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Cumming C, Kinner SA, McKetin R, Young JT, Li I, Preen DB. Using the Alcohol, Smoking and Substance Involvement Screening Test to predict substance-related hospitalisation after release from prison: A cohort study. Addiction 2024; 119:236-247. [PMID: 37855049 PMCID: PMC10952305 DOI: 10.1111/add.16365] [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: 06/09/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND AND AIMS Poor substance use-related health outcomes after release from prison are common. Identifying people at greatest risk of substance use and related harms post-release would help to target support at those most in need. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST) is a validated substance use screener, but its utility in predicting substance-related hospitalisation post-release is unestablished. We measured whether screening for moderate/high-risk substance use on the ASSIST was associated with increased risk of substance-related hospitalisation. DESIGN A prospective cohort study. SETTING Prisons in Queensland and Western Australia. PARTICIPANTS Participants were incarcerated and within 6 weeks of expected release when recruited. A total of 2585 participants were followed up for a median of 873 days. MEASUREMENTS Baseline survey data were combined with linked unit record administrative hospital data. We used the ASSIST to assess participants for moderate/high-risk cannabis, methamphetamine and heroin use in the 3 months prior to incarceration. We used International Classification of Diseases (ICD) codes to identify substance-related hospitalisations during follow-up. We compared rates of substance-related hospitalisation between those classified as low/no-risk and moderate/high-risk on the ASSIST for each substance. We estimated adjusted hazard ratios (aHR) by ASSIST risk group for each substance using Weibull regression survival analysis allowing for multiple failures. FINDINGS During follow-up, 158 (6%) participants had cannabis-related, 178 (7%) had opioid-related and 266 (10%) had methamphetamine-related hospitalisation. The hazard rates of substance-related hospitalisation after prison were significantly higher among those who screened moderate/high-risk compared with those screening low risk on the ASSIST for cannabis (aHR 2.38, 95% confidence interval [CI] 1.74, 3.24), methamphetamine (aHR 2.23, 95%CI 1.75, 2.84) and heroin (aHR 5.79, 95%CI 4.41, 7.60). CONCLUSIONS Incarcerated people with an Alcohol Smoking and Substance Involvement Screening Test (ASSIST) screening of moderate/high-risk substance use appear to have a significantly higher risk of post-release substance-related hospitalisation than those with low risk. Administering the ASSIST during incarceration may inform who has the greatest need for substance use treatment and harm reduction services in prison and after release from prison.
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Affiliation(s)
- Craig Cumming
- Centre for Health Services Research, School of Population and Global HealthUniversity of Western AustraliaCrawleyAustralia
| | - Stuart A. Kinner
- Centre for Adolescent HealthMurdoch Children's Research InstituteParkvilleAustralia
- Melbourne School of Population and Global HealthThe University of MelbourneParkvilleAustralia
- Griffith Criminology InstituteGriffith UniversityMt GravattAustralia
- School of Population HealthCurtin UniversityPerthAustralia
| | - Rebecca McKetin
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyAustralia
| | - Jesse T. Young
- Centre for Adolescent HealthMurdoch Children's Research InstituteParkvilleAustralia
- Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoCanada
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneParkvilleAustralia
- National Drug Research InstituteCurtin UniversityPerthAustralia
- School of Population and Global HealthUniversity of Western AustraliaCrawleyAustralia
| | - Ian Li
- School of Population and Global HealthUniversity of Western AustraliaCrawleyAustralia
| | - David B. Preen
- Centre for Health Services Research, School of Population and Global HealthUniversity of Western AustraliaCrawleyAustralia
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Staton M, Tillson M, Levi MM, Webster M, Oser C, Leukefeld C. Screening Incarcerated Women for Opioid Use Disorder. JOURNAL OF DRUG ISSUES 2024; 54:57-73. [PMID: 38046434 PMCID: PMC10688603 DOI: 10.1177/00220426231151595] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree of correlation between street opioid misuse and other high-risk drug indicators (overdose and injection practices). These findings underscore the importance of outreach, screening, and intervention in real-world settings, including jails, in order to increase access to OUD treatment among this vulnerable sample of women.
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Affiliation(s)
- Michele Staton
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Martha Tillson
- Department of Sociology, College of Arts & Sciences, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Mary M. Levi
- Department of Psychology, College of Arts & Sciences, University of Kentucky, Lexington, KY, USA
| | - Matthew Webster
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Carrie Oser
- Faculty Affiliate, Center for Health Equity Transformation, Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Carl Leukefeld
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, USA
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Staton M, Tillson M, Levi MM, Dickson M, Webster M, Leukefeld C. Identifying and Treating Incarcerated Women Experiencing Substance Use Disorders: A Review. Subst Abuse Rehabil 2023; 14:131-145. [PMID: 38026785 PMCID: PMC10655602 DOI: 10.2147/sar.s409944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
While research on substance use disorder (SUD) treatment among justice-involved populations has grown in recent years, the majority of corrections-based SUD studies have predominantly included incarcerated men or men on community supervision. This review 1) highlights special considerations for incarcerated women that may serve as facilitating factors or barriers to SUD treatment; 2) describes selected evidence-based practices for women along the cascade of care for SUD including screening and assessment, treatment and intervention strategies, and referral to services during community re-entry; and 3) discusses conclusions and implications for SUD treatment for incarcerated women.
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Affiliation(s)
- Michele Staton
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Martha Tillson
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Mary M Levi
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Megan Dickson
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Matt Webster
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Carl Leukefeld
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
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Liang Y, Roberts J, Conigrave K, Kim S, Doyle MF. Alcohol relapse prevention health care after alcohol withdrawal in New South Wales prisons, Australia: A patient file review. Drug Alcohol Rev 2023; 42:1733-1743. [PMID: 37608431 DOI: 10.1111/dar.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION People who enter custody have complex health issues and comorbidities may include alcohol use disorders. We investigated clinical service provision and comorbidities recorded among individuals with a likely alcohol withdrawal syndrome within prison in New South Wales, Australia. METHODS For this clinical case series review, electronic medical data were used to identify 50 people entering custody between August and November 2018 who likely had a treated alcohol withdrawal syndrome. We aimed for a 3:2 ratio of men and women, and a 1:1 ratio of Aboriginal and non-Aboriginal individuals. Data were extracted using a purposefully designed tool which included current alcohol withdrawal management, comorbidities and alcohol relapse prevention approaches used or recommended. RESULTS Thirty-eight men and 12 women, of whom 22 were Aboriginal, were included. Twenty-nine individuals (58%) reported a history of medical comorbidities. Thirty-five (70%) reported using other substances and over half (60%) had a diagnosis of mental health disorders. Fourteen (28%) individuals had a record of receiving brief intervention and five (10%) of motivational interviewing. Twenty-three individuals (46%) were referred to and seen by drug and alcohol clinicians. Only seven (14%) of the sample had pre-release community care plans. DISCUSSION AND CONCLUSIONS Individuals treated for an alcohol withdrawal syndrome in New South Wales prisons have a high prevalence of medical comorbidities and other substance use. Clinical interventions focused on alcohol withdrawal management, and relapse prevention interventions were not recorded for most individuals. Service innovation and expansion are needed to increase the provision of post-withdrawal management.
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Affiliation(s)
- Yichao Liang
- Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Jillian Roberts
- Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Katherine Conigrave
- Centre of Research Excellence in Indigenous Health and Alcohol, Sydney Medical School, The University of Sydney, Sydney, Australia
- Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia
- Royal Prince Alfred Hospital, Sydney, Australia
| | - Sobi Kim
- Justice Health and Forensic Mental Health Network, Sydney, Australia
- Edith Collins Centre (Translational Research in Alcohol Drugs and Toxicology), Drug Health Services, Sydney Local Health District, Sydney, Australia
| | - Michael F Doyle
- Centre of Research Excellence in Indigenous Health and Alcohol, Sydney Medical School, The University of Sydney, Sydney, Australia
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Hoff E, Hansen L, Pulitzer Z, Campalans N, Salyards M, Muquith M, Shavit S, Nguyen H, Crain C, Walker R, Nijhawan AE. A randomized control trial of a combined community health worker and re-entry intervention for people with HIV recently released from jail who use substances. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209118. [PMID: 37454733 DOI: 10.1016/j.josat.2023.209118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/21/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION People with human immunodeficiency virus (HIV; PWH) who use substances are disproportionately involved in the criminal justice system. While HIV viral suppression typically improves during incarceration, these gains are frequently lost after release. We evaluated the impact of a combined intervention (formerly incarcerated community health workers [CHW] plus a re-entry organization; CHW+) on postrelease HIV- and substance use-related outcomes. METHODS We conducted a pilot randomized controlled trial of a CHW+ for PWH who use substances, within 30 days of release from a large southern, urban jail. Between February 2019 and August 2021, participants were recruited, enrolled, and randomized to treatment as usual (TAU; passive referral to care) or CHW+. Follow up study visits occurred at 3, 6, and 12 months. The primary outcome was HIV VL at 6 months; secondary outcomes included 6-month urinary toxicology and high-risk substance use at 12 months. RESULTS A total of 31 participants were enrolled who were primarily male (n = 24; 77 %), Black (n = 22; 71 %), unemployed (n = 23; 74.2 %), had unstable housing (n = 18; 58 %), had food insecurity (n = 14; 45 %), and reported their drug of choice was stimulants (n = 24; 77 %). The study identified no significant difference in HIV VL suppression at 6 months (20 % v. 37 %; [CHW+ v. TAU], p = 0.61). We observed improved substance use outcomes in CHW+ v. TAU, including fewer positive urinary toxicology screens for stimulants (40 % v. 100 %; p = 0.01) and a trend toward less high-risk substance use (30 % v. 43 %). The CHW+ group met more basic needs, such as food security [+32 % v. +11 %], housing security [+52 % v. -7 %] and full-time employment [+20 % v. +5 %] compared to TAU. CONCLUSIONS PWH who use substances assigned to a combined intervention of CHW+ after jail release did not achieve higher rates of HIV VL suppression than TAU; however, they had improved substance use outcomes and met more basic subsistence needs. Results highlight the potential of culturally informed interventions to address the competing needs of PWH who use substances after release from jail and call for further development of innovative solutions to successfully bridge to HIV care in the community.
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Affiliation(s)
- Emily Hoff
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Laura Hansen
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Zoe Pulitzer
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Nicholas Campalans
- Department of Internal Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Maverick Salyards
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; Department of Public Health, Texas Christian University, United States
| | - Maishara Muquith
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States
| | - Shira Shavit
- Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hue Nguyen
- Unlocking DOORS®, Dallas, TX, United States
| | | | - Robrina Walker
- Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States; The Emmes Company, Rockville, MD, United States
| | - Ank E Nijhawan
- Department of Internal Medicine, University of Texas-Southwestern, Dallas, TX, United States; Division of Infectious Diseases and Geographic Medicine, University of Texas-Southwestern, Dallas, TX, United States.
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Cumming C, Kinner SA, McKetin R, Young JT, Li I, Preen DB. The predictive validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for moderate- to high-risk cannabis, methamphetamine and opioid use after release from prison. Addiction 2023; 118:1107-1115. [PMID: 36680769 PMCID: PMC10952147 DOI: 10.1111/add.16138] [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: 08/26/2022] [Accepted: 12/24/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Illicit substance use is common among people entering prisons, as is returning to substance use after release from prison. We aimed to assess the predictive validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) for returning to substance use after release from prison. DESIGN A longitudinal design with baseline survey conducted between 2008 and 2010 in the 6 weeks before expected prison release and up to three follow-up surveys in the 6 months after release. SETTING Prisons in Queensland, Australia. PARTICIPANTS A total of 1054 adults within 6 weeks of expected release from prison. MEASUREMENTS The ASSIST was used to assess problematic use of cannabis, methamphetamine, heroin and other non-prescribed opioids in the 3 months before incarceration. Post-incarceration substance use was measured at 1, 3 and 6 months after release. We calculated the area under the receiver operating characteristic curve (AUROC) and the optimal ASSIST cut-off score for each substance, using Youden's index (J). FINDINGS Forty-one per cent (n = 434) of the cohort reported any substance use during follow-up: 33% (n = 344) used cannabis, 20% (n = 209) methamphetamine, 10% (n = 109) heroin and 9% (n = 97) illicit other opioids. The optimal ASSIST cut-off score was ≥ 4 for heroin, methamphetamine and cannabis and ≥ 1 for other opioids. Using these cut-offs, the AUROC was highest for heroin in predicting both any use (AUROC = 0.82) and weekly use (AUROC = 0.88) in the past 4 weeks. AUROCs for other drugs ranged from 0.73 to 0.79. CONCLUSIONS The ASSIST shows promise as an accurate and potentially scalable tool that may be useful for predicting a return to substance use after release from prison and could inform service delivery. The substantial rates of returning to substance use after release from prison suggest that prison serves to interrupt rather than cease substance use.
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Affiliation(s)
- Craig Cumming
- Centre for Health Services Research, School of Population and Global HealthUniversity of Western AustraliaCrawleyWAAustralia
| | - Stuart A. Kinner
- Centre for Adolescent HealthMurdoch Children’s Research InstituteParkvilleVICAustralia
- Melbourne School of Population and Global HealthUniversity of MelbourneParkvilleVICAustralia
- Griffith Criminology InstituteGriffith UniversityMt GravattQLDAustralia
- School of Population HealthCurtin UniversityPerthWAAustralia
| | - Rebecca McKetin
- National Drug and Alcohol Research CentreUniversity of New South WalesSydneyNSWAustralia
| | - Jesse T. Young
- Centre for Health Equity, Melbourne School of Population and Global HealthUniversity of MelbourneParkvilleVICAustralia
- Centre for Adolescent HealthMurdoch Children's Research InstituteParkvilleVICAustralia
- National Drug Research InstituteCurtin UniversityPerthWAAustralia
- School of Population and Global HealthUniversity of Western AustraliaCrawleyWAAustralia
| | - Ian Li
- School of Population and Global HealthUniversity of Western AustraliaCrawleyWAAustralia
| | - David B. Preen
- Centre for Health Services Research, School of Population and Global HealthUniversity of Western AustraliaCrawleyWAAustralia
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COVID-Dynamic: A large-scale longitudinal study of socioemotional and behavioral change across the pandemic. Sci Data 2023; 10:71. [PMID: 36737442 PMCID: PMC9897616 DOI: 10.1038/s41597-022-01901-6] [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: 02/18/2022] [Accepted: 12/14/2022] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic has caused enormous societal upheaval globally. In the US, beyond the devastating toll on life and health, it triggered an economic shock unseen since the great depression and laid bare preexisting societal inequities. The full impacts of these personal, social, economic, and public-health challenges will not be known for years. To minimize societal costs and ensure future preparedness, it is critical to record the psychological and social experiences of individuals during such periods of high societal volatility. Here, we introduce, describe, and assess the COVID-Dynamic dataset, a within-participant longitudinal study conducted from April 2020 through January 2021, that captures the COVID-19 pandemic experiences of >1000 US residents. Each of 16 timepoints combines standard psychological assessments with novel surveys of emotion, social/political/moral attitudes, COVID-19-related behaviors, tasks assessing implicit attitudes and social decision-making, and external data to contextualize participants' responses. This dataset is a resource for researchers interested in COVID-19-specific questions and basic psychological phenomena, as well as clinicians and policy-makers looking to mitigate the effects of future calamities.
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Bunting AM, Nowotny K, Farabee D, McNeely J, Beckwith CG. Characteristics of Substance Use Screening at Intake in a Sample of U.S. Jails. J Health Care Poor Underserved 2023; 34:180-191. [PMID: 37464488 PMCID: PMC10938471 DOI: 10.1353/hpu.2023.0012] [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] [Indexed: 02/21/2023]
Abstract
BACKGROUND Despite high rates of substance use among justice-involved populations, the use of substance screening tools in justice settings varies. METHODS Data are from the National Jail Health Care Study, which surveyed jails across the U.S. about their health care practices (n=371). Jails were asked to voluntarily submit their medical intake forms. A content analysis of intake forms (n=63) specific to questions about substance use was completed. RESULTS Seventy-three percent (73%) of intake forms used non-standardized questions to assess current substance use, and 27% did not ask any questions about substance use. Alcohol use was most assessed (52%), followed by tobacco (30%), and marijuana (22%). Less than 11% of jails asked about use of opioids and 40% of forms asked about withdrawal history. CONCLUSIONS The lack of adequate substance use screening in jails hinders identification of substance use disorders, potential for withdrawal symptoms, and appropriate connection to treatment resources.
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Hoopsick RA, Homish DL, Lawson SC, Homish GG. Drug use over time among never-deployed US Army Reserve and National Guard soldiers: The longitudinal effects of non-deployment emotions and sex. Stress Health 2022; 38:1045-1057. [PMID: 35500288 PMCID: PMC9853315 DOI: 10.1002/smi.3156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 01/24/2023]
Abstract
Some US military service members who have never been deployed experience negative emotions related to never having been deployed, and some work shows these non-deployment emotions (NDE) are cross-sectionally associated with hazardous drinking for male, but not female, US Army Reserve/National Guard (USAR/NG) soldiers. However, it is not known if these effects extend to drug use or persist longitudinally, which is the focus of the current study. We conducted a longitudinal residual change analysis of a subset of data (N = 182 never-deployed soldiers) from Operation: SAFETY, an ongoing survey-based study of USAR/NG soldiers recruited from units across New York State. Outcome measures included current tobacco use, non-medical use of prescription drugs (NMUPD), current cannabis use, and other current illicit drug use (excluding cannabis) at four time points over a 3-year period. Results from bootstrapped residual change generalized estimating equation (GEE) models show that more negative NDE were longitudinally associated with a greater likelihood of current NMUPD among male, but not female, soldiers (p < 0.05). NDE were not longitudinally associated with current tobacco use, cannabis use, or other illicit drug use among male or female soldiers (ps > 0.05). NDE may contribute to ongoing NMUPD among male USAR/NG soldiers who have never been deployed. Never-deployed soldiers, especially those with negative emotions related to never having been deployed, should not be overlooked in military screening and intervention efforts.
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Affiliation(s)
- Rachel A. Hoopsick
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, 1206 S. Fourth Street, Champaign, IL 61820, USA
| | - D. Lynn Homish
- Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY 14214, USA
| | - Schuyler C. Lawson
- Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY 14214, USA
| | - Gregory G. Homish
- Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY 14214, USA
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Developing a cascade of care for opioid use disorder among individuals in jail. J Subst Abuse Treat 2022; 138:108751. [DOI: 10.1016/j.jsat.2022.108751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/25/2022] [Accepted: 02/14/2022] [Indexed: 12/30/2022]
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Latent class analysis of self-reported substance use during incarceration: Gender differences and associations with emotional distress and aggressiveness. J Subst Abuse Treat 2021; 132:108582. [PMID: 34353671 DOI: 10.1016/j.jsat.2021.108582] [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] [Received: 04/11/2021] [Revised: 06/29/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION We know little about the prevalence and patterns of substance use during incarceration, and we know even less about comparative substance use patterns by gender. To address these gaps in the literature, this study used latent class analysis (LCA) to identify substance use subgroups of incarcerated men (n = 1118) and women (n = 207). METHODS The study drew data from six prisons in Spain. Participants completed a self-administered questionnaire with items probing for types of drugs used in the past three months, depression, anxiety, stress symptoms, aggressiveness, and perceived social support. RESULTS Substance use was common among incarcerated men and women, with tobacco, cannabis, and sedatives being most prevalent. LCA revealed different patterns of substance use by gender. Four- and two-class solutions best fitted the data for men and women, respectively. Aggressiveness and depression were associated with high depressant use membership for men. Among women, aggressiveness and anxiety symptoms were positively associated with high polydrug use membership. CONCLUSIONS The prevalent and patterned use of substances inside Spanish prisons and their association with aggressiveness and depression elevates the risk of harm during incarceration. In the interest of safety and wellness, correctional behavioral health services should include and expand the availability of gender-specific integrated mental health and substance use interventions that address maladaptive behaviors such as aggression.
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Van Gerwen OT, Tamhane A, Westfall AO, Mugavero MJ, Crane HM, Moore RD, Karris M, Christopoulos K, Dombrowski JC, Mayer KH, Marrazzo J, Dionne-Odom J. Prevalence of and Factors Associated With Genital and Extragenital Chlamydia and Gonorrhea Among Transgender Women in HIV Care in the United States, 2005 to 2016. Sex Transm Dis 2021; 48:410-416. [PMID: 33229965 PMCID: PMC8711312 DOI: 10.1097/olq.0000000000001335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Data on testing rates and prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women with HIV in the United States are limited. METHODS This retrospective cohort analysis included transgender women living with HIV enrolled in the US Centers for AIDS Research Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with chlamydia or gonorrhea testing performed in HIV clinic. The primary outcome was a positive test result for chlamydia or gonorrhea at urogenital or extragenital (rectal/pharyngeal) sites. Factors associated with infection were examined using logistic regression and generalized estimating equations to account for multiple tests per woman. RESULTS Among 312 transgender women in HIV care, 252 (81%) were tested for chlamydia or gonorrhea at least once. Annual testing rates were low: 23% to 53% at genital sites and 24% to 47% at extragenital sites. A total of 88 infections were detected, and 22% of women (55/252) had at least one positive test result. Most infections occurred at extragenital sites (80% of chlamydia and 82% of gonorrhea positive test results). Factors associated with infection in an adjusted model were as follows: age 18 to 29 years compared with ≥50 years (adjusted odds ratio [aOR], 7.6; 95% confidence interval [CI], 1.8-31.2), CD4 count >350 compared with CD4 <200 (aOR, 5.5; 95% CI, 1.2-25.1), and higher engagement in HIV care (aOR, 2.2; 95% CI, 1.0-4.5). CONCLUSIONS Among transgender women living with HIV, testing rates for chlamydia and gonorrhea are inadequate, particularly at extragenital sites where most infections occur.
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Affiliation(s)
- Olivia T. Van Gerwen
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Ashutosh Tamhane
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Andrew O. Westfall
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Michael J. Mugavero
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Heidi M. Crane
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA
| | - Richard D. Moore
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD
| | - Maile Karris
- Department of Medicine, Division of Infectious Diseases, University of California at San Diego, San Diego
| | - Katerina Christopoulos
- Department of Medicine, Division of Infectious Diseases, University of California at San Francisco, San Francisco, CA
| | - Julia C. Dombrowski
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA
| | - Kenneth H. Mayer
- Fenway Health and Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Jeanne Marrazzo
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
| | - Jodie Dionne-Odom
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL
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Dionne-Odom J, Westfall AO, Dombrowski JC, Kitahata MM, Crane HM, Mugavero MJ, Moore RD, Karris M, Christopoulos K, Geng E, Mayer KH, Marrazzo J. Intersecting Epidemics: Incident Syphilis and Drug Use in Women Living With Human Immunodeficiency Virus in the United States (2005-2016). Clin Infect Dis 2021; 71:2405-2413. [PMID: 31712815 DOI: 10.1093/cid/ciz1108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Rates of early syphilis in US women are steadily increasing, but predictors of infection in this group are not clearly defined. METHODS This retrospective analysis focused on women enrolled in the US CFAR Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with syphilis testing performed. The primary outcome of incident syphilis infection was defined serologically as a newly positive test with positive confirmatory testing after a negative test or a 2-dilution increase in rapid plasma regain titer. Infection rates were calculated for each woman-year in care with testing. Predictors of syphilis were sought among sociodemographics, clinical information, and self-reported behaviors. Multivariable logistic regression models were created; a subgroup analysis assessed predictors in women of reproductive age. RESULTS The annual rate of incident syphilis among 4416 women engaged in human immunodeficiency virus (HIV) care and tested during the 12-year study period was 760/100 000 person-years. Independent predictors of infection were injection drug use as a risk factor for HIV acquisition (aOR, 2.2; 95% CI, 1.3-3.9), hepatitis C infection (aOR, 1.9; 95% CI, 1.1-3.4), black race (aOR, 2.2; 95% CI, 1.3-3.7 compared with white race), and more recent entry to care (since 2005 compared with 1994-2004). Predictors were similar in women aged 18-49. CONCLUSIONS Syphilis infection is common among US women in HIV care. Syphilis screening and prevention efforts should focus on women reporting drug use and with hepatitis C coinfection. Future studies should identify specific behaviors that mediate syphilis acquisition risk in women who use drugs.
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Affiliation(s)
- Jodie Dionne-Odom
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrew O Westfall
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Julia C Dombrowski
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Mari M Kitahata
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Heidi M Crane
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Michael J Mugavero
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard D Moore
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Maile Karris
- Division of Infectious Diseases, Department of Medicine, University of California at San Diego, San Diego, California, USA
| | - Katerina Christopoulos
- Division of Infectious Diseases, Department of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Elvin Geng
- Division of Infectious Diseases, Department of Medicine, University of California at San Francisco, San Francisco, California, USA
| | - Kenneth H Mayer
- Division of Infectious Diseases, Fenway Health and Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Jeanne Marrazzo
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Hoopsick RA, Homish DL, Vest BM, Bartone PT, Homish GG. Resilience to Hazardous Drinking Among Never-Deployed Male United States Army Reserve and National Guard Soldiers. Alcohol Clin Exp Res 2021; 45:566-576. [PMID: 33503277 DOI: 10.1111/acer.14561] [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] [Received: 10/05/2020] [Accepted: 01/19/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Negative emotions related to never having been deployed to active duty are associated with an increased risk of hazardous drinking among United States Army Reserve/National Guard (USAR/NG) soldiers. Resiliency factors are known to buffer the effects of combat on hazardous drinking among service members who have been deployed, but it is not known whether these factors are protective for never-deployed service members, or which domains of hazardous drinking might be affected. Therefore, we examined the effects of a range of resiliency factors (i.e., marital satisfaction, psychological hardiness, intrinsic religiosity) on the relation between nondeployment emotions (NDE) and domains of hazardous drinking. METHODS We drew a subset of data from Operation: Soldiers and Families Excelling Through the Years (N = 112 never-deployed male soldiers), an ongoing study of USAR/NG soldiers. Regression models examined the main effects of NDE on each of the domains of hazardous drinking (i.e., total Alcohol Use Disorders Identification Test [AUDIT] score, consumption subscale, dependence subscale, alcohol-related problems subscale) and effect modification of each of the resiliency factors on the relations between NDE and the domains of hazardous drinking, separately. Final models controlled for years of military service, rank (enlisted vs. officer), number of military friends in the social network, and depression. RESULTS Greater NDE were associated with a higher total AUDIT score, alcohol consumption, and alcohol dependence (ps < 0.05), but not alcohol-related problems (p > 0.05). Marital satisfaction and psychological hardiness buffered the effects of NDE on total AUDIT score and alcohol dependence (p < 0.05). Intrinsic religiosity only modified the effect of NDE on total AUDIT score. None of the resiliency factors modified the effects of NDE on alcohol consumption or alcohol-related problems. CONCLUSIONS Soldiers with greater NDE had a greater risk of hazardous drinking in the presence of low resilience. Interventions to promote resiliency are an important consideration for protecting USAR/NG soldiers from hazardous drinking, regardless of their deployment history.
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Affiliation(s)
- Rachel A Hoopsick
- Department of Family Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - D Lynn Homish
- Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Bonnie M Vest
- Department of Family Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Paul T Bartone
- Institute for National Strategic Studies, National Defense University, Washington, DC, USA
| | - Gregory G Homish
- Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA
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Prost SG, Kennedy S, Peck J, Bouchaud MT, Shelton D. Measurement in Correctional Health Research: Unique Challenges and Strategies for Enhanced Rigor. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:238-252. [DOI: 10.1177/1078345819854216] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Jennifer Peck
- Department of Criminal Justice, University of Central Florida, Orlando, FL, USA
| | | | - Deborah Shelton
- Center for Correctional Heath Networks, School of Nursing, University of Connecticut, Storrs, CT, USA
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Staton M, Ciciurkaite G, Oser C, Tillson M, Leukefeld C, Webster JM, Havens JR. Drug Use and Incarceration among Rural Appalachian Women: Findings From a Jail Sample. Subst Use Misuse 2018; 53:931-941. [PMID: 29161158 PMCID: PMC6121714 DOI: 10.1080/10826084.2017.1385631] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND/OBJECTIVE The purpose of this paper is to examine drug use and incarceration history among rural Appalachian women. METHODS This study involved random selection, screening, and interviews with rural women from local jails in Appalachia. RESULTS Of the women randomly selected and screened, 97% met criteria for substance use intervention. Significant factors associated with incarceration history included age, education, custody status, and mental health. A significant interaction was observed between male sex partners and drug use on incarceration history. CONCLUSIONS Study findings suggest that the drug/crime relationship among rural Appalachian women is associated with their high-risk home environment, partner relationships, and mental health. Specifically, in addition to drug use, factors such as family and child relationships, anxiety, victimization, and relationships with partners should also be considered in the trajectory of criminal careers among rural Appalachian women.
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Affiliation(s)
- Michele Staton
- a Department of Behavioral Science , University of Kentucky , College of Medicine, Lexington , Kentucky , USA
| | - Gabriele Ciciurkaite
- b Department of Sociology , Social Work and Anthropology, Utah State University , Logan , Utah , USA
| | - Carrie Oser
- c Department of Sociology , University of Kentucky , Lexington , Kentucky , USA
| | - Martha Tillson
- d Department of Behavioral Science, Center on Drug and Alcohol Research , University of Kentucky , Lexington , Kentucky , USA
| | - Carl Leukefeld
- d Department of Behavioral Science, Center on Drug and Alcohol Research , University of Kentucky , Lexington , Kentucky , USA
| | - J Matthew Webster
- d Department of Behavioral Science, Center on Drug and Alcohol Research , University of Kentucky , Lexington , Kentucky , USA
| | - Jennifer R Havens
- d Department of Behavioral Science, Center on Drug and Alcohol Research , University of Kentucky , Lexington , Kentucky , USA
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Sugarman DE, Campbell ANC, Iles BR, Greenfield SF. Technology-Based Interventions for Substance Use and Comorbid Disorders: An Examination of the Emerging Literature. Harv Rev Psychiatry 2018; 25:123-134. [PMID: 28475504 PMCID: PMC5421396 DOI: 10.1097/hrp.0000000000000148] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Among individuals with substance use disorders (SUDs), comorbidity with other psychiatric disorders is common and often noted as the rule rather than the exception. Standard care that provides integrated treatment for comorbid diagnoses simultaneously has been shown to be effective. Technology-based interventions (TBIs) have the potential to provide a cost-effective platform for, and greater accessibility to, integrated treatments. For the purposes of this review, we defined TBIs as interventions in which the primary targeted aim was delivered by automated computer, Internet, or mobile system with minimal to no live therapist involvement. A search of the literature identified nine distinct TBIs for SUDs and comorbid disorders. An examination of this limited research showed promise, particularly for TBIs that address problematic alcohol use, depression, or anxiety. Additional randomized, controlled trials of TBIs for comorbid SUDs and for anxiety and depression are needed, as is future research developing TBIs that address SUDs and comorbid eating disorders and psychotic disorders. Ways of leveraging the full capabilities of what technology can offer should also be further explored.
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Affiliation(s)
- Dawn E Sugarman
- From Harvard Medical School (Drs. Sugarman and Greenfield); Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478 (Drs. Sugarman and Greenfield, and Ms. Iles); Department of Psychiatry, Columbia University Medical Center, New York, NY (Dr. Campbell); New York State Psychiatric Institute, New York, NY (Dr. Campbell)
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Schwartz RP, McNeely J, Wu LT, Sharma G, Wahle A, Cushing C, Nordeck CD, Sharma A, O'Grady KE, Gryczynski J, Mitchell SG, Ali RL, Marsden J, Subramaniam GA. Identifying substance misuse in primary care: TAPS Tool compared to the WHO ASSIST. J Subst Abuse Treat 2017; 76:69-76. [PMID: 28159441 PMCID: PMC5377907 DOI: 10.1016/j.jsat.2017.01.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is a need for screening and brief assessment instruments to identify primary care patients with substance use problems. This study's aim was to examine the performance of a two-step screening and brief assessment instrument, the TAPS Tool, compared to the WHO ASSIST. METHODS Two thousand adult primary care patients recruited from five primary care clinics in four Eastern US states completed the TAPS Tool followed by the ASSIST. The ability of the TAPS Tool to identify moderate- and high-risk use scores on the ASSIST was examined using sensitivity and specificity analyses. RESULTS The interviewer and self-administered computer tablet versions of the TAPS Tool generated similar results. The interviewer-administered version (at cut-off of 2), had acceptable sensitivity and specificity for high-risk tobacco (0.90 and 0.77) and alcohol (0.87 and 0.80) use. For illicit drugs, sensitivities were >0.82 and specificities >0.92. The TAPS (at a cut-off of 1) had good sensitivity and specificity for moderate-risk tobacco use (0.83 and 0.97) and alcohol (0.83 and 0.74). Among illicit drugs, sensitivity was acceptable for moderate-risk of marijuana (0.71), while it was low for all other illicit drugs and non-medical use of prescription medications. Specificities were 0.97 or higher for all illicit drugs and prescription medications. CONCLUSIONS The TAPS Tool identified adult primary care patients with high-risk ASSIST scores for all substances as well moderate-risk users of tobacco, alcohol, and marijuana, although it did not perform well in identifying patients with moderate-risk use of other drugs or non-medical use of prescription medications. The advantages of the TAPS Tool over the ASSIST are its more limited number of items and focus solely on substance use in the past 3months.
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Affiliation(s)
- R P Schwartz
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
| | - J McNeely
- New York University School of Medicine, Department of Population Health, 550 First Avenue, VZ30 6th floor, New York, NY 10016, USA.
| | - L T Wu
- Duke University, Department of Psychiatry and Behavioral Sciences and Department of Medicine, Duke University Medical Center, Durham, NC, USA.
| | - G Sharma
- Emmes Corporation, 401 North Washington Street, Suite 700, Rockville, MD 20850, USA.
| | - A Wahle
- Emmes Corporation, 401 North Washington Street, Suite 700, Rockville, MD 20850, USA
| | - C Cushing
- National Institute on Drug Abuse, 6001 Executive Boulevard, Rockville, MD 20852, USA
| | - C D Nordeck
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA
| | - A Sharma
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA
| | - K E O'Grady
- University of Maryland, College Park, Department of Psychology, 4094 Campus Dr., College Park, MD 20742, USA
| | - J Gryczynski
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA
| | - S G Mitchell
- Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA
| | - R L Ali
- University of Adelaide, Department of Pharmacology, Frome Road, Level 5, Medical School North Bldg, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - J Marsden
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Addiction Sciences Building, 4 Windsor Walk, Denmark Hill, SE5 8BB London, United Kingdom.
| | - G A Subramaniam
- National Institute on Drug Abuse, 6001 Executive Boulevard, Rockville, MD 20852, USA.
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Christoff AO, Barreto HGA, Boerngen-Lacerda R. Development of a Computer-Based Format for the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) With University Students. Subst Use Misuse 2016; 51:1207-17. [PMID: 27191627 DOI: 10.3109/10826084.2016.1161053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) is a reliable and valid tool for the early detection of harmful and hazardous drug use in primary care settings when administered by interview in the general population. In university students, substance use is high, so a reliable and feasible screening instrument is needed. OBJECTIVES To compare the computer-based ASSIST (ASSISTc) with the interview format (ASSISTi). METHODS A convenience sample with counterbalanced design was used alternating between the ASSISTi and ASSISTc with 15-day interval. Although this is not a traditional test-retest reliability study, the same statistical analysis was used: intraclass correlations (ICC), kappa (κ), and Cronbach's alpha (α) to compare the two formats. A satisfaction questionnaire was applied immediately after the second session. RESULTS Both formats were completed by the students (n = 809) over 15 days. The scores of involvement with all substances and with tobacco, alcohol, cannabis, and cocaine obtained with the two formats demonstrated excellent ICC (> .77). The level of agreement was considered substantial for tobacco (κ = .69) and cannabis (κ = .70) and moderate for alcohol (κ = .58). The consistency of the ASSISTc was considered satisfactory (α: .85 for tobacco, .73 for alcohol, and .87 for cannabis). The analysis of satisfaction and feasibility showed that the ASSISTi was easier to understand, but the two formats were considered similar when considering acceptability, ease of responding, and degree of intimidation. CONCLUSIONS/IMPORTANCE The two formats are acceptable, the scores are comparable, and they can be used interchangeably.
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Affiliation(s)
| | | | - Roseli Boerngen-Lacerda
- c Universidade Federal do Parana, Pharmacology, Setor de Ciencias Biologicas, Centro Politecnico Jardim das Americas , Curitiba , Brazil
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Spear SE, Shedlin M, Gilberti B, Fiellin M, McNeely J. Feasibility and acceptability of an audio computer-assisted self-interview version of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in primary care patients. Subst Abus 2016; 37:299-305. [PMID: 26158798 PMCID: PMC4962999 DOI: 10.1080/08897077.2015.1062460] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study explores the feasibility and acceptability of a computer self-administered approach to substance use screening from the perspective of primary care patients. METHODS Forty-eight patients from a large safety net hospital in New York City completed an audio computer-assisted self-interview (ACASI) version of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and a qualitative interview to assess feasibility and acceptability, comprehension, comfort with screening questions, and preferences for screening mode (interviewer or computer). Qualitative data analysis organized the participants' feedback into major themes. RESULTS Participants overwhelmingly reported being comfortable with the ACASI ASSIST. Mean administration time was 5.2 minutes (range: 1.6-14.8 minutes). The major themes from the qualitative interviews were (1) ACASI ASSIST is feasible and acceptable to patients, (2) Social stigma around substance use is a barrier to patient disclosure, and (3) ACASI screening should not preclude personal interaction with providers. CONCLUSIONS The ACASI ASSIST is an appropriate and feasible approach to substance use screening in primary care. Because of the highly sensitive nature of substance use, screening tools must explain the purpose of screening, assure patients that their privacy is protected, and inform patients of the opportunity to discuss their screening results with their provider.
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Affiliation(s)
| | | | - Brian Gilberti
- New York University School of Medicine, New York, NY, USA
| | - Maya Fiellin
- New York University School of Medicine, New York, NY, USA
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Queiroz NDR, Portella LF, Abreu AMM. Associação entre o consumo de bebidas alcoólicas e tabaco e a religiosidade. ACTA PAUL ENFERM 2015. [DOI: 10.1590/1982-0194201500091] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Verificar a associação entre a religiosidade e o padrão de consumo de álcool e tabaco em população atendida na Atenção Primária à Saúde. Métodos Estudo transversal realizado com 363 indivíduos, maiores de 18 anos. A variável de exposição, religiosidade, foi avaliada segundo o Índice de Religiosidade da Universidade de Duke. O desfecho, consumo de álcool e tabaco, foi avaliado pelo questionário Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Verificou-se a associação entre exposição e desfecho, com base na análise de regressão logística multivariada. Resultados Foi alta a prevalência no consumo de álcool e tabaco nos grupos mais vulneráveis. As religiosidades organizacional e intrínseca mostraram-se fator de proteção em relação ao consumo moderado/alto de álcool e tabaco. Conclusão Quanto maior o escore para a religiosidade organizacional e intrínseca, menor o consumo para essas substâncias.
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