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Romm KF, Berg CJ, Wang Y, Cohn AM. Patterns of Tobacco and Cannabis Use Among Sexual Minority Females and Males From PATH Wave 5: The Role of Sociodemographic and Psychosocial Correlates. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:397-407. [PMID: 38281150 DOI: 10.1177/29767342231222245] [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] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Although sexual minority (SM; vs heterosexual) individuals display higher rates of tobacco and cannabis use, limited research has examined sociodemographic and psychosocial correlates of single and co-use among this population. METHODS Participants were SM-identifying female (N = 2419; Mage = 27.80; 50.0% racial/ethnic minority) and male (N = 1142; Mage = 30.34; 46.1% racial/ethnic minority) adults from Wave 5 of the Population Assessment of Tobacco and Health study. Multinomial logistic regressions examined sociodemographic (ie, sexual identity, age, race/ethnicity, education, income) and psychosocial (ie, alcohol use, mental health, substance use) correlates of single and co-use (ie, no use [referent], tobacco-only, cannabis-only, co-use), controlling for state cannabis legalization, among SM females and males, separately. RESULTS The proportions of SM females reporting no use, tobacco-only, cannabis-only, and co-use were 37.9%, 24.0%, 10.5%, and 27.6%, respectively. Among males, 40.6%, 27.8%, 10.1%, and 21.5% reported no use, tobacco-only, cannabis-only, and co-use, respectively. Among females and males, substance use problems were associated with all 3 use groups (vs no use); past-month alcohol use was associated with cannabis-only and co-use; and mental health symptoms were associated with co-use (and cannabis-only in males). Sociodemographic correlates among females were: tobacco-only-identifying as bisexual (vs lesbian), White (vs Black), older, lower education, and lower income; cannabis-only-bisexual, other race (vs White); and co-use-White (vs Hispanic), lower education, and lower income. Among males, sociodemographic correlates were: tobacco-only-older, lower education, and lower income; cannabis-only-Black (vs White) and higher income. CONCLUSIONS Public health efforts to reduce tobacco and cannabis use among SM adults should target single versus co-use patterns and their corresponding sociodemographic, mental health, and substance use profiles.
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Affiliation(s)
- Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- George Washington Cancer Center, George Washington University, Washington, DC, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Amy M Cohn
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Kaufman RA, Mallick M, Louis JT, Williams M, Oriol N. The Role of Street Medicine and Mobile Clinics for Persons Experiencing Homelessness: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:760. [PMID: 38929006 PMCID: PMC11204218 DOI: 10.3390/ijerph21060760] [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: 05/08/2024] [Revised: 06/08/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION An estimated 5800 to 46,500 lives are lost due to homelessness each year. Experiencing homelessness and poor health are cyclically related, with one reinforcing the other. Mobile programs, which include vehicles that travel to deliver care, and street medicine, the act of bringing care to spaces where PEH live, may play a role in alleviating this burden by providing trusted, affordable, and accessible care to this community. METHODS We conducted a scoping review of peer-reviewed literature on the role of mobile clinics and street medicine in providing care for PEH by searching PubMed, Embase, and Web of Science on 10 August 2023. Articles from 2013 to 2023 specific to programs in the United States were included. The protocol was developed following the PRISMA-ScR guidelines. The primary outcome was the role of mobile programs for persons experiencing homelessness. RESULTS A total of 15 articles were included in this review. The descriptive findings emphasized that street medicine and mobile clinics provide primary care, behavioral health, and social services. The utilization findings indicate that street medicine programs positively impact the health system through their ability to defer emergency department and hospital visits, providing financial benefits. The comparative findings between mobile programs and office-based programs indicate current successes and areas for improvement. DISCUSSION Mobile clinics and street medicine programs that serve PEH provide a wide range of services. While more significant structural change is needed to address healthcare costs and housing policies in the United States, mobile clinics and street medicine teams can improve healthcare access and the healthcare system.
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Affiliation(s)
- Rebekah A. Kaufman
- Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA; (R.A.K.); (J.T.L.); (N.O.)
| | - Mahwish Mallick
- Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA; (R.A.K.); (J.T.L.); (N.O.)
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Jarvis Thanex Louis
- Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA; (R.A.K.); (J.T.L.); (N.O.)
| | - Mollie Williams
- Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA; (R.A.K.); (J.T.L.); (N.O.)
| | - Nancy Oriol
- Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA; (R.A.K.); (J.T.L.); (N.O.)
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA
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Sifat MS, Ehlke SJ, Ogunsanya M, Frank-Pearce SG, Boozary LK, Alexander AC, Businelle MS, Kendzor DE. Greater Discrimination Frequency and Lower Distress Tolerance Are Associated with Mental Health Problems Among Racially Privileged and Minoritized Adults Accessing an Urban Day Shelter. J Racial Ethn Health Disparities 2024; 11:45-61. [PMID: 36607564 PMCID: PMC10699794 DOI: 10.1007/s40615-022-01496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/29/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Discrimination experiences may be a contributing factor to the elevated prevalence of mental health problems among adults experiencing homelessness. METHODS Using survey data (N = 552) collected from adults seeking services at an urban day shelter, the relationships between everyday and major discrimination experiences, distress tolerance, and mental health problems (depression, anxiety, post-traumatic stress disorder, poor mental health days) were characterized. Distress tolerance was examined as a moderator of the relationship between discrimination and mental health problems. RESULTS Participants were predominantly from racially minoritized groups (59.6%), non-Hispanic (88.7%), and male (70.9%), with an average age of 45.7 years old (SD = 11.7). Descriptive analyses indicated that the main reason for discrimination differed between racially privileged (i.e., White participants) and racially minoritized participants (i.e., participants who identified as Black, American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, or multi-race), such that homelessness was most commonly endorsed among racially privileged participants while racial discrimination was most commonly reported among racially minoritized participants. Multivariate logistic regression analyses revealed associations between everyday discrimination, major discrimination, and distress tolerance with mental health problems. Distress tolerance did not moderate the relations between discrimination and mental health problems in most analyses. Notably, major discrimination was no longer associated with all mental health variables when both everyday and major discrimination were included in all models. CONCLUSION Findings suggest that reducing everyday discrimination and addressing the adverse impact of everyday discrimination experiences may have a beneficial impact on mental health.
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Affiliation(s)
- Munjireen S Sifat
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Sarah J Ehlke
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Motolani Ogunsanya
- College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Summer G Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Laili Kharazi Boozary
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Cellular and Behavioral Neurobiology, Psychology, University of Oklahoma, Norman, OK, USA
| | - Adam C Alexander
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Huynh N, Kendzor DE, Ra CK, Frank-Pearce SG, Alexander AC, Businelle MS, Samson DR. The association of sleep with physical and mental health among people experiencing homelessness. Sleep Health 2024; 10:48-53. [PMID: 37989628 PMCID: PMC10922033 DOI: 10.1016/j.sleh.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Sleep deprivation is a critical risk factor for physical and mental health problems. The current study examined whether sleep problems were related to housing status and physical and mental health among people experiencing homelessness. METHODS Data were collected via an anonymous survey completed by adults accessing services at a day shelter in Oklahoma City, OK. Demographic characteristics, sleep problems, days of poor physical and mental health, and self-rated health were assessed and compared across housing subgroups. Logistic regression analyses were performed to examine potential associations between sleep and health. RESULTS Participants (N = 404) were predominantly male (71.0%) and racially minoritized (57.4%) with an average age of 47.0 (SD=11.6) years. Days of unintentional sleep over the past 30days differed significantly by housing status. Logistic regression analyses indicated that short sleep duration of ≤6 hours was associated with poorer self-rated health and more days of poor physical health over the past 30days compared to those who reported an optimal sleep duration of 7-9 hours. Additionally, reporting ≥1 day of unintentional daytime sleep was associated with more days of poor mental and physical health over the past 30-day. Reporting more days of inadequate sleep was associated with poorer self-rated health, and more days of poor physical and mental health over the past 30days. CONCLUSION Sleep problems were associated with poorer physical and mental health among people experiencing homelessness. Safe environments where adults experiencing homelessness can sleep comfortably and without interruption may be needed to support good physical and mental health.
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Affiliation(s)
- Nhu Huynh
- Department of Anthropology, University of Toronto, Mississauga, Ontario, Canada
| | - Darla E Kendzor
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, Oklahoma, USA.
| | - Chaelin K Ra
- Section of Behavioral Sciences, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Summer G Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, Oklahoma, USA; Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Adam C Alexander
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, Oklahoma, USA
| | - Michael S Businelle
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA; TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, Oklahoma, USA
| | - David R Samson
- Department of Anthropology, University of Toronto, Mississauga, Ontario, Canada
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Boozary LK, Frank-Pearce SG, Alexander AC, Sifat MS, Kurien J, Waring JJ, Ehlke SJ, Businelle MS, Ahluwalia JS, Kendzor DE. Tobacco use characteristics, treatment preferences, and motivation to quit among adults accessing a day shelter in Oklahoma City. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100117. [PMID: 36844157 PMCID: PMC9949321 DOI: 10.1016/j.dadr.2022.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/07/2022] [Accepted: 11/04/2022] [Indexed: 11/08/2022]
Abstract
Background Smoking rates are exceptionally high among adults experiencing homelessness (AEH). Research is needed to inform treatment approaches in this population. Methods Participants (n=404) were adults who accessed an urban day shelter and reported current smoking. Participants completed surveys regarding their sociodemographic characteristics, tobacco and substance use, mental health, motivation to quit smoking (MTQS), and smoking cessation treatment preferences. Participant characteristics were described and compared by MTQS. Results Participants who reported current smoking (N=404) were primarily male (74.8%); White (41.4%), Black (27.8%), or American Indian/Alaska Native (14.1%) race; and 10.7% Hispanic. Participants reported a mean age of 45.6 (SD=11.2) years, and they smoked an average of 12.6 (SD=9.4) cigarettes per day. Most participants reported moderate or high MTQS (57%) and were interested in receiving free cessation treatment (51%). Participants most frequently selected the following options as among the top 3 treatments that offered the best chance of quitting: Nicotine replacement therapy (25%), money/gift cards for quitting (17%), prescription medications (17%), and switching to e-cigarettes (16%). Craving (55%), stress/mood (40%), habit (39%), and being around other smokers (36%) were frequently identified as the most challenging aspects of quitting. Low MTQS was associated with White race, lack of religious participation, lack of health insurance, lower income, greater cigarettes smoked per day, and higher expired carbon monoxide. Higher MTQS was associated with sleeping unsheltered, cell phone ownership, higher health literacy, more years of smoking, and interest in free treatment. Discussion Multi-level, multi-component interventions are needed to address tobacco disparities among AEH.
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Affiliation(s)
- Laili Kharazi Boozary
- Department of Psychology, Cellular and Behavioral Neurobiology, University of Oklahoma, Norman OK 73019
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Summer G. Frank-Pearce
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Adam C. Alexander
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Munjireen S. Sifat
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jasmin Kurien
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Joseph J.C. Waring
- Bloomberg School of Public of Health, Johns Hopkins University, Baltimore, MD, United States
| | - Sarah J. Ehlke
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Michael S. Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Jasjit S. Ahluwalia
- School of Public Health, Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Darla E. Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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