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A Feasibility Study to Direct System Level Change for Hospital Patients With Alcohol Use Disorder. J Addict Nurs 2021; 32:95-106. [PMID: 34060760 DOI: 10.1097/jan.0000000000000395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/BACKGROUND/SIGNIFICANCE The purpose of this feasibility study was to make system level change using motivational interviewing (MI), tailored discharge education, and electronic medical record (EMR) flow sheet intervention in patients with alcohol use disorder (AUD). Alcohol is known to be one of the most commonly misused addictive substances. METHODS It is a feasibility study with a descriptive exploratory design of an intervention with MI, tailored discharge education, and EMR flow sheet documentation. Participants were patients with AUD chosen over 3 months from two medical surgical floors. Instruments used were the readiness and confidence rulers (reliability/validity = .84 and .77, respectively). Analysis included descriptive statistics, estimation of effect size, and hypothesis generation. RESULTS Of 14 participants, EMR flow sheet documentation was completed and the mean post readiness and confidence scores were 8.86 (1.167) and 8.07 (1.639), respectively. CONCLUSION The pre/post confidence scores were statistically significant (p = .095) using the .10 significance level, indicating the intervention was effective in raising the confidence level for behavior change. High scores indicated patients were in contemplation and intending to change. Seven scores increased postintervention suggesting a future hypothesis that MI, tailored education, and EMR flow sheet documentation intervention is feasible for patients with AUD contemplating change in the near future.
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Majd Z, Mohan A, Abughosh SM. Using group-based trajectory modeling to characterize the association of past ACEIs/ARBs adherence with subsequent statin adherence patterns among new statin users. J Am Pharm Assoc (2003) 2021; 61:829-837.e2. [PMID: 34344613 DOI: 10.1016/j.japh.2021.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/21/2021] [Accepted: 07/09/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Despite well-documented benefits, statin adherence remains suboptimal. Studies have suggested that previous adherence to other chronic medications is a strong predictor of future adherence to newly initiated statins. Group-based trajectory modeling (GBTM) has been applied as a method to longitudinally depict the dynamic nature of adherence. OBJECTIVES This study aimed to examine the association between patients' adherence patterns to newly initiated statins and previous adherence trajectories of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) using GBTM. METHODS This retrospective cohort study was conducted among continuously enrolled statin initiators using claims data. Patients were included if they had ACEI/ARB use within 1 year before statin initiation (preindex period). Monthly adherence to ACEIs/ARBs was calculated during the preindex period and monthly adherence to statins was assessed 1 year after statin initiation using proportion of days covered (PDC). The monthly PDCs were modeled as a longitudinal response in a logistic GBTM to provide distinct patterns of adherence for ACEIs/ARBs and statins, separately. A multinomial logistic regression was conducted to determine an association between ACEI/ARB adherence trajectories and future statin trajectories, controlling for patient characteristics. RESULTS A total of 1078 patients were categorized into 4 distinct statin adherence trajectories: adherent (40.8%), gradual decline (37.4%), gaps in adherence (13.9%), and rapid decline (7.9%). Patients were further categorized into 4 groups on the basis of their distinct past ACEIs/ARBs trajectories: adherent (43%), gaps in adherence (29%), delayed nonadherence (15.2%), and gradual decline (12.8%). In the multinomial logistic regression, patients in the gaps in adherence or gradual decline groups were more likely to follow similar trajectories for future statin use than the adherent trajectory. CONCLUSION Previous adherence trajectories of ACEIs/ARBs may predict future adherence patterns for newly initiated statins. Knowledge of past medication-taking behavior could provide valuable information for developing tailored interventions to improve adherence.
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Ogilvie L, Carson J. Trauma, stages of change and post traumatic growth in addiction: A new synthesis. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1905093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abughosh SM, Vadhariya A, Johnson ML, Essien EJ, Esse TW, Serna O, Gallardo E, Boklage SH, Choi J, Holstad MM, Fleming ML. Enhancing Statin Adherence Using a Motivational Interviewing Intervention and Past Adherence Trajectories in Patients with Suboptimal Adherence. J Manag Care Spec Pharm 2019; 25:1053-1062. [PMID: 31556824 PMCID: PMC10398332 DOI: 10.18553/jmcp.2019.25.10.1053] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Statins have been shown to be effective in reducing the occurrence of cardiovascular (CV) events and are widely prescribed for the risk reduction of CV diseases and recurrent CV events. However, poor adherence prevents some patients from receiving the maximum benefit of the therapy. Motivational interviewing (MoI) is a patient-centered collaborative approach that can be used to improve medication adherence. Group-based trajectory modeling depicts patterns of adherence over time and may help tailor the MoI intervention to further enhance adherence. OBJECTIVE To assess the effect of a phone-based MoI intervention tailored by patients' past adherence trajectory in improving adherence to statins among patients in a Medicare Advantage prescription drug plan (MAPD). METHODS Patients continuously enrolled in an MAPD from 2013 to 2017 with a statin prescription between January and June 2015 to allow 2 years of pre-index period and 1 year of follow-up were included in the study. Adherence to statins was measured monthly during the 1-year follow-up as proportion of days covered (PDC) and incorporated into a group-based trajectory model to provide 4 distinct patterns of adherence: adherent, rapid decline, gradual decline, and gaps in adherence. Patients in the 3 nonadherent groups were randomized to either control or intervention. The intervention was an initial counseling call and up to 2 monthly follow-up calls by pharmacy students trained in MoI, providing education consistent with a previously identified pattern of use. Refill data at 6 months post-intervention were evaluated to examine the intervention's effect on PDC, as continuous and dichotomized as PDC ≥ 0.8, as well as discontinuation. Multivariable regression adjusted for baseline demographics, clinical characteristics, and past adherence trajectory. RESULTS There were 152 patients included in the analysis who received MoI phone calls and 304 randomly selected controls. Mean PDC for the intervention group (0.67 ± 0.3) was significantly higher than the control (0.55 ± 0.4; P < 0.001). The intervention group was also less likely to discontinue (OR = 0.38; 95% CI = 0.19-0.76) and more likely to be adherent in the linear regression model (β = 12.4; P < 0.001) as well as in the logistic regression model (OR = 1.87; 95% CI = 1.18-2.95). Previous adherence trajectories were significantly associated with adherence in the follow-up. CONCLUSIONS Patients who received the MoI intervention were more likely to be adherent and less likely to discontinue the statin in the 6 months follow-up compared with controls. Future research can identify other approaches to tailor interventions and expand the intervention to other languages. This intervention may also prove valuable to improve adherence to other medications for chronic and asymptomatic diseases. DISCLOSURES This study was funded by Regeneron Pharmaceuticals, which provided critical input during study design, implementation, and manuscript preparation. Abughosh reports grants from Sanofi, BMS/Pfizer, and Valeant Pharmaceuticals, unrelated to this study. Vadhariya reports a past internship at Regeneron Pharmaceuticals, unrelated to this study. Esse, Serna, and Gallardo are employees of CareAllies, a Cigna subsidiary. Boklage is an employee of Regeneron Pharmaceuticals. Choi was an employee of Sanofi during this study. Johnson, Essien, Fleming, and Holstad have nothing to disclose. A poster based on this study was presented at AMCP Nexus 2018; October 22-25, 2018; Orlando, FL.
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Affiliation(s)
- Susan M. Abughosh
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, Texas
| | - Aisha Vadhariya
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, Texas
| | - Michael L. Johnson
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, Texas
| | - E. James Essien
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, Texas
| | | | | | | | - Susan H. Boklage
- Health Economics and Outcomes Research, Regeneron Pharmaceuticals, Terrytown, New York
| | - Jeannie Choi
- Health Economics and Value Assessment, Sanofi, Bridgewater, New Jersey
| | - Marcia M. Holstad
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Marc L. Fleming
- Department of Pharmacotherapy, University of North Texas System College of Pharmacy, Dallas
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Lowrey O, Ciampaglio K, Messerli JL, Hanson JD. Utilization of the Transtheoretical Model to Determine the Qualitative Impact of a Tribal FASD Prevention Program. SAGE OPEN 2019; 9:10.1177/2158244018822368. [PMID: 31763057 PMCID: PMC6874303 DOI: 10.1177/2158244018822368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Alcohol consumption during pregnancy can lead to damaging effects on an infant's health, including fetal alcohol spectrum disorders. Project Changing High-risk alcOhol use and Increasing Contraception Effectiveness Study (CHOICES), a program developed to reduce alcohol-exposed pregnancies through decreased alcohol consumption and increased birth control use, has been implemented with success in a variety of populations. The CHOICES program was structured to align with the transtheoretical model (Stages of Change), a popular public health model. Although studies have described the Stages of Change in the context of a variety of health behaviors, none have addressed the qualitatively distinct characteristics of each stage in the context of American Indian (AI) women's alcohol and birth control use. A framework analysis of 203 participants' written responses during their experience in the Oglala Sioux Tribe (OST) CHOICES Program was conducted. As a conceptual framework, the transtheoretical model of behavior change was applied to the participants' experiences, with two staff reading the open-ended responses and coding based on the stage of change. Participants' responses suggest qualitatively distinct stages as well as a progression through the stages for both behaviors during the course of the program. Many participants mentioned their children, education, and work as inspiration to decrease their unhealthy behaviors. Common barriers to behavior change were found across both behaviors. The open-ended responses uncover common themes in the experiences of the participants. These results can help inform future programs which hope to address the needs of AI communities.
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Paranjpe R, John G, Trivedi M, Abughosh S. Identifying adherence barriers to oral endocrine therapy among breast cancer survivors. Breast Cancer Res Treat 2018; 174:297-305. [DOI: 10.1007/s10549-018-05073-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 01/30/2023]
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Johnson SK, von Sternberg K, Velasquez MM. Changing multiple health risk behaviors in CHOICES. Prev Med Rep 2018; 11:69-73. [PMID: 29984141 PMCID: PMC6030232 DOI: 10.1016/j.pmedr.2018.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/04/2018] [Accepted: 05/05/2018] [Indexed: 11/29/2022] Open
Abstract
Multiple health behavior change (MHBC) intervention trials to date have only considered behaviors that were directly targeted. Research has yet to consider how untargeted behaviors can affect change in behaviors directly targeted by an intervention or how changes in targeted behaviors might lead to changes in other, untargeted behaviors. This study addresses these gaps with a secondary analysis of change in risk drinking (targeted behavior) and smoking (behavior that was not addressed) in the efficacy trial of CHOICES, an intervention for the prevention of alcohol-exposed pregnancies. Measures included the Timeline Followback for daily alcohol consumption and questions about smoking behavior. Participants were women of childbearing age who were at risk of alcohol-exposed pregnancy at baseline. Baseline smokers were less likely to change their drinking behavior than baseline non-smokers at nine months (n = 579) with Odds Ratio (OR) of 0.681 (95% CI = 0.471–0.985); 41.1% of smokers vs 50.6% of non-smokers reduced drinking to below risk levels (<5 drinks/day and < 8 drinks per week). Meanwhile, smokers who had changed their drinking behavior were more likely than smokers who had not changed their drinking behavior to have also quit smoking at nine months (OR = 2.769; 95% CI = 1.533–5.000); 19.5% vs. 8.1%, respectively. Together, these findings suggest a natural tendency towards change of multiple related behaviors and indicate that while the presence of unaddressed risk behaviors may make a targeted behavior change more difficult, change in one behavior may facilitate change in related behaviors, even when they are not addressed.
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Affiliation(s)
- Shannon K Johnson
- The Catholic University of America, National Catholic School of Social Service, Washington, DC, United States
| | - Kirk von Sternberg
- The University of Texas at Austin School of Social Work, Health Behavior Research and Training Institute, Austin, TX, United States
| | - Mary M Velasquez
- The University of Texas at Austin School of Social Work, Health Behavior Research and Training Institute, Austin, TX, United States
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Nhunzvi C, Galvaan R, Peters L. Recovery From Substance Abuse Among Zimbabwean Men: An Occupational Transition. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2017; 39:14-22. [PMID: 28685660 DOI: 10.1177/1539449217718503] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Substance abuse is a rising global problem, associated with medical, psychiatric, family, occupational, legal, political, financial, and spiritual problems. Recovery is an important area of consideration in occupational therapy's quest to promoting health and well-being. This narrative inquiry explored the journey of recovery from substance abuse among young adult Zimbabwean men. Three men were purposively selected to participate in in-depth narrative interviews about their occupations during recovery. Data were analyzed using a narrative analysis. Explanatory stories and three superordinate themes illustrated how substance abuse was associated with both positive and negative outcomes. The recovery process emerged as an ongoing occupational transition, influenced by occupational identity and involving changes in occupational participation. Recovery from substance abuse can be conceptualized as an occupational transition. Ongoing participation in "healthy" and meaningful occupations is key factor in this process. Construction of a positive occupational identity is also central.
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Han H, Pettee Gabriel K, Kohl HW. Application of the transtheoretical model to sedentary behaviors and its association with physical activity status. PLoS One 2017; 12:e0176330. [PMID: 28448531 PMCID: PMC5407750 DOI: 10.1371/journal.pone.0176330] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 04/10/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Transtheoretical Model (TTM) is a successful framework for guiding behavior change programs for several health behaviors, yet its application to reduce of sedentary behavior has been neglected. In addition, no data exist regarding the association between determinants of sedentary behaviors based on the TTM and physical activity behavior. The purpose of this study was to investigate college students' stages of motivational readiness to avoid sedentary behaviors and relevant psychological determinants using newly developed TTM questionnaires and to identify the association between current physical activity and sedentary behaviors based on TTM constructs. METHODS Data were obtained from 225 college students enrolled in health education and physical education courses. Participants completed a package of questionnaires including validated TTM, physical activity and sitting time questionnaires. Participants also wore an accelerometer for seven consecutive days. MANOVAs were conducted to determine mean differences in psychological constructs across the TTM stages, and Chi-square tests and Spearman correlation were used to evaluate the associations between current physical activity and sedentary behavior. RESULTS A majority of the participants were in the sedentary stages, and men and women differed in proportion of individuals in the stages (78.0% vs. 68.1%, respectively). The gender difference was also found in use of the processes of change. In general, the mean scores of the TTM constructs increased as the stages progressed. No significant associations were found between the TTM constructs for sedentary behavior and current physical activity levels (p>0.05). CONCLUSIONS A high proportion of college students were in sedentary stages regardless of physical activity levels, but different distributions in men and women. Participants in earlier stages were less likely to utilize the TTM constructs to reduce sedentary behaviors than those in later stages. A lack of association between physical activity and the psychological determinants of sedentary behavior was found.
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Affiliation(s)
- Ho Han
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States of America
| | - Kelley Pettee Gabriel
- Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Austin, TX, United States of America
| | - Harold Willis Kohl
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States of America
- Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health, Austin, TX, United States of America
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Bray JH, Kowalchuk A, Waters V, Allen E, Laufman L, Shilling EH. Baylor Pediatric SBIRT Medical Residency Training Program: Model Description and Evaluation. Subst Abus 2014; 35:442-9. [DOI: 10.1080/08897077.2014.954026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Zalmanowitz SJ, Babins-Wagner R, Rodger S, Corbett BA, Leschied A. The association of readiness to change and motivational interviewing with treatment outcomes in males involved in domestic violence group therapy. JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:956-974. [PMID: 23071082 DOI: 10.1177/0886260512459381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The present study investigated the impact of motivational interviewing (MI) and stage of change on a self-report measure of global functioning (Outcome Questionnaire [OQ 45.2]). Participants were men mandated to attend the Responsible Choices for Men (RCM) group therapy program following an incident of domestic violence. The study design utilized a quasi-experimental between-groups comparison utilizing data collected at three time points (pregroup, first group session, and final group session). One group of mandated program attendees received two sessions of MI (n = 106), whereas the comparison group did not (n = 106). Stage of change was assessed using the URICA-G and the URICA-DV (University of Rhode Island Change Assessment--Domestic Violence). Multilevel growth modeling indicated that stage of change has a significant relationship to global functioning. Discussion focuses on the potential benefits of MI as a pregroup treatment and the importance of accounting for individual readiness to change.
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Bray JH, Kowalchuk A, Waters V, Laufman L, Shilling EH. Baylor SBIRT Medical Residency Training Program: Model Description and Initial Evaluation. Subst Abus 2012; 33:231-40. [DOI: 10.1080/08897077.2011.640160] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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SBIRT outcomes in Houston: final report on InSight, a hospital district-based program for patients at risk for alcohol or drug use problems. Alcohol Clin Exp Res 2009; 33:1374-81. [PMID: 19426184 DOI: 10.1111/j.1530-0277.2009.00967.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Screening, Brief Intervention, and Referral to Treatment (SBIRT) services have been implemented as the standard of care for patients in the Harris County Hospital District (HCHD). The present analysis addresses alcohol and drug use for patients admitted over a 39-month period from July 1, 2005 through September 30, 2008. METHODS Patients were screened for alcohol and drug use at medical admission. Those who were positive received further assessment and were transitioned to receive services as appropriate. A sample of consenting patients who were positive and received services was contacted at 6 months for a follow-up interview. Using an intent-to-treat (ITT) protocol, the analysis included all patients who were assigned for follow-up, including those with completed follow-ups as well as those who could not be contacted at follow-up. Patients not contacted at follow-up were assumed to have maintained their baseline drug and alcohol consumption levels. RESULTS Of 59,760 patients who were screened by generalists (primarily nurses, physicians, and medical care technicians), 15,241 (26%) were positive and received further assessment and services. The 6-month follow-up interview completion rate was 66%. The ITT sample consisted of all 1,937 patients who were assigned for follow-up. There was an overall reduction in the number of patients reporting any days of heavy drinking from 70% at intake to 37% at 6-month follow-up and a reduction in the mean number of days of heavy drinking from 7.8 days at intake to 4.1 days at follow-up. The number of patients reporting any days of drug use was 82% at intake versus 33% at follow-up, and the mean number of days of drug use declined from 8.3 days at intake to 4.2 days at follow-up. CONCLUSIONS The results were consistent with but of greater magnitude than most other studies reporting positive outcomes for SBIRT patients. Drug use and heavy alcohol use were found to decrease substantially from admission to follow-up. This finding holds good for all levels of drug or alcohol misuse severity, with the highest severity patients showing the largest decreases. Future studies are needed to control for potential regression to the mean effects and to develop improved understanding of differences in outcomes by race/ethnicity.
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Duvall JL, Oser CB, Leukefeld CG. Readiness to change as a predictor of drug-related behaviors in a sample of rural felony probationers. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2008; 34:741-8. [PMID: 19016179 DOI: 10.1080/00952990802326272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Relationships between readiness to change and common drug-related behaviors were explored in a sample (N = 776) of rural probationers in the state of Kentucky. METHODS Self-reported data was gathered on measures of readiness to change, frequency of marijuana use, possession of drugs/related paraphernalia, and driving while under the influence of drugs/alcohol at time periods before and after arrest. RESULTS Independent of the influence of demographic characteristics such as age, gender, race, and treatment history, increases in readiness to change scores were accompanied by reductions in all three drug-related behaviors. CONCLUSION Readiness to change has important implications for treatment involving rural probationers.
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Affiliation(s)
- Jamieson L Duvall
- Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky 40506, USA.
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Abstract
AIM The popularity of methamphetamine among gay men has been documented; however, few studies have examined the complex behavioral and psychological motivations behind methamphetamine use, particularly over time. This study aimed to (i) identify the trajectories for methamphetamine use; (ii) explore factors related to methamphetamine use; and (iii) determine factors which predict changes in usage over a year. DESIGN This analysis utilized hierarchical linear modeling to identify the trajectories for methamphetamine use and explore factors related to patterns of methamphetamine use. PARTICIPANTS A sample of 293 gay and bisexual men who indicated methamphetamine use at baseline were drawn from Project BUMPS (Boys Using Multiple Party Substances), which was a longitudinal, mixed-methodologies study of 450 club drug-using gay and bisexual men. MEASUREMENTS Participants were assessed via quantitative measures in four waves of data collection over the course of a year (baseline, 4, 8 and 12 months post-baseline). FINDINGS Frequency of methamphetamine use is related to reliance on the drug to avoid unpleasant emotions and physical discomfort, outcome expectancies for use and combining the drug with Viagra. Those with higher levels of drug-related sensation-seeking and those who combine use with Viagra show more consistent use over time, although a decrease in use is noted for most of the sample. CONCLUSIONS Longitudinal analyses support the idea that methamphetamine is used by gay men to mask feelings of discomfort and to enhance sensations as well as sexual pleasure. Longitudinal non-intervention studies of drug use may have intervention-like effects.
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Affiliation(s)
- Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, Department of Applied Psychology, The Steinhardt School, New York University, NY, USA
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Keller S, Maddock JE, Laforge RG, Velicer WF, Basler HD. Binge drinking and health behavior in medical students. Addict Behav 2007; 32:505-15. [PMID: 16820268 DOI: 10.1016/j.addbeh.2006.05.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Revised: 04/14/2006] [Accepted: 05/24/2006] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The objective of this study was to assess the prevalence of binge drinking and its relation to other health behaviors, drinking-related attitudes and perceived social norms among German medical students. METHODS 271 first-year German medical students completed a cross-sectional, self-administered survey. A total of 252 (62% female and 38% male) students provided useable surveys. The mean age was 20.6years (S.D.=1.7). RESULTS Most students reported heavy drinking with 24% having one episode in the past 2 weeks (Infrequent Bingers) and 28% having two or more episodes (Frequent Bingers). Men were more likely than women to have had a binge drinking episode. Frequent binge drinkers saw more pros of drinking and reported a higher temptation to drink than students in the other groups. Additionally, they were more likely to smoke, use cannabis, not exercise and not eat fruits and vegetables. All students overestimated their peers' alcohol intake and binge drinking frequency. CONCLUSIONS Binge drinking was highly prevalent in this sample and clearly related to other health risk behaviors. Drinking rates were similar to college students in other Western countries. Future research needs to assess the consequences of this multiple risk behavior among medical students regarding academic and professional performance as well as personal health.
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Affiliation(s)
- Stefan Keller
- Department of Public Health Sciences and Epidemiology, University of Hawaii at Manoa, USA
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