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Villanueva-Blasco VJ, Eslava D, Olave L, Torrens M. Electronic interventions in primary care to address substance use: A systematic review. Addict Behav 2024; 156:108073. [PMID: 38821009 DOI: 10.1016/j.addbeh.2024.108073] [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: 03/20/2024] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 06/02/2024]
Abstract
The present systematic review aims to identify electronic interventions for addressing substance use and understand their effectiveness in primary care settings. A systematic search was carried out in the Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library. The search included the keywords "electronic intervention", "substance use", "primary care" and synonyms. To determine the quality and recommendation of the analyzed interventions, the efficacy results reported by the studies were considered, as well as the Mixed Methods Appraisal Tool (MMAT) assessment and the GRADE Evidence Assessment. Twenty-one electronic interventions in Primary Care were identified: internet, mobile or tablet applications, text messages, emails, automated telephone calls, or electronic self-reports. These interventions had diverse components, incorporating theories that have proven effective in face-to-face interventions as their theoretical frameworks. Some of them were complementary to in-person treatment, while others replaced it. Six interventions (28.5 %) displayed high quality: HealthCall, AB-CASI, Quit Genius, eCHECKUP-TOGO, CBI, and TES. Another nine interventions (42.8 %) were found to have moderate-high quality: Alcohol y Salud, IVR-BI, Program of Wallace et al., Let's Talk About Smoking, SMSalud, ESCAPE, AAC-ASPIRE, iQuit, and Programa VIH. One intervention (4.7 %) had moderate-low quality: Vive sin tabaco ¡Decídete! The remaining five interventions (23.8 %) were found to have very low quality: Connection to health, cSBI, Teen Well Check, the program of Helzer et al. (2008), and Down your drink. The programs with the highest recommendation for addressing alcohol-related issues are HealthCall and AB-CASI; for tobacco use, it is Quit Genius; for cannabis use, it is eCHECKUP-TOGO; for addressing both legal and illegal substances, it is CBI and TES. Finally, for specific illicit drug use, the only recommended program is CBI. This last intervention, CBI, is of the highest quality and, therefore, can be considered a model intervention for dissemination in the primary care setting.
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Affiliation(s)
- Víctor J Villanueva-Blasco
- Faculty of Health Sciences, Valencian International University, C/ Pintor Sorolla, 21, 46002, Spain; Research Group on Health and Psycho-Social Adjustment (GI-SAPS), Valencian International University, Spain; Research Network in Primary Addiction Care (RIAPAd), Spain.
| | - Dalila Eslava
- Research Network in Primary Addiction Care (RIAPAd), Spain; Faculty of Human Sciences and Education, University of Zaragoza, Spain.
| | - Leticia Olave
- Faculty of Health Sciences, Valencian International University, C/ Pintor Sorolla, 21, 46002, Spain; Research Group on Health and Psycho-Social Adjustment (GI-SAPS), Valencian International University, Spain.
| | - Marta Torrens
- Research Network in Primary Addiction Care (RIAPAd), Spain; Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Research Institute, Spain; School of Medicine, Universitat de Vic-Central de Catalunya (UCC), Spain.
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Courtney D, Mason J, Amani B, Rodak T, Szatmari P, Henderson J, de Oliveira C. Economic evaluations of treatment of depressive disorders in adolescents: Protocol for a scoping review. Early Interv Psychiatry 2024; 18:391-396. [PMID: 38323501 DOI: 10.1111/eip.13498] [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: 02/23/2023] [Revised: 09/28/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
AIM Depressive disorders in adolescents are common and impairing. Evidence-based treatments are available; however, at a cost. In the context of the COVID-19 pandemic, we anticipate increased demand for treatment services for adolescents with depression. We also anticipate that economic resources will be strained. Identifying cost-effective strategies to optimally treat depression in adolescents is imperative. This protocol for a scoping review aims to describe the literature with respect to economic evaluations of treatments for depression in adolescents. METHODS We will conduct a scoping review using established methods and reporting guidelines. MEDLINE, Embase, PsyclNFO, Econlit, and the International HTA Database will be searched from inception to June 13, 2023, with an update closer to time of manuscript submission, while the NHS Economic Evaluation Database archives will be searched from inception to December 2014. Publications that contain economic evaluations, in the context of a clinical trial or a model-based study, testing a treatment of depression in adolescents will be selected for inclusion. Extracted data items will include: economic evaluation perspectives, health outcome variables and costs used in economic evaluations, types of analyses performed, as well as quality of reporting and methodology. RESULT A narrative synthesis with summary tables will be used to describe our findings. CONCLUSION Our findings will help identify gaps in the literature with respect to economic analyses for the treatment of depression such that these gaps can be filled with future research. Policy-makers, funders and administrators may also use our findings to inform their decisions around provision of various treatments for depression in adolescents. REGISTRATION osf.io/5fteb (note that information on this link will be updated upon acceptance for publication based on reviewer comments).
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Affiliation(s)
- Darren Courtney
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Joyce Mason
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Bahar Amani
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Terri Rodak
- CAMH Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jo Henderson
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Claire de Oliveira
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Shaw E, Nunns M, Spicer SG, Lawal H, Briscoe S, Melendez‐Torres GJ, Garside R, Liabo K, Coon JT. What is the volume, quality and characteristics of evidence relating to the effectiveness and cost-effectiveness of multi-disciplinary occupational health interventions aiming to improve work-related outcomes for employed adults? An evidence and gap map of systematic reviews. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1412. [PMID: 38751859 PMCID: PMC11094349 DOI: 10.1002/cl2.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background In the UK, tens of millions of working days are lost due to work-related ill health every year, costing billions of pounds. The role of Occupational Health (OH) services is vital in helping workers to maintain employment when they encounter injury or illness. OH providers traditionally rely on a clinical workforce to deliver these services, particularly doctors and nurses with OH qualifications. However, the increasing demand for OH services is unlikely to be met in the future using this traditional model, due to the declining number of OH-trained doctors and nurses in the UK. Multi-disciplinary models of OH delivery, including a more varied range of healthcare and non-healthcare professionals, could provide a way to meet this new demand for OH services. There is a need to identify collaborative models of OH service delivery and review their effectiveness on return-to work outcomes. There is an existing pool of systematic review evidence evaluating workplace based, multi-disciplinary OH interventions, but it is difficult to identify which aspects of the content and/or delivery of these interventions may be associated with improved work-related outcomes. Objectives The aim of this evidence and gap map (EGM) was to provide an overview of the systematic review evidence that evaluates the effectiveness and cost-effectiveness of multi-disciplinary OH interventions intending to improve work-related outcomes. Search Methods In June 2021 we searched a selection of bibliographic databases and other academic literature resources covering a range of relevant disciplines, including health care and business studies, to identify systematic review evidence from a variety of sectors of employment. We also searched Google Search and a selection of topically relevant websites and consulted with stakeholders to identify reports already known to them. Searches were updated in February 2023. Selection Criteria Systematic reviews needed to be about adults (16 years or over) in employment, who have had absence from work for any medical reason. Interventions needed to be multi-disciplinary (including professionals from different backgrounds in clinical and non-clinical professions) and designed to support employees and employers to manage health conditions in the workplace and/or to help employees with health conditions retain and/or return to work following medical absence. Effectiveness needed to be measured in terms of return to work, work retention or measures of absence, or economic evaluation outcomes. These criteria were applied to the title and abstract and full text of each systematic review independently by two reviewers, with disagreements resolved through discussion. We awarded each systematic review a rating of 'High', 'Medium' or 'Low' relevance to indicate the extent to which the populations, interventions and their contexts synthesised within the review were consistent with our research question. We also recorded the number of primary studies included within each of the 'High' and 'Medium' reviews that were relevant to research question using the same screening process applied at review level. Data Collection and Analysis Summary data for each eligible review was extracted. The quality of the systematic reviews, rated as 'High' or 'Medium' relevance following full text screening, was appraised using the AMSTAR-2 quality appraisal tool. All data were extracted by one reviewer and checked by a second, with disagreements being settled through discussion. Summary data for all eligible systematic reviews were tabulated and described narratively. The data extracted from reviews of 'High' and 'Medium' relevance was imported into EPPI-Mapper software to create an EGM. Stakeholder Involvement We worked alongside commissioners and policy makers from the Department of Health and Social Care (DHSC) and Department of Work and Pensions (DWP), OH personnel, and people with lived experience of accessing OH services themselves and/or supporting employees to access OH services. Individuals contributed to decision making at all stages of the project. This ensured our EGM reflects the needs of individuals who will use it. Main Results We identified 98 systematic reviews that contained relevant interventions, which involved a variety of professionals and workplaces, and which measured effectiveness in terms of return to work (RTW). Of these, we focused on the 30 reviews where the population and intervention characteristics within the systematic reviews were considered to be of high or medium relevance to our research questions. The 30 reviews were of varying quality, split evenly between High/Moderate quality and Low/Critically-Low quality ratings. We did not identify any relevant systematic review evidence on any other work-related outcome of interest. Interventions were heterogenous, both within and across included systematic reviews. The EGM is structured according to the health condition experienced by participants, and the effectiveness of the interventions being evaluated, as reported within the included systematic reviews. It is possible to view (i) the quality and quantity of systematic review evidence for a given health condition, (ii) how review authors assessed the effectiveness or cost-effectiveness of the interventions evaluated. The EGM also details the primary studies relevant to our research aim included within each review. Authors’ Conclusions This EGM map highlights the array of systematic review evidence that exists in relation to the effectiveness or cost-effectiveness of multi-disciplinary, workplace-based OH interventions in supporting RTW. This evidence will allow policy makers and commissioners of services to determine which OH interventions may be most useful for supporting different population groups in different contexts. OH professionals may find the content of the EGM useful in identifying systematic review evidence to support their practice. The EGM also identifies where systematic review evidence in this area is lacking, or where existing evidence is of poor quality. These may represent areas where it may be particularly useful to conduct further systematic reviews.
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Affiliation(s)
- Elizabeth Shaw
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Michael Nunns
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Stuart G. Spicer
- NIHR Applied Research CollaborationUniversity of PlymouthPlymouthUK
| | - Hassanat Lawal
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Simon Briscoe
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - G. J. Melendez‐Torres
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Ruth Garside
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Kristin Liabo
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
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Levine JA. The Fidget Factor and the obesity paradox. How small movements have big impact. Front Sports Act Living 2023; 5:1122938. [PMID: 37077429 PMCID: PMC10106700 DOI: 10.3389/fspor.2023.1122938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/05/2023] Open
Abstract
The hypothesis is that the Fidget Factor is the innate neurological pulse that propels humans and other species to move to support their health. Fidgets, previously thought to be spontaneous, are neurologically regulated and highly ordered (non-random). Modern societies being chair-based overwhelm Fidget Factor pulses and consequently inflict chair-based living for transportation, labor, and leisure. Despite impulses firing through the nervous system, people sit because environmental design overwhelms the biology. Urbanization and chair-based societies were designed after the industrial revolution to promote productivity; however, the consequence has been opposite. Crushing the natural urge to move—the Fidget Factor—is a public health calamity. Excess sitting is associated with a myriad of detrimental health consequences and impairs productivity. Fidgeting may reduce all-cause mortality associated with excessive sitting. The Fidget Factor offers hope; data demonstrate that workplaces and schools can be designed to promote activity and free people's Fidget Factors. Evidence shows that people are happier, healthier, wealthier, and more successful if their Fidget Factors are freed.
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de Oliveira C, Saka M, Bone L, Jacobs R. The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:167-193. [PMID: 36376610 PMCID: PMC9663290 DOI: 10.1007/s40258-022-00761-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Mental health disorders in the workplace have increasingly been recognised as a problem in most countries given their high economic burden. However, few reviews have examined the relationship between mental health and worker productivity. OBJECTIVE To review the relationship between mental health and lost productivity and undertake a critical review of the published literature. METHODS A critical review was undertaken to identify relevant studies published in MEDLINE and EconLit from 1 January 2008 to 31 May 2020, and to examine the type of data and methods employed, study findings and limitations, and existing gaps in the literature. Studies were critically appraised, namely whether they recognised and/or addressed endogeneity and unobserved heterogeneity, and a narrative synthesis of the existing evidence was undertaken. RESULTS Thirty-eight (38) relevant studies were found. There was clear evidence that poor mental health (mostly measured as depression and/or anxiety) was associated with lost productivity (i.e., absenteeism and presenteeism). However, only the most common mental disorders were typically examined. Studies employed questionnaires/surveys and administrative data and regression analysis. Few studies used longitudinal data, controlled for unobserved heterogeneity or addressed endogeneity; therefore, few studies were considered high quality. CONCLUSION Despite consistent findings, more high-quality, longitudinal and causal inference studies are needed to provide clear policy recommendations. Moreover, future research should seek to understand how working conditions and work arrangements as well as workplace policies impact presenteeism.
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Affiliation(s)
- Claire de Oliveira
- Centre for Health Economics, University of York, York, UK.
- Hull York Medical School, Hull and York, UK.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
| | | | | | - Rowena Jacobs
- Centre for Health Economics, University of York, York, UK
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Penev T, Zhao S, Lee JL, Chen CE, Metcalfe L, Ozminkowski RJ. The Impact of a Workforce Mental Health Program on Employer Medical Plan Spend: An Application of Cost Efficiency Measurement for Mental Health Care. Popul Health Manag 2023; 26:60-71. [PMID: 36799934 PMCID: PMC9969895 DOI: 10.1089/pop.2022.0240] [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] [Indexed: 02/18/2023] Open
Abstract
Mental health issues often result in significant impairment and financial challenges, both at home and in the workplace. Solutions vary widely in their usage and cost-effectiveness. This study presents an analysis of medical and prescription drug spending and utilization data for the employees of 4 companies who were eligible for an evidence-based workforce mental health program (WMHP). A variation of coarsened exact matching paired WMHP users to nonusers, based on demographics, location, and medical factors. Individuals included 2791 pairs of members whose medical claims were incurred in 2018 and 3883 pairs with claims in 2019. Using a cost efficiency measurement process, mean cost and utilization per person per year (PPPY) were compared. WMHP users had lower medical (-$2295 in 2018; -$2304 in 2019) and prescription drug spending (-$295 in 2018; -$312 in 2019). Over half of the cost reduction (-$1252 in 2018; -$1211 in 2019) resulted from shifting therapy services from the medical benefit to WMHP. WMHP users attended about 12 sessions PPPY, whereas the comparison group of nonusers attended about 7 mental health office visits PPPY under the medical benefit. WMHP users had more mental health-related visits in both years, but had fewer visits on the medical plan, and fewer emergency department visits for mental health than comparison group members. These results provide evidence that high-quality, evidence-based mental health services can reduce total expenditures and change utilization patterns. Evidence-based WMHP may represent a prudent investment for employers in providing mental health care to employees.
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Affiliation(s)
- Todor Penev
- Health Solutions, Aon plc, Atlanta, Georgia, USA
| | - Shelley Zhao
- Health Solutions, Aon plc, Portland, Oregon, USA
| | - Jennifer L Lee
- Lyra Health, Burlingame, California, USA.,Emory University School of Medicine, Atlanta, Georgia, USA
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Park D, Minnick D. Workplace Context to Prevent Substance Misuse in the United States: Associations Between workplace Policies and Employee Substance Use Disorders. JOURNAL OF DRUG ISSUES 2023. [DOI: 10.1177/00220426231152913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Workplace policies are important because employee rates of alcohol and drug misuse can be associated with work-related risk factors in the United States. To explore the associations, this study analyzed the 2010–2014 National Survey on Drug Use and Health datasets. The overall sample size was 130,726, and the SUD outcome variables included alcohol, marijuana, pain reliever, and illicit drug use disorders. 20% of participants reported no substance use policies in their workplace. Significant associations were identified between all four measured SUD outcome variables, the presence of specific substance use workplace policies, and individual employment sectors. Specifically, comprehensive policies out of six policies were significantly associated with decreased SUDs in nearly every employment sector. The results of this study suggest that workplace substance use policies are important to prevent the development of employee SUDs and comprehensive policies in place can be most effective.
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Affiliation(s)
- Daejun Park
- Department of Social Work, Ohio University, Athens, OH, USA
| | - Dane Minnick
- Department of Social Work, Ball State University, Muncie, IN, USA
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Syurin S, Vinnikov D. Occupational disease predictors in the nickel pyrometallurgical production: a prospective cohort observation. J Occup Med Toxicol 2022; 17:21. [PMID: 36335380 PMCID: PMC9636620 DOI: 10.1186/s12995-022-00362-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/10/2022] [Accepted: 10/24/2022] [Indexed: 11/08/2022] Open
Abstract
Background Pyrometallurgical nickel production exposes workers to a wide range of occupational risk factors, including nickel aerosol, occupational noise and heat, but occupational (compensation) claims do not get enough attention in the literature. We, therefore, aimed to identify and analyze new occupational disease predictors in order to tailor prevention measures in the nickel pyrometallurgical production workers. Methods In a prospective observational study, a cohort of workers grouped in 16 occupations (N = 1424, 88% males, median age 39 (interquartile range (IQR) 31–47 years)), was fixed in 2007 at a large nickel production plant in the Russian High North. We then followed the cohort until 2021 and analyzed the association of selected predictors, including exposure to nickel and occupational group, with the risk of an occupational (compensation) claim in a Cox regression analysis. Results With 18,843 person-years of observation, occupational disease claims were confirmed in 129 workers (9% of the initial cohort, N = 108 men (84%)). Top three diagnoses were chronic bronchitis (3.81 cases/1000 workers/year), sensorineural deafness (2.36 cases/1000 workers /year) and musculoskeletal disorders (1.90 cases/1000 workers/year). Smoking was significantly associated with each diagnosis (adjusted hazard ratio (HR) ranged from 2.56 (95% confidence interval (CI) 1.17–5.57) for bronchitis to 6.69 (95% CI 1.46–30.64) for chronic obstructive pulmonary disease (COPD)). High nickel exposure was associated with occupational bronchitis and occupational asthma, whereas associations of occupational groups were also identified for COPD, asthma and musculoskeletal disorders. Conclusion Smoking, high exposure to nickel and specific exposure in the occupational groups increase the risk of occupational disease claims and should be prioritized directions for targeted intervention.
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Morgan JR, Murphy SM, Assoumou SA, Linas BP. Estimating Absenteeism Related to Nonalcohol Substance Use in a US National Cohort of Full-Time Employees. J Occup Environ Med 2022; 64:899-904. [PMID: 35901222 PMCID: PMC9637773 DOI: 10.1097/jom.0000000000002612] [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: 12/31/2022]
Abstract
OBJECTIVE We aimed to estimate absenteeism due to substance use disorder among full-time employees. METHODS We used the 2018 National Survey on Drug Use and Health to identify a sample of individuals employed full time. We used a survey-weighted multivariable negative binomial model to evaluate the association between absenteeism and type of substance use disorder controlling for available demographic information. RESULTS In the adjusted model, we estimated that opioid use without a disorder had the highest absenteeism for use, and polysubstance use disorder had the highest absenteeism among use disorders. In a hypothetical firm of 10,000 employees, we estimate $232,000 of lost wage value annually. CONCLUSIONS Substance use is associated with absenteeism and presents a compelling argument for employers to promote programs that support treatment for employees and reduce downstream costs associated with absenteeism and turnover.
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Affiliation(s)
- Jake R Morgan
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts (Dr Morgan); Department of Population Health Sciences, Weill Cornell Medical College, New York, New York (Dr Murphy); Department of Medicine, Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (Dr Assoumou, Dr Linas); Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, Massachusetts (Dr Assoumou, Dr Linas); and Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts (Dr Linas)
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Psychiatric Symptoms and Frequency of Eating out among Commuters in Beijing: A Bidirectional Association? Nutrients 2022; 14:nu14204221. [PMID: 36296905 PMCID: PMC9609142 DOI: 10.3390/nu14204221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 09/30/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Mental illness places as a distant first in global burdens, exceeding both cardiovascular and circulatory diseases, in terms of the years lived with the disability. The emergence of the new and burgeoning area of “Nutrition Psychiatry” offers promise in improving mental health with diet. Mental health and well-being are critical to commuters but rarely recieve the attention they need. This study aimed to examine the bidirectional relationship between the frequency of eating out and depression, anxiety, and stress symptoms in a sample of Beijing commuters. Methods: A total of 3337 commuters (mean (SD) age, 38.78 (10.41); 74.74% males) from the cohort study CHCN-BTH were included. The psychiatric symptoms were evaluated using a 21-item self-reported depression–anxiety–stress scale (DASS-21). A Cochran–Armitage trend chi-square test, restricted cubic spline, multiple logistic regression, multinomial logit models, and E-values were performed to estimate the associations between eating out and psychiatric symptoms in both directions. Results: A daily rate of eating out more than 50% had a higher risk for depression (OR, 95% CI: 1.68, 1.184–2.393), anxiety (1.73, 1.259–2.369), and stress (1.99, 1.191–3.329) than the individuals eating at home. A higher frequency of eating out for lunch was significantly associated with an increased risk of depression (1.78, 1.28–2.46), anxiety (1.67, 1.26–2.23), and stress (2.05, 1.31–3.22). Similar results were found when eating out for dinner with increased risks for depression 2.20 (1.59, 3.06), anxiety 1.91 (1.42, 2.59), and stress 2.61 (1.68, 4.05). There is limited evidence supporting the effects of psychiatric symptoms on the frequency of eating out in the reverse analyses. Conclusions: The frequency of eating out is positively associated with an increased risk of psychiatric symptoms, especially when eating out for lunch and dinner. People eating at home have the lowest risk of suffering psychiatric symptoms, followed by those eating in the workplace canteen. Eating at home should be considered for future recommendations for the prevention of psychiatric symptoms.
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Nazarova A, Schmidt M, Cookey J, Uher R. Neural markers of familial risk for depression - A systematic review. Dev Cogn Neurosci 2022; 58:101161. [PMID: 36242901 PMCID: PMC9557819 DOI: 10.1016/j.dcn.2022.101161] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 01/13/2023] Open
Abstract
Structural and functional brain alterations are found in adults with depression. It is not known whether these changes are a result of illness or exist prior to disorder onset. Asymptomatic offspring of parents with depression offer a unique opportunity to research neural markers of familial risk to depression and clarify the temporal sequence between brain changes and disorder onset. We conducted a systematic review to investigate whether asymptomatic offspring at high familial risk have structural and functional brain changes like those reported in adults with depression. Our literature search resulted in 44 studies on 18,645 offspring ranging from 4 weeks to 25 years old. Reduced cortical thickness and white matter integrity, and altered striatal reward processing were the most consistent findings in high-risk offspring across ages. These alterations are also present in adults with depression, suggesting the existence of neural markers of familial risk for depression. Additional studies reproducing current results, streamlining fMRI data analyses, and investigating underexplored topics (i.e intracortical myelin, gyrification, subcortical shape) may be among the next steps required to improve our understanding of neural markers indexing the vulnerability to depression.
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Affiliation(s)
- Anna Nazarova
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Memorial Building QEII Health Sciences Centre, B3H 2E2 Halifax, NS, Canada,Nova Scotia Health Authority, 5909 Veterans’ Memorial Lane, B3H 2E2 Halifax, NS, Canada
| | - Matthias Schmidt
- Nova Scotia Health Authority, 5909 Veterans’ Memorial Lane, B3H 2E2 Halifax, NS, Canada,Department of Diagnostic Radiology, Dalhousie University, Victoria Building, Office of the Department Head, Room 307, 1276 South Park Street PO BOX 9000, B3H 2Y9 Halifax NS, Canada
| | - Jacob Cookey
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Memorial Building QEII Health Sciences Centre, B3H 2E2 Halifax, NS, Canada,Nova Scotia Health Authority, 5909 Veterans’ Memorial Lane, B3H 2E2 Halifax, NS, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Memorial Building QEII Health Sciences Centre, B3H 2E2 Halifax, NS, Canada,Nova Scotia Health Authority, 5909 Veterans’ Memorial Lane, B3H 2E2 Halifax, NS, Canada,Corresponding author at: Department of Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Abbie J. Lane Memorial Building QEII Health Sciences Centre, B3H 2E2 Halifax, NS, Canada.
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Joanna Y, Rachel L, Alice S, Georgia M, Fehmidah M. Meta-synthesis of qualitative research on the barriers and facilitators to implementing workplace mental health interventions. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bai F, Li M, Han J, Qin Y, Yao L, Yan W, Liu Y, He G, Zhou Y, Ma X, Aboudou T, Guan L, Lu M, Wei Z, Li X, Yang K. More work is needed on cost-utility analyses of robotic-assisted surgery. J Evid Based Med 2022; 15:77-96. [PMID: 35715999 DOI: 10.1111/jebm.12475] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 05/19/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To comprehensively analyze the cost-utility of robotic surgery in clinical practice and to investigate the reporting and methodological quality of the related evidence. METHODS Data on cost-utility analyses (CUAs) of robotic surgery were collected in seven electronic databases from the inception to July 2021. The quality of the included studies was assessed using the CHEERs and QHES checklists. A systematic review was performed with the incremental cost-effectiveness ratio as the outcome of interest. RESULTS Thirty-one CUAs of robotic surgery were eligible. Overall, the identified CUAs were fair to high quality, and 63% of the CUAs ranked the cost-utility of robotic surgery as "favored," 32% categorized as "reject," and the remaining 5% ranked as "unclear." Although a high heterogeneity was present in terms of the study design among the included CUAs, most studies (81.25%) consistently found that robotic surgery was more cost-utility than open surgery for prostatectomy (ICER: $6905.31/QALY to $26240.75/QALY; time horizon: 10 years or lifetime), colectomy (dominated by robotic surgery; time horizon: 1 year), knee arthroplasty (ICER: $1134.22/QALY to $1232.27/QALY; time horizon: lifetime), gastrectomy (dominated by robotic surgery; time horizon: 1 year), spine surgery (ICER: $17707.27/QALY; time horizon: 1 year), and cystectomy (ICER: $3154.46/QALY; time horizon: 3 months). However, inconsistent evidence was found for the cost-utility of robotic surgery versus laparoscopic surgery and (chemo)radiotherapy. CONCLUSIONS Fair or high-quality evidence indicated that robotic surgery is more cost-utility than open surgery, while it remains inconclusive whether robotic surgery is more cost-utility than laparoscopic surgery and (chemo)radiotherapy. Thus, an additional evaluation is required.
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Affiliation(s)
- Fei Bai
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- National Center for Medical Service Administration, National Health Commission of the People's Republic of China, Beijing, China
| | - Meixuan Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Jiani Han
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Yu Qin
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Liang Yao
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Wenlong Yan
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yujun Liu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Gege He
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yinjuan Zhou
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Xiaoya Ma
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Taslim Aboudou
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Ling Guan
- School/Hospital of Stomatology, Lanzhou University, Lanzhou, China
| | - Mengying Lu
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Zhipeng Wei
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiuxia Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China
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Li M, Bai F, Yao L, Qin Y, Chen K, Xin T, Ma X, Ma Y, Zhou Y, Dai H, Li R, Li X, Yang K. Economic Evaluation of Cognitive Behavioral Therapy for Depression: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1030-1041. [PMID: 35422392 DOI: 10.1016/j.jval.2021.11.1379] [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: 05/08/2021] [Revised: 11/06/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to conduct a systematic review of cost-utility studies of internet-based and face-to-face cognitive behavioral therapy (CBT) for depression from childhood to adulthood and to examine their reporting and methodological quality. METHODS A structured search for cost-utility studies concerning CBT for depression was performed in 7 comprehensive databases from their inception to July 2020. Two reviewers independently screened the literature, abstracted data, and assessed quality using the Consolidated Health Economic Evaluation Reporting Standards and Quality of Health Economic Studies checklists. The primary outcome was the incremental cost-effectiveness ratio (ICER) across all studies. To make a relevant comparison of the ICERs across the identified studies, cost data were inflated to the year 2020 and converted into US dollars. RESULTS Thirty-eight studies were included in this review, of which 26 studies (68%) were deemed of high methodological quality and 12 studies (32%) of fair quality. Despite differences in study designs and settings, the conclusions of most included studies for adult depression were general agreement; they showed that face-to-face CBT monotherapy or combination therapy compared with antidepressants and usual care for adult depression were cost-effective from the societal, health system, or payer perspective (ICER -$241 212.4/quality-adjusted life-year [QALY] to $33 032.47/QALY, time horizon 12-60 months). Internet-based CBT regardless of guided or unguided also has a significant cost-effectiveness advantage (ICER -$37 717.52/QALY to $73 841.34/QALY, time horizon 3-36 months). In addition, CBT was cost-effective in preventing depression (ICER -$23 932.07/QALY to $26 092.02/QALY, time horizon 9-60 months). Nevertheless, the evidence for the cost-effectiveness of CBT for children and adolescents was still ambiguous. CONCLUSIONS Fair or high-quality evidence showed that CBT monotherapy or combination therapy for adult depression was cost-effective; whether CBT-related therapy was cost-effective for children and adolescents depression remains inconclusive.
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Affiliation(s)
- Meixuan Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Fei Bai
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; National Center for Medical Service Administration, Beijing, China
| | - Liang Yao
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Yu Qin
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Kaiyue Chen
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Tianjiao Xin
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiaoya Ma
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - YinXia Ma
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Yinjuan Zhou
- The Second School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Hui Dai
- The First School of Clinical Medicine Lanzhou University, Lanzhou, China
| | - Rui Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xiuxia Li
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; Health Technology Assessment Center, Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China.
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15
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Baird A, Xia Y, Cheng Y. Consumer perceptions of telehealth for mental health or substance abuse: a Twitter-based topic modeling analysis. JAMIA Open 2022; 5:ooac028. [PMID: 35495736 PMCID: PMC9047171 DOI: 10.1093/jamiaopen/ooac028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/18/2022] [Accepted: 04/14/2022] [Indexed: 12/26/2022] Open
Abstract
Objective The objective of this study is to understand the primary topics of consumer discussion on Twitter associated with telehealth for mental health or substance abuse for prepandemic versus during-pandemic time-periods, using a state-of-the-art machine learning (ML) natural language processing (NLP) method. Materials and Methods The primary methodological phases of this project were: (1) collecting, cleaning, and filtering data (tweets) from January 2014 to June 2021, (2) describing the final corpus, (3) running and optimizing Bidirectional Encoder Representations from Transformers (BERT; using BERTopic in Python) models, and (4) human refinement of topic model results and thematic classification of topics. Results The number of tweets in this context increased by 4 times during the pandemic (2017 tweets prepandemic vs 8672 tweets during the pandemic). During the pandemic topics were more frequently mental health related than substance abuse related. Top during-pandemic topics were therapy, suicide, pain (associated with burnout and drinking), and mental health diagnoses such as ADHD and autism. Anxiety was a key topic of discussion both pre- and during the pandemic. Discussion Telehealth for mental health and substance abuse is being discussed more frequently online, which implies growing demand. Given the topics extracted as proxies for demand, the most demand is currently for telehealth for mental health primarily, especially for children, parents, and therapy for those with anxiety or depression, and substance abuse secondarily. Conclusions Scarce telehealth resources can be allocated more efficiently if topics of consumer discussion are included in resource allocation decision- and policy-making processes. Telehealth for mental health and substance abuse is being discussed more frequently online. To determine what aspects of telehealth for mental health and/or substance abuse were being discussed most on Twitter, both before the pandemic and during the pandemic, we downloaded relevant tweets and ran a specialized machine learning model that extracts the most popular keywords from tweets as well as combines similar keywords into overall topics. We find 33 relevant topics prepandemic and 32 relevant topics during the pandemic to be relevant in this context. Given the topics extracted as proxies for demand, the most demand is currently for telehealth for mental health primarily, especially for children, parents, and therapy for those with anxiety or depression, and substance abuse secondarily. We also find that therapy and therapists were the top areas of discussion in regard to telehealth for mental health and/or substance abuse during the pandemic. These results can be applied to telehealth decision-making processes. In particular, scarce telehealth resources can be allocated more efficiently, particularly to those who currently need or want them most, if topics of consumer discussion are included in resource allocation decision- and policy-making processes.
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Affiliation(s)
- Aaron Baird
- Institute of Health Administration, Georgia State University, Atlanta, Georgia, USA
- Department of Computer Information Systems, Robinson College of Business, Georgia State University, Atlanta, Georgia, USA
| | - Yusen Xia
- Institute for Insight, Robinson College of Business, Georgia State University, Atlanta, Georgia, USA
| | - Yichen Cheng
- Institute for Insight, Robinson College of Business, Georgia State University, Atlanta, Georgia, USA
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16
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 301] [Impact Index Per Article: 150.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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17
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A smartphone app for the prevention and early intervention of body dysmorphic disorder: Development and evaluation of the content, usability, and aesthetics. Internet Interv 2022; 28:100521. [PMID: 35281703 PMCID: PMC8907679 DOI: 10.1016/j.invent.2022.100521] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
Body dysmorphic disorder (BDD) is an impairing condition characterized by excessive appearance concerns that frequently begin in adolescence, thus making this phase an eminent target for prevention and early intervention. We developed a cognitive-behavioral app-based program (AINA) intended for prevention and early intervention of BDD. As part of the iterative development process, perceptions of usability, aesthetics, and content were investigated. A sample of 38 adolescents and young adults aged between 14 and 21 years tested the app in a laboratory setting and completed a survey of diagnostic and user experience questionnaires. Overall, usability, aesthetics, and content of the app received positive evaluations. Regression analyses did not point to any large effects of age, gender, years of education, self-esteem, or BDD symptom severity on user evaluations. On average, participants had no concerns about privacy or data security of the app, indicating that these aspects will presumably not act as barriers to usage. Altogether, the present results are encouraging. Future research needs to examine whether AINA is an efficacious measure for prevention and early intervention of BDD.
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Buntrock C, Freund J, Smit F, Riper H, Lehr D, Boß L, Berking M, Ebert DD. Reducing problematic alcohol use in employees: economic evaluation of guided and unguided web-based interventions alongside a three-arm randomized controlled trial. Addiction 2022; 117:611-622. [PMID: 34648235 DOI: 10.1111/add.15718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
Abstract
AIMS To perform an economic evaluation of guided and unguided internet-based interventions to reduce problematic alcohol consumption in employees compared with a waiting-list control condition (WLC) with unrestricted access to treatment-as-usual. DESIGN A cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) from a societal and a cost-benefit analysis from the employer's perspective with a 6-month time horizon. SETTING Open recruitment in the German working population. PARTICIPANTS Employees (178 males, 256 females, mean age 47 years) consuming at least 14 (women) or 21 (men) standard units of alcohol (SUAs) per week and scoring ≥ 8 (men) or 6 (women) on the Alcohol Use Disorders Identification Test. MEASUREMENTS On-line questionnaires administered to assess SUAs and assess quality of life (AQoL-8D) and resource use. Outcome measure was responder (≤ 14/≤ 21 SUAs) for the CEA and quality-adjusted life years (QALYs) for the CUA. Net benefit regression was used to estimate cost-effectiveness for each study arm. Bootstrapping and sensitivity analyses were performed to account for uncertainty. INTERVENTIONS Five weekly modules including personalized normative feedback, motivational interviewing, goal setting, problem-solving and emotion regulation, provided with adherence-focused guidance [n = 142; responders: n = 73 (51.4%); QALYs = 0.364, standard error (SE) = 0.006] or without guidance [n = 146; n = 66 (45.2%); 0.359, 0.007]. Controls were on a waiting-list [n = 144; n = 38 (26.4%); 0.342, 0.007]. FINDINGS From a societal perspective, the guided intervention had a probability of 55% (54%) of being the most efficient strategy at a willingness-to-pay (WTP) of €0 per responder (QALY) gained, compared with the unguided intervention and the control condition. At a WTP of €20 000 per QALY gained, the probability was 78%. From an employer's perspective, the guided intervention had a higher probability of a positive return on investment (81%) compared with the unguided intervention (58%). CONCLUSION A guided internet-based intervention to reduce problematic alcohol consumption in employees appears to be both cost-beneficial and cost-effective.
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Affiliation(s)
- Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy. Institute of Psychology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Johanna Freund
- Department of Clinical Psychology and Psychotherapy. Institute of Psychology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Filip Smit
- Trimbos Institute (Netherland Institute of Mental Health and Addiction), Utrecht, the Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, the Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, VU University, Amsterdam, the Netherlands
| | - Heleen Riper
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, VU University, Amsterdam, the Netherlands.,Telepsychiatric Centre, University of Southern Denmark, Odense, Denmark
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lüneburg, Lüneburg, Germany
| | - Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lüneburg, Lüneburg, Germany
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy. Institute of Psychology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - David Daniel Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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McEntee A, Kim S, Harrison N, Chapman J, Roche A. Patterns and prevalence of daily tobacco smoking in Australia by industry and occupation: 2007-2016. Nicotine Tob Res 2021; 23:2047-2055. [PMID: 34129034 DOI: 10.1093/ntr/ntab126] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/11/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Australian workers' daily tobacco smoking over time was examined by industry, and occupation, to identify factors associated with high/low prevalence. METHODS Secondary analyses of 2007, 2010, 2013 and 2016 National Drug Strategy Household Surveys were undertaken (pooled n=49,395). Frequency analyses informed subsequent modelling of select industries and occupations. Four logistic regression models estimated adjusted effects of demographics on daily smoking in industries with high (≥20%) and low (≤15%) daily smoking prevalence, and occupations with high (≥20%) and moderate/low (<20%) daily smoking prevalence. RESULTS The sample comprised: 55.7% men; 34.1% 25-39 year olds; 31.4% New South Wales residents; 70.1% metropolitan residents; 66.9% high SES workers; and 70.6% with low psychological distress. Daily smoking prevalence differed by industry and occupation in 2007, generally decreasing between 2007-2016. In high prevalence industries, daily smoking was associated with male gender and age (25-39 year olds); and in low prevalence industries with males and non-metropolitan workers. In high prevalence occupations, daily smoking was associated with males, female non-metropolitan workers, and age 25-39 years; and in moderate/low prevalence occupations with non-metropolitan workers, and negatively associated with females aged 14-24 years. In all models, increased odds of daily smoking were associated with low socio-economic status and very high psychological distress. CONCLUSIONS Low socio-economic status and very high psychological distress were risk factors for daily smoking regardless of industry, occupation, or high pre-existing smoking prevalence. Targeted, as well as universal, interventions are required for workplaces and workers with greatest smoking vulnerability and least smoking cessation progress. IMPLICATIONS Specific strategies are warranted for identified industries, occupations and subgroups with increased odds of daily tobacco smoking. Industries/occupations with moderate/low smoking prevalence may confer workers some protection but are not without risk; some subgroups in these settings (e.g., non-metropolitan areas), had elevated daily smoking risk. Hence, the following are supported: 1. Universal interventions directed at low socio-economic workers, and workers with very high psychological distress regardless of workplace; 2. Interventions targeted at high prevalence industries; 3. Cessation efforts targeted for young workers in high prevalence industries/occupations, and 4. Focussed interventions addressing specific needs of non-metropolitan at-risk workers in low prevalence industries.
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Affiliation(s)
- Alice McEntee
- National Centre for Education and Training on Addiction, Flinders University
| | - Susan Kim
- National Centre for Education and Training on Addiction, Flinders University
| | - Nathan Harrison
- National Centre for Education and Training on Addiction, Flinders University
| | - Janine Chapman
- National Centre for Education and Training on Addiction, Flinders University
| | - Ann Roche
- National Centre for Education and Training on Addiction, Flinders University
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