of the COVID-19 pandemic, more research into the digital inequalities faced by those who misuse opioids may provide insight into ways of engaging and encouraging this population to utilize treatment.
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Affiliation(s)
| | - Sean D. Young
- Department of Emergency Medicine, University of California Irvine, CA Irvine, USA
- University of California Institute for Prediction Technology, Department of Informatics, University of California Irvine, CA Irvine, USA
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13
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Abstract
BACKGROUND New data sources and analysis methods are urgently needed to improve opioid surveillance and prevent potential overdose. Social media data is one potential data source that might be used and integrated to address this issue. Objective: This study explored opioid-related topics discussed across geographical regions of varying population sizes to determine whether social media data might inform opioid surveillance. Methods: Between March 17th to July 17th, 2020, we collected tweets (N = 19,721) mentioning opioid-related keywords across seven cities within the United States. Results: Results found that opioid-related keywords were distributed as follows: New York (29%), Los Angeles (23%), Chicago (18%), Atlanta (18%), San Francisco (8%), Iowa (3%), and Orange County, CA (1%). We also found regional differences in the types of opioids and topics mentioned. Conclusions: Findings suggest the feasibility of using opioid-related social media data to inform surveillance efforts, as well as potential regional and time-varying differences in topics discussed.
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Affiliation(s)
- Lidia Flores
- Department of Emergency Medicine, University of California, Irvine, CA, USA
| | - Sean D Young
- Department of Emergency Medicine, University of California, Irvine, CA, USA
- University of California Institute for Prediction Technology, Department of Informatics, Bren School of Information and Computer Sciences, UC Irvine, Irvine, CA, USA
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14
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Abstract
Morbidity and mortality attributable to opioid use and misuse among adolescents and young adults are evident. Although recent trend data suggest a decrease in both opioid misuse and opioid use disorder among adolescents and young adults in the last few years, overdose cases continue to rise. The opioid epidemic among this population is complex and has a different profile compared to adults, with family facilitating exposure to opioids more often than other sources. Additionally, despite recommendations by experts to initiate medications for opioid use disorder, few initiate treatment. The recent COVID-19 pandemic has impacted many facets of daily life and its effects on the opioid crisis are largely unknown. Stay-at-home mandates resulting in online schooling and limited social interaction has had deleterious consequences for adolescents, especially their mental health. This viewpoint attempts to explore the effects of the pandemic on the opioid crisis in this vulnerable population.
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Affiliation(s)
- Romina A Romero
- Department of Emergency Medicine, University of California, Irvine, CA, USA
| | - Sean D Young
- Department of Emergency Medicine, University of California, Irvine, CA, USA.,University of California Institute for Prediction Technology, Department of Informatics, University of California, Irvine, CA, USA
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15
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Su Z, Schneider JA, Young SD. The Role of Conversational Agents for Substance Use Disorder in Social Distancing Contexts. Subst Use Misuse 2021; 56:1732-1735. [PMID: 34286669 DOI: 10.1080/10826084.2021.1949609] [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] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic and its related policies, such as social distancing orders, are affecting the ability for people with substance use disorders (SUD) to seek prevention and treatment. In this commentary, we introduce conversational agents, a type of social technology. We discuss the role of conversational agents in the prevention and treatment of SUD in social distancing contexts and the potential benefits and limitations of designing and implementing such technology in the prevention and care for patients with SUD.
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Affiliation(s)
- Zhaoyuan Su
- Department of Informatics, University of California, Irvine, California, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Sean D Young
- Departments of Emergency Medicine and Informatics, University of California, Irvine, California, USA
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16
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Soliz S, Young SD. Feasibility of a citizen-driven hackathon to increase public engagement and solutions to address the opioid crisis. JOURNAL OF SUBSTANCE USE 2020; 25:615-620. [PMID: 36531337 PMCID: PMC9757730 DOI: 10.1080/14659891.2020.1753833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background Interdisciplinary approaches are needed to address complex societal problems, such as the opioid crisis. We sought to explore the feasibility and potential issues encountered in planning and implementing a 24-hour hackathon competition to bring together teams from law enforcement, public health, and data science to develop solutions to the opioid epidemic. Methods We enlisted an advisory board and planning committee, including key stakeholders (e.g., high-level representatives from government agencies) to plan the event. Teams completed an online registration form with questions about team composition. Each team captain completed a survey at the event describing prior experiences with their team, knowledge and interest around the opioid epidemic, and hackathon expectations. Results Twenty-nine teams (108 individuals) registered. 76% had a technical/engineering background. Participants were from industry (55%), academia (30%), public health/medicine (9%), and government/public policy (6%). Nineteen teams attended the event. Team captains were primarily 18-29 years of age, had moderate experience and interest in the opioid crisis, and had never attended an opioid-related event. Conclusions It is feasible to implement a 24-hour opioid-focused hackathon and recruit teams/participants from a broad range of disciplines. We discuss the solutions developed, barriers encountered, and insights gained throughout the planning and implementation process.
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Affiliation(s)
- Stephanie Soliz
- Department of Family Medicine, University of California Institute for Prediction Technology, UCLA, Los Angeles, CA, USA
| | - Sean D. Young
- Department of Emergency Medicine, School of Medicine, UC Irvine, Irvine, CA, USA
- Department of Informatics, University of California Institute for Prediction Technology, UC Irvine, Irvine, CA, USA
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17
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Young SD. The Adaptive Behavioral Components (ABC) Model for Planning Longitudinal Behavioral Technology-Based Health Interventions: A Theoretical Framework. J Med Internet Res 2020; 22:e15563. [PMID: 32589152 PMCID: PMC7351148 DOI: 10.2196/15563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/28/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
A growing number of interventions incorporate digital and social technologies (eg, social media, mobile phone apps, and wearable devices) into their design for behavior change. However, because of a number of factors, including changing trends in the use of technology over time, results on the efficacy of these interventions have been mixed. An updated framework is needed to help researchers better plan behavioral technology interventions by anticipating the needed resources and potential changes in trends that may affect interventions over time. Focusing on the domain of health interventions as a use case, we present the Adaptive Behavioral Components (ABC) model for technology-based behavioral interventions. ABC is composed of five components: basic behavior change; intervention, or problem-focused characteristics; population, social, and behavioral characteristics; individual-level and personality characteristics; and technology characteristics. ABC was designed with the goals of (1) guiding high-level development for digital technology–based interventions; (2) helping interventionists consider, plan for, and adapt to potential barriers that may arise during longitudinal interventions; and (3) providing a framework to potentially help increase the consistency of findings among digital technology intervention studies. We describe the planning of an HIV prevention intervention as a case study for how to implement ABC into intervention design. Using the ABC model to plan future interventions might help to improve the design of and adherence to longitudinal behavior change intervention protocols; allow these interventions to adapt, anticipate, and prepare for changes that may arise over time; and help to potentially improve intervention behavior change outcomes. Additional research is needed on the influence of each of ABC’s components to help improve intervention design and implementation.
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Affiliation(s)
- Sean D Young
- Institute for Prediction Technology, Department of Informatics, University of California, Irvine, Irvine, CA, United States.,Department of Emergency Medicine, UCI School of Medicine, Irvine, CA, United States
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