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Sogbesan A, Lenz D, Lister JJ, Lundahl LH, Greenwald MK, Woodcock EA. Mediational pathways among drug use initiation, use-related consequences, and quit attempts. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 11:100229. [PMID: 38638305 PMCID: PMC11024908 DOI: 10.1016/j.dadr.2024.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/20/2024]
Abstract
Background Factors that predict attempts to discontinue drug use are clinically relevant and may inform treatment. This study investigated drug use-related consequences as a predictor of drug quit attempts and treatment seeking among two cohorts of persons who use drugs. Methods Drug use and clinical characteristics were assessed among persons who use cocaine (N=176; urine-verified; 'Cocaine Cohort') and among those who use heroin (N=166; urine-verified; 'Heroin Cohort'). Mediation analyses assessed relationships among age at initial drug use, adverse drug-specific use-related consequences, and drug-specific quit attempts, separately for each cohort. Forward conditional logistic regression models evaluated drug use and clinical symptom scores as predictors of drug-specific treatment seeking. Results Controlling for age, mediation models showed that drug use consequences fully mediated the relationship between age at initial drug use and number of drug-specific quit attempts for the 'Cocaine Cohort' and 'Heroin Cohort' (R2=0.30, p<.001; R2=0.17, p<.001; respectively). Reporting more consequences predicted more quit attempts in each cohort, accounting for duration of use (ps<.001). Reporting more consequences also predicted greater likelihood of seeking drug use treatment (ps<.001) and was associated with more severe clinical symptoms in each cohort (ps<.05). Conclusions Using a parallel analysis design, we showed that reporting more drug-specific use-related consequences predicted more drug-specific quit attempts and greater likelihood to seek treatment in two cohorts: persons who use cocaine and those who use heroin. Our findings suggest that experiencing more drug use consequences predicts more attempts to seek drug abstinence and that assessment of consequences may be informative for treatment.
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Affiliation(s)
- Adura Sogbesan
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Danielle Lenz
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Jamey J. Lister
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Leslie H. Lundahl
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Mark K. Greenwald
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, USA
| | - Eric A. Woodcock
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
- Department of Pharmacology, Wayne State University, Detroit, MI, USA
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Tavakoli Ghouchani H, Lashkardoost H, Afshari-Safavi A, Kaviyani F, Akbarzadeh M, Yousefnejad Z, Saadati H. Association between substance use treatment motivations and retention in treatment. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2023.2173101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Hamid Tavakoli Ghouchani
- Addiction and Behavioral Sciences Research Center & Department of Health Education and Promotion, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hossein Lashkardoost
- Addiction and Behavioral Sciences Research Center & Department of Epidemiology and Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Alireza Afshari-Safavi
- Addiction and Behavioral Sciences Research Center & Department of Epidemiology and Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Faezeh Kaviyani
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mostafa Akbarzadeh
- Department of mental health, Vice-chancellor for health of North khorasan University of medical sciences, Bojnurd, Iran
| | | | - Hassan Saadati
- Addiction and Behavioral Sciences Research Center & Department of Epidemiology and Biostatistics, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Prasad S, Basu D, Mattoo SK, Subodh BN. Assist-linked brief intervention to reduce risky pattern of substance use in male workers employed at a tertiary care hospital in India: A randomized controlled trial. Indian J Psychiatry 2023; 65:36-44. [PMID: 36874527 PMCID: PMC9983456 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_660_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/13/2022] [Accepted: 12/04/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Substance use in workplace leads to adverse effects both on the employees and on the workplace. Existing research focuses on alcohol-related harm, while workplace use of other substances has been neglected. There are no randomized controlled studies of brief interventions in Indian hospital settings. AIM To evaluate the efficacy of World Health Organization (WHO) alcohol, smoking, and substance involvement screening test (ASSIST)-linked brief intervention (ALBI) for reducing risky patterns of substance use in male workers at a tertiary-care hospital in North India. MATERIAL AND METHODS The study was conducted in two phases. In Phase-I, a random list of 400 employees was generated from the entire pool of male hospital workers, of which 360 participated. Data on the ASSIST risk categories (mild, moderate, and high) were generated from Phase I. In Phase-II, moderate- or high-risk subjects ('ASSIST screen-positive') were randomized into intervention and control groups, with 35 screen-positive subjects in each group. The intervention group was provided a 15-30-min structured session per ALBI protocol, while the control group was given a 15-30-min general talk on health-related consequences associated with substance use. The subjects were compared on ASSIST score, WHO quality-of-life brief version (WHOQOL-BREF) and readiness to change questionnaire (RCQ) at baseline and at 3-month follow up. RESULTS The prevalence of moderate-to-high-risk use of tobacco, alcohol, and cannabis in the total sample was 28.6%, 27.5%, and 6.9%, respectively. At 3-months postintervention follow-up of the randomized sample, recipients of ALBI had significant reduction of ASSIST scores for all substances compared to the control group (p < 0.001). More participants receiving ALBI were ready to change to RCQ action stage (p values for tobacco, alcohol, and cannabis <0.001, <0.001 and 0.007, respectively). WHOQOL-BREF scores significantly improved in ALBI group across all domains. CONCLUSION ALBI was effective in reducing risky substance use, increasing readiness to change and improving the QOL of the subjects at workplace setting.
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Affiliation(s)
- Sambhu Prasad
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India
| | - Debasish Basu
- Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Surendra K Mattoo
- Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B N Subodh
- Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Placide V, Unruh L, Atkins D, Chisholm L, Scott JB. Factors associated with counselling adherence in opioid treatment programs. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6303-e6311. [PMID: 36250340 DOI: 10.1111/hsc.14069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/12/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Federally certified opioid treatment programs (OTPs) provide psychosocial counselling in addition to medications for opioid use disorder (MOUDs) using a patient-centered approach in providing substance use disorder treatment. This study explored factors associated with patients' adherence to counselling while receiving MOUD at an OTP. A retrospective cohort design using data on adult patients (n = 1151, 61% females, 39% males) admitted to an OTP from July 1, 2014, to June 30, 2016, was employed. The data were for single episodes of care up to 52 weeks. Survival analysis (cox proportional hazards regression) assessed the relationship of personal characteristics, socio-economic status, payment for services, type of substance use, comprehensive care and social support with counselling for up to a year. Results indicated that age, having services paid for by public means, was associated with counselling adherence. Primary heroin use patients had a higher risk of counselling adherence failure than patients who primarily used non-medicinal prescription substances. Treatment agencies may benefit from funding and using evidence-based practices for primary heroin use patients and young adults to better engage and retain these populations in treatment.
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Affiliation(s)
- Vierne Placide
- Health Department, State University of New York College at Cortland, Cortland, New York, USA
- School of Global Health Management & Informatics, University of Central Florida, Orlando, Florida, USA
| | - Lynn Unruh
- School of Global Health Management & Informatics, University of Central Florida, Orlando, Florida, USA
| | - Danielle Atkins
- School of Global Health Management & Informatics, University of Central Florida, Orlando, Florida, USA
- Askew School of Public Administration, Florida State University, Tallahassee, Florida, USA
| | - Latarsha Chisholm
- School of Global Health Management & Informatics, University of Central Florida, Orlando, Florida, USA
| | - J Blake Scott
- Department of Writing and Rhetoric, University of Central Florida, Orlando, Florida, USA
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Expanding the continuum of substance use disorder treatment: Nonabstinence approaches. Clin Psychol Rev 2022; 91:102110. [PMID: 34864497 PMCID: PMC8815796 DOI: 10.1016/j.cpr.2021.102110] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 02/04/2023]
Abstract
Only a small minority of people with substance use disorders (SUDs) receive treatment. A focus on abstinence is pervasive in SUD treatment, defining success in both research and practice, and punitive measures are often imposed on those who do not abstain. Most adults with SUD do not seek treatment because they do not wish to stop using substances, though many also recognize a need for help. This narrative review considers the need for increased research attention on nonabstinence psychosocial treatment of SUD - especially drug use disorders - as a potential way to engage and retain more people in treatment, to engage people in treatment earlier, and to improve treatment effectiveness. We describe the development of nonabstinence approaches within the historical context of SUD treatment in the United States, review theoretical and empirical rationales for nonabstinence SUD treatment, and review existing models of nonabstinence psychosocial treatment for SUD among adults to identify gaps in the literature and directions for future research. Despite significant empirical support for nonabstinence alcohol interventions, there is a clear gap in research examining nonabstinence psychosocial treatment for drug use disorders. Future research must test the effectiveness of nonabstinence treatments for drug use and address barriers to implementation.
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Neural and Behavioral Correlates of Impaired Insight and Self-awareness in Substance Use Disorder. Curr Behav Neurosci Rep 2021; 8:113-123. [DOI: 10.1007/s40473-021-00240-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Taufique SR, Weller RE, Johnson B, Herring J. CARES: an innovative approach to treating adolescents with co-occurring mental health and substance use disorders. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1984241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - Brandon Johnson
- Icahn School of Medicine, Mount Sinai, New York, United States
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Hashemzadeh M, Rahimi A, Zare-Farashbandi F, Alavi-Naeini AM, Daei A. Transtheoretical Model of Health Behavioral Change: A Systematic Review. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:83-90. [PMID: 30820217 PMCID: PMC6390443 DOI: 10.4103/ijnmr.ijnmr_94_17] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Transtheoretical model (TTM) is one of the most commonly used methods in behavioral change modeling. The aim of this study was to conduct a systematic review (SR) to determine research gaps with regard to this template with an emphasis on intervention for patients with chronic diseases (CDs). Materials and Methods: ISI-WOS, Scopus, PubMed, SID, and Magiran databases were examined systematically and on the basis of defined criteria. Titles, abstracts, and full texts of articles retrieved were examined for the presence of defined criteria. Then finalized articles were analyzed in consensus meetings. After that, references of selected articles and full text of those meeting the criteria were also analyzed. Results: We screened 103 articles, excluded 27 in abstract review and 34 in full-text review, leaving 42 articles for critical appraisal. Then the references of these 42 articles were also screened. Fifty articles were excluded on abstract review and 5 on full-text review, leaving 15 articles. The result of the analysis of 57 final articles of this SR determined that 28 articles were about aspects of TTM and 5 stages of change were the most commonly used aspect. Eight articles used TTM in intervention about CDs. A total of 21 articles examined TTM's pros and cons, most of which were about TTM's pros. Conclusions: The majority of studies focused on the effectiveness of TTM on the behavioral change management. This finding supported the hypothesis that TTM can be applied in the prevention of CDs.
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Affiliation(s)
- Mozhdeh Hashemzadeh
- School of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Rahimi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Mansur Alavi-Naeini
- Department of Medical Librarianship and Information Science, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azra Daei
- Department of Community Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Komasi S, Saeidi M, Sariaslani P, Soroush A. Applying Behavioural Incentives to Increase Adherence to Maintenance Treatment. Malays J Med Sci 2018; 25:137-140. [PMID: 30914887 PMCID: PMC6422568 DOI: 10.21315/mjms2018.25.6.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/22/2018] [Indexed: 11/13/2022] Open
Abstract
A significant portion of the various communities, especially developing countries, is involved in drug abuse and receive formal drug treatments. Although the benefits of available therapeutics such as methadone maintenance treatment (MMT) for controlling infectious diseases have been confirmed, treatment failure has been seen in a large range of the patients. This review addresses the importance of a less attentive behavioural approach in reducing treatment withdrawal. The executive protocol, the outcomes and challenges, and the benefits of this approach are debatable.
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Affiliation(s)
- Saeid Komasi
- Clinical Research Development Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mozhgan Saeidi
- Cardiac Rehabilitation Centre, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Payam Sariaslani
- Neurology Department, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Soroush
- Lifestyle Modification Research Centre, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Serafini K, Decker S, Kiluk BD, Añez L, Paris M, Frankforter T, Carroll KM. Outcome expectations and associated treatment outcomes in motivational enhancement therapy delivered in English and Spanish. Am J Addict 2015; 24:732-9. [PMID: 26541501 DOI: 10.1111/ajad.12301] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 09/28/2015] [Accepted: 10/24/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The relationship between patients' baseline expectations regarding treatment outcome and actual outcomes has not been widely studied within the field of substance use disorders. We hypothesized that outcome expectations would be unrelated to outcomes in a study investigating motivational enhancement therapy delivered in English (MET-E) consistent with our earlier work, and conducted exploratory analyses in a separate study that investigated the same treatment delivered in Spanish (MET-S). METHODS These secondary analyses compared patient outcome expectations and substance use treatment outcomes in two large, multisite randomized controlled clinical trials that evaluated three sessions of MET-E or MET-S. The MET-E sample included 461 participants and the MET-S sample included 405 participants. Outcome expectations were measured by a single item regarding expectations about abstinence prior to initiating treatment. RESULTS Outcome expectations were strongly associated with most substance use outcomes in the MET-S trial (but not in MET-E), even after controlling for severity of substance use at baseline. In MET-S, those who indicated that they were "unsure" that they would achieve abstinence during treatment submitted a greater percentage of drug-positive urine toxicology screens during the treatment period than those who were 'sure' they would achieve abstinence (F = 18.83, p < .001). DISCUSSION AND CONCLUSIONS Patients' outcome expectations regarding the likelihood of abstinence may be an important predictor of drug use treatment outcomes among Spanish-speakers, but not necessarily for English-speakers. SCIENTIFIC SIGNIFICANCE Individual differences and cultural factors may play a role in the association between outcome expectations and treatment outcomes.
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Affiliation(s)
- Kelly Serafini
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Suzanne Decker
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.,VA Connecticut Health Care System and New England Mental Illness Research, Education, and Clinical Center, West Haven, Connecticut
| | - Brian D Kiluk
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Luis Añez
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Manuel Paris
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Tami Frankforter
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Kathleen M Carroll
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
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McCarthy DE, Ebssa L, Witkiewitz K, Shiffman S. Paths to tobacco abstinence: A repeated-measures latent class analysis. J Consult Clin Psychol 2015; 83:696-708. [PMID: 25867447 DOI: 10.1037/ccp0000017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Knowledge of smoking change processes may be enhanced by identifying pathways to stable abstinence. We sought to identify latent classes of smokers based on their day-to-day smoking status in the first weeks of a cessation attempt. We examined treatment effects on class membership and compared classes on baseline individual differences and 6-month abstinence rates. METHOD In this secondary analysis of a double-blind randomized placebo-controlled clinical trial (N = 1,433) of 5 smoking cessation pharmacotherapies (nicotine patch, nicotine lozenge, bupropion SR, patch and lozenge, or bupropion SR and lozenge), we conducted repeated-measures latent class analysis of daily smoking status (any smoking vs. none) for the first 27 days of a quit attempt. Treatment and covariate relations with latent class membership were examined. Distal outcome analysis compared confirmed 6-month abstinence rates among the latent classes. RESULTS A 5-class solution was selected. Three-quarters of smokers were in stable smoking or abstinent classes, but 25% were in classes with unstable abstinence probabilities over time. Active treatment (compared to placebo), and particularly the patch and lozenge combination, promoted early quitting. Latent classes differed in 6-month abstinence rates and on several baseline variables, including nicotine dependence, quitting history, self-efficacy, sleep disturbance, and minority status. CONCLUSIONS Repeated-measures latent class analysis identified latent classes of smoking change patterns affected by treatment, related to known risk factors, and predictive of distal outcomes. Tracking behavior early in a change attempt may identify prognostic patterns of change and facilitate adaptive treatment planning.
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Affiliation(s)
| | - Lemma Ebssa
- Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey
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Harrell PT, Marquinez NS, Correa JB, Meltzer LR, Unrod M, Sutton SK, Simmons VN, Brandon TH. Expectancies for cigarettes, e-cigarettes, and nicotine replacement therapies among e-cigarette users (aka vapers). Nicotine Tob Res 2014; 17:193-200. [PMID: 25168035 DOI: 10.1093/ntr/ntu149] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Use of e-cigarettes has been increasing exponentially, with the primary motivation reported as smoking cessation. To understand why smokers choose e-cigarettes as an alternative to cigarettes, as well as to US Food and Drug Administration (FDA)--approved nicotine replacement therapies (NRT), we compared outcome expectancies (beliefs about the results of drug use) for the three nicotine delivery systems among vapers, i.e., e-cigarette users, who were former smokers. METHODS Vapers (N = 1,434) completed an online survey assessing 14 expectancy domains as well as perceived cost and convenience. We focused on comparisons between e-cigarettes and cigarettes to determine the attraction of e-cigarettes as a smoking alternative and between e-cigarettes and NRT to determine perceived advantages of e-cigarettes over FDA-approved pharmacotherapy. RESULTS Participants believed that e-cigarettes, in comparison to conventional cigarettes, had fewer health risks; caused less craving, withdrawal, addiction, and negative physical feelings; tasted better; and were more satisfying. In contrast, conventional cigarettes were perceived as better than e-cigarettes for reducing negative affect, controlling weight, providing stimulation, and reducing stress. E-cigarettes, compared to NRT, were perceived to be less risky, cost less, cause fewer negative physical feelings, taste better, provide more satisfaction, and be better at reducing craving, negative affect, and stress. Moderator analyses indicated history with ad libitum forms of NRT was associated with less positive NRT expectancies. CONCLUSIONS The degree to which expectancies for e-cigarettes differed from expectancies for either tobacco cigarettes or NRT offers insight into the motivation of e-cigarette users and provides guidance for public health and clinical interventions to encourage smoking-related behavior change.
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Affiliation(s)
- Paul T Harrell
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL;
| | - Nicole S Marquinez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL
| | - John B Correa
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Marina Unrod
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Steven K Sutton
- Department of Biostatistics, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL; Department of Oncologic Sciences, University of South Florida, Tampa, FL
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL; Department of Oncologic Sciences, University of South Florida, Tampa, FL
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