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Bonato PDPQ, Ventura CAA, Maulide Cane R, Craveiro I. Health Education Initiatives for People Who Have Experienced Prison: A Narrative Review. Healthcare (Basel) 2024; 12:274. [PMID: 38275554 PMCID: PMC10815199 DOI: 10.3390/healthcare12020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Due to the selectiveness of criminal systems and the context of social vulnerability, there is a high prevalence of health problems among individuals with a history of incarceration. When there is an insufficient level of health care, prior clinical conditions can worsen, and health education can be a response to this problem. Health education is a process of building health knowledge that is intended to facilitate thematic appropriation by the population that enables people to access, understand, and use health-related information for health improvement. In the context of criminal justice, health education can contribute to the successful transition of people who have experienced prison from their custody to the community setting. This study aimed to identify, synthesize, and critically evaluate peer-reviewed evidence concerning health education initiatives developed during or after incarceration aimed at people released from prison. A narrative review methodology was used to analyze 19 studies about health education interventions for prisoners or people who were arrested. Initiatives were identified in five countries, which showed differences in approaches, with motivational interviewing and group sessions standing out in the studies. All of them were grouped into the following themes: HIV and other sexually transmitted infections, alcohol, opioids and other substances, tuberculosis, and women's health. We have not performed a quality assessment of the studies included (using checklists such as PRISMA, AMSTAR, or SANRA) as this study is a narrative review and was not intended to be a systematic review or meta-analysis. This review has the potential impact of informing future health education initiatives and policies for individuals transitioning from prison.
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Affiliation(s)
- Patrícia de Paula Queiroz Bonato
- Unidade de Ensino e Investigação de Saúde Pública Global, Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (P.d.P.Q.B.); (R.M.C.)
- Ribeirão Preto College of Nursing, University of São Paulo (USP), Rua Prof. Hélio Lourenço 3900, Ribeirão Preto 14040-902, Brazil;
| | - Carla Aparecida Arena Ventura
- Ribeirão Preto College of Nursing, University of São Paulo (USP), Rua Prof. Hélio Lourenço 3900, Ribeirão Preto 14040-902, Brazil;
| | - Réka Maulide Cane
- Unidade de Ensino e Investigação de Saúde Pública Global, Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (P.d.P.Q.B.); (R.M.C.)
- Instituto Nacional de Saúde (INS), Ministério da Saúde (MISAU), Estrada Nacional EN1, Bairro da Vila—Parcela no 3943, Distrito de Marracuene, Marracuene 264, Província de Maputo, Mozambique
| | - Isabel Craveiro
- Unidade de Ensino e Investigação de Saúde Pública Global, Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal; (P.d.P.Q.B.); (R.M.C.)
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Schwenker R, Dietrich CE, Hirpa S, Nothacker M, Smedslund G, Frese T, Unverzagt S. Motivational interviewing for substance use reduction. Cochrane Database Syst Rev 2023; 12:CD008063. [PMID: 38084817 PMCID: PMC10714668 DOI: 10.1002/14651858.cd008063.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Substance use is a global issue, with around 30 to 35 million individuals estimated to have a substance-use disorder. Motivational interviewing (MI) is a client-centred method that aims to strengthen a person's motivation and commitment to a specific goal by exploring their reasons for change and resolving ambivalence, in an atmosphere of acceptance and compassion. This review updates the 2011 version by Smedslund and colleagues. OBJECTIVES To assess the effectiveness of motivational interviewing for substance use on the extent of substance use, readiness to change, and retention in treatment. SEARCH METHODS We searched 18 electronic databases, six websites, four mailing lists, and the reference lists of included studies and reviews. The last search dates were in February 2021 and November 2022. SELECTION CRITERIA We included randomised controlled trials with individuals using drugs, alcohol, or both. Interventions were MI or motivational enhancement therapy (MET), delivered individually and face to face. Eligible control interventions were no intervention, treatment as usual, assessment and feedback, or other active intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane, and assessed the certainty of evidence with GRADE. We conducted meta-analyses for the three outcomes (extent of substance use, readiness to change, retention in treatment) at four time points (post-intervention, short-, medium-, and long-term follow-up). MAIN RESULTS We included 93 studies with 22,776 participants. MI was delivered in one to nine sessions. Session durations varied, from as little as 10 minutes to as long as 148 minutes per session, across included studies. Study settings included inpatient and outpatient clinics, universities, army recruitment centres, veterans' health centres, and prisons. We judged 69 studies to be at high risk of bias in at least one domain and 24 studies to be at low or unclear risk. Comparing MI to no intervention revealed a small to moderate effect of MI in substance use post-intervention (standardised mean difference (SMD) 0.48, 95% confidence interval (CI) 0.07 to 0.89; I2 = 75%; 6 studies, 471 participants; low-certainty evidence). The effect was weaker at short-term follow-up (SMD 0.20, 95% CI 0.12 to 0.28; 19 studies, 3351 participants; very low-certainty evidence). This comparison revealed a difference in favour of MI at medium-term follow-up (SMD 0.12, 95% CI 0.05 to 0.20; 16 studies, 3137 participants; low-certainty evidence) and no difference at long-term follow-up (SMD 0.12, 95% CI -0.00 to 0.25; 9 studies, 1525 participants; very low-certainty evidence). There was no difference in readiness to change (SMD 0.05, 95% CI -0.11 to 0.22; 5 studies, 1495 participants; very low-certainty evidence). Retention in treatment was slightly higher with MI (SMD 0.26, 95% CI -0.00 to 0.52; 2 studies, 427 participants; very low-certainty evidence). Comparing MI to treatment as usual revealed a very small negative effect in substance use post-intervention (SMD -0.14, 95% CI -0.27 to -0.02; 5 studies, 976 participants; very low-certainty evidence). There was no difference at short-term follow-up (SMD 0.07, 95% CI -0.03 to 0.17; 14 studies, 3066 participants), a very small benefit of MI at medium-term follow-up (SMD 0.12, 95% CI 0.02 to 0.22; 9 studies, 1624 participants), and no difference at long-term follow-up (SMD 0.06, 95% CI -0.05 to 0.17; 8 studies, 1449 participants), all with low-certainty evidence. There was no difference in readiness to change (SMD 0.06, 95% CI -0.27 to 0.39; 2 studies, 150 participants) and retention in treatment (SMD -0.09, 95% CI -0.34 to 0.16; 5 studies, 1295 participants), both with very low-certainty evidence. Comparing MI to assessment and feedback revealed no difference in substance use at short-term follow-up (SMD 0.09, 95% CI -0.05 to 0.23; 7 studies, 854 participants; low-certainty evidence). A small benefit for MI was shown at medium-term (SMD 0.24, 95% CI 0.08 to 0.40; 6 studies, 688 participants) and long-term follow-up (SMD 0.24, 95% CI 0.07 to 0.41; 3 studies, 448 participants), both with moderate-certainty evidence. None of the studies in this comparison measured substance use at the post-intervention time point, readiness to change, and retention in treatment. Comparing MI to another active intervention revealed no difference in substance use at any follow-up time point, all with low-certainty evidence: post-intervention (SMD 0.07, 95% CI -0.15 to 0.29; 3 studies, 338 participants); short-term (SMD 0.05, 95% CI -0.03 to 0.13; 18 studies, 2795 participants); medium-term (SMD 0.08, 95% CI -0.01 to 0.17; 15 studies, 2352 participants); and long-term follow-up (SMD 0.03, 95% CI -0.07 to 0.13; 10 studies, 1908 participants). There was no difference in readiness to change (SMD 0.15, 95% CI -0.00 to 0.30; 5 studies, 988 participants; low-certainty evidence) and retention in treatment (SMD -0.04, 95% CI -0.23 to 0.14; 12 studies, 1945 participants; moderate-certainty evidence). We downgraded the certainty of evidence due to inconsistency, study limitations, publication bias, and imprecision. AUTHORS' CONCLUSIONS Motivational interviewing may reduce substance use compared with no intervention up to a short follow-up period. MI probably reduces substance use slightly compared with assessment and feedback over medium- and long-term periods. MI may make little to no difference to substance use compared to treatment as usual and another active intervention. It is unclear if MI has an effect on readiness to change and retention in treatment. The studies included in this review were heterogeneous in many respects, including the characteristics of participants, substance(s) used, and interventions. Given the widespread use of MI and the many studies examining MI, it is very important that counsellors adhere to and report quality conditions so that only studies in which the intervention implemented was actually MI are included in evidence syntheses and systematic reviews. Overall, we have moderate to no confidence in the evidence, which forces us to be careful about our conclusions. Consequently, future studies are likely to change the findings and conclusions of this review.
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Affiliation(s)
- Rosemarie Schwenker
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Carla Emilia Dietrich
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Selamawit Hirpa
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Monika Nothacker
- Institute for Medical Knowledge Management, Association of the Scientific Medical Societies in Germany, Berlin, c/o Philipps University Marburg, Berlin & Marburg, Germany
| | | | - Thomas Frese
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
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Dougherty DM, Moon TJ, Liang Y, Roache JD, Lamb RJ, Mathias CW, Wasserman AM, Wood EE, Hill-Kapturczak N. Effectiveness of contingency management using transdermal alcohol monitoring to reduce heavy drinking among driving while intoxicated (DWI) arrestees: A randomized controlled trial. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:1989-2001. [PMID: 37864527 PMCID: PMC11205128 DOI: 10.1111/acer.15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Driving while intoxicated (DWI) is a serious public health problem. However, treatment for DWI arrestees is not readily available. This study examines the effectiveness of a contingency management (CM) procedure using transdermal alcohol concentration (TAC) monitoring to reduce drinking among DWI arrestees. METHOD The study participants were 216 DWI arrestees under pretrial and included both Mandated participants undergoing court-ordered TAC monitoring and Non-Mandated participants wearing a study-provided TAC monitor. Participants were randomly assigned to either a CM (Mandated = 35; Non-Mandated = 74) or a Control condition (Mandated = 37; Non-Mandated = 70) and completed the 8-week intervention. CM participants received $50/week for not exceeding a TAC of 0.02 g/dL during the previous week. Payments to Controls were yoked to the CM group. RESULTS Among Non-Mandated participants, the probability of meeting the contingency was higher and remained stable (about 65%) over time in the CM group, whereas the probability was lower and declined in the Control group, widening the gaps in the probability between the study conditions (16.7%-24.1% greater in the CM group from visit 4 to 8, all p < 0.05). Among Mandated participants, the probability was not significantly different between conditions (p = 0.06-0.95). Furthermore, among Non-Mandated participants, the percentage of heavy drinking days remained low (9.16%-11.37%) in the CM group, whereas it was greater and increased over time (17.43%-26.59%) in the Control group. In Mandated participants, no significant differences in percent heavy drinking days were observed between conditions (p = 0.07-0.10). CONCLUSION We found that contingency effects on alcohol use are more pronounced among frequent and heavy alcohol users, i.e., Non-Mandated DWI arrestees. However, for individuals whose drinking was already suppressed by existing contingencies (i.e., court-mandated TAC monitoring), our CM procedure did not produce additional reductions in drinking.
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Affiliation(s)
| | - Tae-Joon Moon
- Department of Health, Behavior, and Society, University of Texas School of Public Health San Antonio, San Antonio, Texas, USA
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Yuanyuan Liang
- Department of Epidemiology and Public Health, University of Maryland, Baltimore County, Baltimore, Maryland, USA
| | - John D. Roache
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Richard J. Lamb
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Charles W. Mathias
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | - Erin E. Wood
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Nathalie Hill-Kapturczak
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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Teeters JB, Armstrong NM, King SA, Hubbard SM. A randomized pilot trial of a mobile phone-based brief intervention with personalized feedback and interactive text messaging to reduce driving after cannabis use and riding with a cannabis impaired driver. J Subst Abuse Treat 2022; 142:108867. [PMID: 36007434 PMCID: PMC10810297 DOI: 10.1016/j.jsat.2022.108867] [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: 10/19/2021] [Revised: 07/27/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Driving after cannabis use (DACU) and riding with a cannabis-impaired driver (RWCD) are national public health concerns. Though driving impairments and increased crash risk make DACU and RWCD two of the riskiest cannabis-related behaviors, many continue to drive after use and ride with others who are under the influence and do not view DACU or RWCD as dangerous. The current study examined the efficacy of an accessible, low-cost, mobile phone-based brief intervention aimed at reducing DACU and RWCD among college cannabis users in the context of a randomized three-group pilot trial. METHOD Participants were 97 college cannabis users (67.4 % women; average age = 21.34; 80.4 % Caucasian) who endorsed DACU at least three times in the past three months. After completing baseline measures, the study randomly assigned participants to one of three conditions: a) a substance impaired-driving personalized feedback plus MI-style interactive text messaging intervention (PF + MIT); b) a substance impaired-driving personalized feedback only intervention (PF); and c) a substance information control condition (IC). All conditions completed outcome measures three months postintervention. RESULTS Generalized linear mixed models (GLMM) analyses indicated that after controlling for sex, cannabis users in the PF + MIT condition significantly reduced DACU and RWCD over time compared to those in the IC condition. CONCLUSIONS These findings provide preliminary support for the short-term efficacy of a mobile phone-based intervention in decreasing DACU and RWCD among college cannabis users. Future research should determine whether these reductions in driving behaviors persist past three months.
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Affiliation(s)
- Jenni B Teeters
- Psychological Sciences Department, Western Kentucky University, United States of America.
| | - Nicole M Armstrong
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, United States of America
| | - Shelby A King
- Psychology Department, East Tennessee State University, United States of America
| | - Sterling M Hubbard
- Counseling Psychology Department, Iowa State University, United States of America
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Brown TG, Moxley-Kelly N, Ouimet MC. Recidivism prevention for impaired driving: Longitudinal 5-year outcomes from Quebec's severity-based intervention assignment program. J Subst Abuse Treat 2022; 142:108855. [PMID: 35988514 DOI: 10.1016/j.jsat.2022.108855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/09/2022] [Accepted: 08/03/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Driving while impaired by alcohol (DWI) is a persistent problem. Tailoring intervention modality to client risk and needs (i.e., risk/needs) is posited to both reduce recidivism more efficiently than uniform approaches and circumvent overtreatment or undertreatment. DWI drivers in Quebec must participate in a severity-based intervention assignment program to be relicensed, but like most tailoring programs it has yet to undergo systematic scrutiny. The current longitudinal cohort study tests two main hypotheses underpinning this approach: 1) drivers classified at higher recidivism risk based on their arrest characteristics (DWIR) show poorer outcomes over up to 5-years postassessment compared to drivers classified at lower risk (DWIF); and 2) for both DWIR and DWIF groups, assignment of drivers with greater risk/needs to intensive intervention (II) will be advantageous for reducing recidivism risk compared to assignment into brief intervention (BI) for those with lower risk/needs. METHODS Drivers who entered the program from 2012 to 2016 were followed to the end of 2018 (N = 37,612). Survival analysis examined the predictive validity of the initial classification into DWIR or DWIF groups for documented recidivism over a follow-up of up to 5 years. Logistic regression discontinuity evaluated the relative outcomes of drivers who were assigned to either BI or II. The study explored interaction effects between classification and intervention assignment with age and sex. RESULTS In line with the hypothesis, the average hazard of recidivism was 58 % greater in DWIR drivers compared to DWIF drivers. In both DWIF and DWIR drivers, assignment of drivers with greater risk/needs to II was associated with reduced recidivism compared to assignment of drivers with lower risk/needs to BI, with 57 % and 35 % decreased probability of recidivism, respectively. Younger age was more strongly associated with recidivism risk in DWIF drivers than in DWIR drivers. CONCLUSIONS The current study found that Quebec's severity-based intervention assignment approach accurately identifies DWI drivers who: i) by their arrest characteristics pose a greater risk for recidivism, which may require expeditious exposure to preventative countermeasures; and ii) as a function of their greater risk/needs, benefit from assignment to more intensive intervention to mitigate their recidivism risk.
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Affiliation(s)
- Thomas G Brown
- Université de Sherbrooke, Longueuil, QC, Canada; McGill University, Montreal, QC, Canada; Douglas Hospital Research Centre, Verdun, QC, Canada
| | - Nathaniel Moxley-Kelly
- McGill University, Montreal, QC, Canada; Douglas Hospital Research Centre, Verdun, QC, Canada
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Delaney D, Balestrieri SG, Bassett SS, Stein LAR. A Brief Screen to Detect Cannabis Use Disorder Among Incarcerated Youth. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2021. [DOI: 10.1080/1067828x.2021.1943587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Shayna S. Bassett
- University of Rhode Island, Kingston, RI, USA
- Steppingstone, Inc., Fall River, MA, USA
| | - L. A. R. Stein
- University of Rhode Island, Kingston, RI, USA
- Brown University, Providence, RI, USA
- Rhode Island Training School, Cranston, RI, USA
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Moon TJ, Mathias CW, Mullen J, Karns-Wright TE, Hill-Kapturczak N, Roache JD, Dougherty DM. Social Support and the Rehabilitation of Alcohol-Impaired Drivers: Drinking Motives as Moderators. HEALTH COMMUNICATION 2021; 36:540-550. [PMID: 32091242 PMCID: PMC7483183 DOI: 10.1080/10410236.2020.1731914] [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: 06/10/2023]
Abstract
Alcohol-impaired driving is a common and costly public health problem associated with alcohol misuse. This investigation aims to understand the role of social support and drinking motives in motivating alcohol-impaired drivers to reduce alcohol use. One hundred nineteen participants with a history of driving-while-intoxicated arrest were recruited from either a correctional treatment facility (n = 59) or the community (n = 60) and asked about their motivation to change alcohol use. Motivation to change was tested in relationships with two types of social support (i.e. Abstinence-Specific Social Support and General Social Support) and drinking motives (Coping, Enhancement, and Social Motives). The results showed: (1) only Abstinence-Specific Social Support was positively associated with motivation to change; (2) Coping and Social Motives had a negative association with motivation to change; (3) the impact of Abstinence-Specific Social Support on motivation to change was greater among those with a stronger Enhancement Motives. In other words, those who drink primarily for pleasure showed a greater increase in motivation to change when more Abstinence-Specific Social Support is available, compared to those with lower Enhancement Motives. The findings of this investigation contribute to our knowledge of the roles of communication in the rehabilitation of alcohol-impaired drivers.
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Affiliation(s)
- Tae-Joon Moon
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Charles W. Mathias
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Jillian Mullen
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Tara E. Karns-Wright
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | | | - John D. Roache
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Donald M. Dougherty
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
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Pederson SD, Curley EJ, Collins CJ. A Systematic Review of Motivational Interviewing to Address Substance Use with Justice-Involved Adults. Subst Use Misuse 2021; 56:639-649. [PMID: 33726607 DOI: 10.1080/10826084.2021.1887247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Motivational Interviewing (MI) is widely used in substance abuse treatment, possibly due to the short sessions and the treatment's cost-effectiveness. Previous research has established the efficacy of MI among a broad range of populations and outcomes. However, there is a lack of a review of the knowledge about if MI works with justice-involved individuals who have substance use issues. Purpose: This review aimed to examine the extent of the literature on MI as a treatment to decrease rates of substance use for justice-involved individuals. Methods: The databases utilized for the review include Academic Search Complete (EBSCO), PsycINFO, and ProQuest. The dates for the literature inclusion were from 2008 to March 2020. The literature search was initiated in February and was completed in March 2020. Results: Five RCT studies were identified. Studies were conducted using populations during incarceration in prison, prior to release from jail, through probation, and those with DWI charges. However, all of the populations included were actively being monitored for substance use. All five studies found no difference between groups at the latest point in the study, which for most included the follow-up measure. Consideration for potential moderators such as severity and type of substance use, and length of treatment and follow up data are discussed. Conclusion: The results of the review indicated that more standardized and rigorous research is needed for exploring MI with individuals involved with the justice system with the focus of decreasing substance use.
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Affiliation(s)
- Shelby D Pederson
- College of Social Work, Florida State University Tallahassee, FL, USA
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Patterson T, Macleod E, Hobbs L, Egan R, Cameron C, Gross J. Measuring both primary and secondary outcomes when evaluating treatment effectiveness in alcohol and drug treatment programmes. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Tess Patterson
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand,
| | - Emily Macleod
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand,
| | - Linda Hobbs
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand,
| | - Richard Egan
- Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand,
| | - Claire Cameron
- Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand,
| | - Julien Gross
- Department of Psychology, University of Otago, Dunedin, New Zealand,
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Treatment Initiation and Alcohol Use Violations Among Adults with DWI Arrests Who Received a Tailored Brief Intervention. ADDICTIVE DISORDERS & THEIR TREATMENT 2020; 19:7-15. [PMID: 33424458 DOI: 10.1097/adt.0000000000000171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective This program evaluation examined rates of treatment initiation and alcohol related violations among adults who completed a brief motivational interviewing (BMI) session after a driving while intoxicated arrest. Method Adults attending orientation for pretrial bond supervision were assessed for eligibility to receive services by counselors in an outpatient clinic. A total of 118 male and female adults with DWI arrests completed a single BMI session. Treatment initiation was assessed one-week after the BMI session and alcohol-related violations were assessed 6-months later. Results Fifty-three percent of those with DWI arrests who received the BMI session-initiated treatment and of those who initiated treatment, alcohol-related violations were significantly lower than for those who did not initiate treatment. Conclusions The results provide preliminary support that a single session BMI delivered soon after arrest and before pretrial conditions are implemented has promise for spurring clients to take steps to initiate treatment and is related to better rates of compliance with alcohol-related pretrial conditions.
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Abstract
OBJECTIVE The aim of this study was to determine the psychometric properties of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within 16 Pediatric Emergency Care Applied Research Network pediatric emergency departments. This article describes the study methodology, sample characteristics, and baseline outcomes of the NIAAA 2-question screen. METHODS Participants included 12- to 17-year-olds treated in one of the participating pediatric emergency departments across the United States. After enrollment, a criterion assessment battery including the NIAAA 2-question screen and other measures of alcohol, drug use, and risk behavior was self-administered by participants on a tablet computer. Two subsamples were derived from the sample. The first subsample was readministered the NIAAA 2-question screen 1 week after their initial visit to assess test-retest reliability. The second subsample is being reassessed at 12 and 24 months to examine predictive validity of the NIAAA 2-question screen. RESULTS There were 4834 participants enrolled into the study who completed baseline assessments. Participants were equally distributed across sex and age. Forty-six percent of the participants identified as white, and 26% identified as black. Approximately one quarter identified as Hispanic. Using the NIAAA 2-question screen algorithm, approximately 8% were classified as low risk, 12% were classified as moderate risk, and 4% were classified as highest risk. Alcohol use was less likely to be reported by black participants, non-Hispanic participants, and those younger than 16 years. DISCUSSION This study successfully recruited a large, demographically diverse sample to establish rates of the NIAAA screen risk categories across age, sex, ethnicity, and race within pediatric emergency departments.
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Teeters JB, Soltis KE, Murphy JG. A Mobile Phone-Based Brief Intervention With Personalized Feedback and Text Messaging Is Associated With Reductions in Driving After Drinking Among College Drinkers. J Stud Alcohol Drugs 2019. [PMID: 30422784 DOI: 10.15288/jsad.2018.79.710] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Driving after drinking (DAD) among college students remains a significant public health concern and is perhaps the single riskiest drinking-related behavior. Counselor-delivered and web-based Brief Alcohol Interventions (BAIs) have been shown to reduce DAD among college students, but to date no study has evaluated the efficacy of a single-session mobile phone-based BAI specific to DAD. The present study examined whether a driving-specific BAI delivered via mobile phone would significantly decrease DAD among college students compared to an informational control. METHOD Participants were 84 college students (67.1% women; average age = 23; 52.4% White) who endorsed driving after drinking two or more drinks at least twice in the past 3 months. After completing baseline measures, participants were randomly assigned to receive either (a) DAD information or (b) DAD mobile BAI that included personalized feedback and interactive text messaging. Participants completed outcome measures at 3-month follow-up. RESULTS Repeated-measures mixed modeling analyses revealed that students receiving the mobile phone-based BAI reported significantly greater reductions in likelihood of DAD (three or more drinks) and the number of drinks consumed before driving than students in the information condition at 3-month follow-up. CONCLUSIONS These findings provide preliminary support for the short-term efficacy of a mobile phone-based BAI for reducing DAD among college students.
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Affiliation(s)
- Jenni B Teeters
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky.,Department of Psychology, The University of Memphis, Memphis, Tennessee
| | - Kathryn E Soltis
- Department of Psychology, The University of Memphis, Memphis Tennessee
| | - James G Murphy
- Department of Psychology, The University of Memphis, Memphis Tennessee
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Brief Interventions for Cannabis Problems in the Postsecondary Setting: a Systematic Review. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00075-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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14
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Spirito A, Bromberg JR, Casper TC, Chun T, Mello MJ, Mull CC, Shenoi RP, Vance C, Ahmad F, Bajaj L, Brown KM, Chernick LS, Cohen DM, Fein J, Horeczko T, Levas MN, McAninch B, Monuteaux MC, Grupp-Phelan J, Powell EC, Rogers A, Suffoletto B, Linakis JG. Screening for Adolescent Alcohol Use in the Emergency Department: What Does It Tell Us About Cannabis, Tobacco, and Other Drug Use? Subst Use Misuse 2019; 54:1007-1016. [PMID: 30727811 PMCID: PMC6476662 DOI: 10.1080/10826084.2018.1558251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The pediatric emergency department (PED) represents an opportune time for alcohol and drug screening. The National Institute of Alcohol Abuse and Alcoholism (NIAAA) recommends a two-question alcohol screen for adolescents as a predictor of alcohol and drug misuse. OBJECTIVE A multi-site PED study was conducted to determine the association between the NIAAA two-question alcohol screen and adolescent cannabis use disorders (CUD), cigarette smoking, and lifetime use of other drugs. METHODS Participants included 12-17-year olds (n = 4834) treated in one of 16 participating PEDs. An assessment battery, including the NIAAA two-question screen and other measures of alcohol, tobacco and drug use, was self-administered on a tablet computer. RESULTS A diagnosis of CUD, lifetime tobacco use or lifetime drug use was predicted by any self-reported alcohol use in the past year, which indicates a classification of moderate risk for middle school ages and low risk for high school ages on the NIAAA two-question screen. Drinking was most strongly predictive of a CUD, somewhat weaker for lifetime tobacco use, and weakest for lifetime drug use. This same pattern held for high school and middle school students and was stronger for high school students over middle school students for all three categories. This association was also found across gender, ethnicity and race. The association was strongest for CUD for high school students, sensitivity 81.7% (95% CI, 77.0, 86.5) and specificity 70.4% (95% CI, 68.6, 72.1). Conclusions/Importance: A single question about past year alcohol use can provide valuable information about other substance use, particularly marijuana.
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Affiliation(s)
- Anthony Spirito
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA
| | - Julie R Bromberg
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
| | - T Charles Casper
- c University of Utah, Department of Pediatrics, Salt Lake City, Utah, USA
| | - Thomas Chun
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
| | - Michael J Mello
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
| | - Colette C Mull
- d Nemours/Alfred I. duPont Hospital for Children, Department of Pediatrics, Wilmington, Delaware, USA
| | - Rohit P Shenoi
- e Baylor College of Medicine/Texas Children's Hospital, Departments of Emergency Medicine and Pediatrics, Houston, Texas, USA
| | - Cheryl Vance
- f University of California , Davis, Department of Pediatrics, Davis , California, USA
| | - Fahd Ahmad
- g St. Louis Children's Hospital/Washington University, Department of Emergency Medicine, St. Louis, Washington, USA
| | - Lalit Bajaj
- h Children's Hospital - Colorado, Departments of Pediatric Emergency Medicine and Pediatrics, Aurora, Colorado, USA
| | - Kathleen M Brown
- i Children's National Medical Center, Department of Emergency Medicine and Trauma Services, Washington, DC, USA
| | - Lauren S Chernick
- j Columbia University Medical Center, Department of Pediatric Emergency Medicine, New York, New York, USA
| | - Daniel M Cohen
- k Nationwide Children's Hospital, Departments of Pediatrics and Emergency Medicine, Columbus, Ohio, USA
| | - Joel Fein
- l The Children's Hospital of Philadelphia, Departments of Pediatrics and Emergency Medicine, Philadelphia, Pennsylvania, USA
| | - Timothy Horeczko
- m Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Emergency and Pediatric Emergency Medicine, Los Angeles, California, USA
| | - Michael N Levas
- n Medical College of Wisconsin, Department of Pediatric Emergency Medicine, Milwaukee, Wisconsin, USA
| | - B McAninch
- o University of Pittsburgh/Children's Hospital of Pittsburgh of UPMC, Division of Pediatric Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - Michael C Monuteaux
- p Boston Children's Hospital, Department of Pediatrics, Boston, Massachusetts, USA
| | - Jackie Grupp-Phelan
- q University of California , San Francisco, Department of Pediatric Emergency Medicine, San Francisco , California, USA
| | - Elizabeth C Powell
- r Lurie Children's Hospital of Chicago, Department of Pediatric Emergency Medicine, Chicago, Illinois, USA
| | - Alexander Rogers
- s University of Michigan, Department of Emergency Medicine, Ann Arbor, Michigan, USA
| | - Brian Suffoletto
- o University of Pittsburgh/Children's Hospital of Pittsburgh of UPMC, Division of Pediatric Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - James G Linakis
- a The Warren Alpert Medical School of Brown University, Departments of Psychiatry and Human Behavior, Pediatrics, Emergency Medicine, Providence, Rhode Island, USA.,b Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, USA
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Nelson SE, Shoov E, LaBrie RA, Shaffer HJ. Externalizing and self-medicating: Heterogeneity among repeat DUI offenders. Drug Alcohol Depend 2019; 194:88-96. [PMID: 30415173 PMCID: PMC6312495 DOI: 10.1016/j.drugalcdep.2018.09.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022]
Abstract
AIM Despite significant reductions in Driving Under the Influence (DUI) in the United States during recent decades, DUI continues to be a major public health threat. The current study investigated the intersection of two domains known to influence DUI: criminal history and psychiatric comorbidity. METHODS DUI recidivists (N = 743) attending a court-mandated two-week inpatient DUI program completed a computerized mental health assessment as part of their intake to that program. Participants' criminal records were obtained 4-5 years after program attendance. FINDINGS This study identified three primary repeat DUI offender subtypes with distinct patterns of criminal behavior and psychiatric comorbidity: (Type I) those whose DUI emerges from a pattern of drinking to cope with mood and anxiety problems, (Type II) those whose DUI emerges as part of a larger pattern of externalizing and criminal behavior, and (Type III) those whose DUI offenses reflect more acute triggers and isolated episodes of excessive drinking. CONCLUSION These findings suggest that current treatment models used in DUI programs are inadequate to address the heterogeneity in the population of DUI recidivists and that earlier and more comprehensive screening would allow for better targeting of resources to DUI offender subtypes.
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Affiliation(s)
- Sarah E Nelson
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA; Harvard Medical School, Department of Psychiatry, 401 Park Drive, Boston, MA, 02215, USA.
| | - Emily Shoov
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA
| | - Richard A LaBrie
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA; Harvard Medical School, Department of Psychiatry, 401 Park Drive, Boston, MA, 02215, USA
| | - Howard J Shaffer
- Division on Addiction, Cambridge Health Alliance, 101 Station Landing, Ste. 2100, Medford, MA 02155, USA; Harvard Medical School, Department of Psychiatry, 401 Park Drive, Boston, MA, 02215, USA
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Moon TJ, Mathias CW, Mullen J, Karns-Wright TE, Hill-Kapturczak N, Roache JD, Dougherty DM. The Role of Social Support in Motivating Reductions in Alcohol Use: A Test of Three Models of Social Support in Alcohol-Impaired Drivers. Alcohol Clin Exp Res 2018; 43:123-134. [PMID: 30431660 DOI: 10.1111/acer.13911] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/12/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Social support has been linked to many therapeutic benefits (e.g., treatment retention, reduced posttreatment relapse) for individuals with alcohol use disorder. However, the positive impacts of social support have not been well understood in the context of alcohol-impaired driving. This article examines the role of social support in motivating those with histories of driving while intoxicated (DWI) arrest to reduce alcohol use by testing 3 major models of social support: the Main-Effects model, the Buffering model, and the Optimal Matching model. METHODS One hundred and nineteen participants with histories of DWI arrest were recruited from a correctional treatment facility (n = 59) and the local community (n = 60). Participants completed interviews to assess alcohol consumption, psychiatric/physical conditions, and psychosocial factors associated with drinking behavior (e.g., social support, alcohol-related problems, and motivation to change). Hierarchical regression analyses were conducted to test the 3 models. Additionally, the relative magnitude of the effects of general and recovery-specific social support was compared based on the approach of statistical inference of confidence intervals. RESULTS Overall social support was positively associated with some motivation to change (i.e., importance of change, confidence in change) among alcohol-impaired drivers, supporting the Main-Effects model. However, the impact of overall social support on motivation to change was not moderated by alcohol-related problems of individuals arrested for DWI, which did not confirm the Buffering model. Last, recovery-specific social support, rather than general social support, contributed to increasing motivation to reduce alcohol use, which supported the Optimal Matching model. CONCLUSIONS These findings highlight the benefits of social support (i.e., increased motivation to change alcohol use) for alcohol-impaired drivers. Regardless of the severity of alcohol-related problems of alcohol-impaired drivers, social support had direct positive impacts on motivation to change. In particular, the results underscore that social support can be more effective when it is matched to the recovery effort of individuals, which is consistent with the Optimal Matching model.
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Affiliation(s)
- Tae-Joon Moon
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Charles W Mathias
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Jillian Mullen
- The EASL International Liver Foundation, Geneva, Switzerland
| | - Tara E Karns-Wright
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Nathalie Hill-Kapturczak
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - John D Roache
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Donald M Dougherty
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Wickens CM, Flam-Zalcman R, Mann RE, Stoduto G, Nochajski T, Koski-Jännes A, Herie M, Watkin-Merek L, Rush B, Thomas RK, LaFontaine S, Watson TM, Matheson J, Ilie G, Mehra K, Le TL, Rehm J. Evaluating moderators of beneficial effects of severity-based assignment to substance use treatments in impaired drivers. J Subst Abuse Treat 2018; 93:49-56. [PMID: 30126541 DOI: 10.1016/j.jsat.2018.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/13/2018] [Accepted: 07/05/2018] [Indexed: 11/28/2022]
Abstract
Remedial programs for impaired driving offenders have proved valuable in reducing subsequent alcohol and other drug use and preventing recidivism in this population. Many of these programs are based on a severity-based assignment scheme, where individuals assessed to have greater problems or be at higher risk are assigned to longer, more intensive interventions. Recent research, using regression discontinuity analyses, provided support for severity-based assignment schemes in demonstrating that those with higher problem or risk levels assigned to longer and more intensive programming showed a significant reduction in drinking days over a follow-up interval, attributable to program assignment. Regression discontinuity analyses can also be used to assess moderators of this assignment benefit. We report an assessment of the impact of eight potential moderators of assignment benefit, derived from a factor analysis of the Research on Addictions Self-Inventory screening instrument. Five of the eight factors were found to moderate the assignment benefit: Negative Affect, Sensation Seeking, High Risk Lifestyle, Alcohol Problems, and Family History. The significance of these results for developing more effective program assignment procedures is discussed.
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Affiliation(s)
- Christine M Wickens
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | | | - Robert E Mann
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Gina Stoduto
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Thomas Nochajski
- School of Social Work, State University of New York at Buffalo, Buffalo, NY, United States of America
| | | | - Marilyn Herie
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lyn Watkin-Merek
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Brian Rush
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Rita K Thomas
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Susan LaFontaine
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Justin Matheson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Gabriela Ilie
- Department of Epidemiology and Community Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kamna Mehra
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Thao Lan Le
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Wickens CM, Flam-Zalcman R, Stoduto G, Docherty C, Thomas RK, Watson TM, Matheson J, Mehra K, Mann RE. Multiple "Lower BAC" offenders: Characteristics and response to remedial interventions. ACCIDENT; ANALYSIS AND PREVENTION 2018; 115:110-117. [PMID: 29550611 DOI: 10.1016/j.aap.2018.02.019] [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: 06/07/2017] [Revised: 01/02/2018] [Accepted: 02/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND In recent years, there has been increasing attention to "lower BAC" drinking drivers, typically those whose blood alcohol content (BAC) is under the legal limits defined in criminal law. In 2009, legislation was enacted in Ontario, Canada that enabled police to issue roadside license suspensions to individuals caught driving with BAC between 0.05% and 0.08%, known as the "warn range". Multiple warn range (MWR) offenders are required to attend the Back on Track (BOT) remedial measures program. This study aimed to provide: (1) a preliminary characterization of MWR drivers charged under warn range legislation; and (2) an initial assessment of outcomes associated with BOT participation among MWR offenders. METHODS A subsample of 727 MWR offenders was drawn from program records, and compared to samples of 3597 first-time Criminal Code (CC) offenders (those caught driving with a BAC of 0.08% or higher) and 359 second-time CC offenders. To provide an initial assessment of outcomes associated with BOT participation, another subsample consisted of 394 MWR participants from whom pre- and post-workshop questionnaires were collected and successfully matched using probabilistic matching processes. RESULTS Similarities in demographic profile and driving history between MWR and first-time CC participants were apparent. MWR offenders scored higher on risk of problem drinking and drink-driving recidivism than either of the CC offender groups. Second-time CC offenders scored higher on these measures than first-time CC offenders. Following BOT participation, MWR participants demonstrated positive change including improved knowledge of and intentions to avoid drink-driving. CONCLUSIONS MWR offenders share a similar demographic profile to that of first-time CC offenders and they report significantly higher risk of problem drinking and recidivism. MWR offenders may include high-functioning problem drinkers who are likely to continue drink-driving and who may escalate to a CC drink-driving offense. Like CC offenders, MWR offenders benefited from BOT participation.
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Affiliation(s)
- Christine M Wickens
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | | | - Gina Stoduto
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Chloe Docherty
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Rita K Thomas
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Justin Matheson
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Kamna Mehra
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robert E Mann
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Malla A, Joober R, Iyer S, Norman R, Schmitz N, Brown T, Lutgens D, Jarvis E, Margolese HC, Casacalenda N, Abdel‐Baki A, Latimer E, Mustafa S, Abadi S. Comparing three-year extension of early intervention service to regular care following two years of early intervention service in first-episode psychosis: a randomized single blind clinical trial. World Psychiatry 2017; 16:278-286. [PMID: 28941098 PMCID: PMC5608831 DOI: 10.1002/wps.20456] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
This study aimed to determine if, following two years of early intervention service for first-episode psychosis, three-year extension of that service was superior to three years of regular care. We conducted a randomized single blind clinical trial using an urn randomization balanced for gender and substance abuse. Participants were recruited from early intervention service clinics in Montreal. Patients (N=220), 18-35 years old, were randomized to an extension of early intervention service (EEIS; N=110) or to regular care (N=110). EEIS included case management, family intervention, cognitive behaviour therapy and crisis intervention, while regular care involved transfer to primary (community health and social services and family physicians) or secondary care (psychiatric outpatient clinics). Cumulative length of positive and negative symptom remission was the primary outcome measure. EEIS patients had a significantly longer mean length of remission of positive symptoms (92.5 vs. 63.6 weeks, t=4.47, p<0.001), negative symptoms (73.4 vs. 59.6 weeks, t=2.84, p=0.005) and both positive and negative symptoms (66.5 vs. 56.7 weeks, t=2.25, p=0.03) compared to regular care patients. EEIS patients stayed in treatment longer than regular care patients (mean 131.7 vs. 105.3 weeks, t=3.98, p<0.001 through contact with physicians; 134.8 ± 37.7 vs. 89.8 ± 55.2, t=6.45, p<0.0001 through contact with other health care providers) and received more units of treatment (mean 74.9 vs. 39.9, t=4.21, p<0.001 from physicians, and 57.3 vs. 28.2, t=4.08, p<0.001 from other health care professionals). Length of treatment had an independent effect on the length of remission of positive symptoms (t=2.62, p=0.009), while number of units of treatment by any health care provider had an effect on length of remission of negative symptoms (t=-2.70, p=0.008) as well as total symptoms (t=-2.40, p=0.02). Post-hoc analysis showed that patients randomized to primary care, based on their better clinical profile at randomization, maintained their better outcome, especially as to remission of negative symptoms, at the end of the study. These data suggest that extending early intervention service for three additional years has a positive impact on length of remission of positive and negative symptoms compared to regular care. This may have policy implications for extending early intervention services beyond the current two years.
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Affiliation(s)
- Ashok Malla
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Douglas Mental Health University InstituteMontrealQCCanada
| | - Ridha Joober
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Douglas Mental Health University InstituteMontrealQCCanada
| | - Srividya Iyer
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Douglas Mental Health University InstituteMontrealQCCanada
| | - Ross Norman
- Departments of Psychiatry and Epidemiology and BiostatisticsUniversity of Western Ontario, and London Health Sciences CentreLondonONCanada
| | - Norbert Schmitz
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Douglas Hospital Research CentreMontrealQCCanada
| | - Thomas Brown
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Douglas Hospital Research CentreMontrealQCCanada
| | - Danyael Lutgens
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Douglas Mental Health University InstituteMontrealQCCanada
| | - Eric Jarvis
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Jewish General HospitalMontrealQCCanada
| | - Howard C. Margolese
- Department of PsychiatryMcGill UniversityMontrealQCCanada,McGill University Health CentreMontrealQCCanada
| | - Nicola Casacalenda
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Jewish General HospitalMontrealQCCanada
| | | | - Eric Latimer
- Department of PsychiatryMcGill UniversityMontrealQCCanada,Douglas Hospital Research CentreMontrealQCCanada
| | - Sally Mustafa
- Douglas Mental Health University InstituteMontrealQCCanada
| | - Sherezad Abadi
- Douglas Mental Health University InstituteMontrealQCCanada
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The Impact of Remedial Programme Participation on Convicted Drinking Drivers’ Alcohol and Other Drug Use 6 Months Following Programme Completion. Int J Ment Health Addict 2017. [DOI: 10.1007/s11469-017-9799-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Wickens CM, Flam-Zalcman R, Mann RE, Stoduto G, Docherty C, Thomas RK. Characteristics and predictors of recidivist drink-drivers. TRAFFIC INJURY PREVENTION 2016; 17:564-572. [PMID: 26761189 DOI: 10.1080/15389588.2015.1125477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 11/24/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The current study compared characteristics of nonrecidivist versus recidivist drink-drivers and of recidivists in their first versus second appearance at Back on Track (BOT), the remedial measures program for impaired drivers in Ontario, Canada. METHODS Information from 59,134 convicted drivers who participated in BOT between 2000 and 2010 was examined to identify drivers who completed the program a second time following reconviction. RESULTS A total of 586 recidivists were identified. Compared to nonrecidivist drivers, recidivists at first attendance were more likely to be male and had higher scores on measures of alcohol dependence and adverse legal consequences of substance use. Compared to nonrecidivist drivers, recidivists at second attendance were significantly older, had a higher income, were more likely to be retired, and were less likely to be employed part-time. They had fewer legal problems. Recidivists reported fewer drinking days and fewer drinks per occasion but greater use of benzodiazepines than nonrecidivists and had higher scores on a measure of future risk of alcohol- and drug-related problems. Comparison of recidivists' characteristics at first versus second attendance confirmed many of these findings, with second-time recidivists reporting fewer drinks per drinking day and greater use of benzodiazepines and having higher scores on a measure of future substance use problems than first-time recidivists. CONCLUSIONS Results suggest that identification of drivers at increased risk of recidivism may be possible at first program attendance by examining indicators of increased alcohol-related problems. In addition, recidivists appear to show a greater readiness to change at second attendance. Implications for remedial program development and recommendations for future research are discussed.
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Affiliation(s)
- Christine M Wickens
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
- b Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
| | | | - Robert E Mann
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
- b Dalla Lana School of Public Health, University of Toronto , Toronto , Ontario , Canada
| | - Gina Stoduto
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
| | - Chloe Docherty
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
| | - Rita K Thomas
- a Centre for Addiction and Mental Health , Toronto , Ontario , Canada
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Benefits of short educational programmes in preventing drink-driving recidivism: A ten-year follow-up randomised controlled trial. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 32:70-6. [DOI: 10.1016/j.drugpo.2016.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/24/2016] [Accepted: 03/07/2016] [Indexed: 01/02/2023]
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Brown TG, Ouimet MC, Eldeb M, Tremblay J, Vingilis E, Nadeau L, Pruessner J, Bechara A. Personality, Executive Control, and Neurobiological Characteristics Associated with Different Forms of Risky Driving. PLoS One 2016; 11:e0150227. [PMID: 26910345 PMCID: PMC4766103 DOI: 10.1371/journal.pone.0150227] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/10/2016] [Indexed: 11/27/2022] Open
Abstract
Background Road crashes represent a huge burden on global health. Some drivers are prone to repeated episodes of risky driving (RD) and are over-represented in crashes and related morbidity. However, their characteristics are heterogeneous, hampering development of targeted intervention strategies. This study hypothesized that distinct personality, cognitive, and neurobiological processes are associated with the type of RD behaviours these drivers predominantly engage in. Methods Four age-matched groups of adult (19–39 years) males were recruited: 1) driving while impaired recidivists (DWI, n = 36); 2) non-alcohol reckless drivers (SPEED, n = 28); 3) drivers with a mixed RD profile (MIXED, n = 27); and 4) low-risk control drivers (CTL, n = 47). Their sociodemographic, criminal history, driving behaviour (by questionnaire and simulation performance), personality (Big Five traits, impulsivity, reward sensitivity), cognitive (disinhibition, decision making, behavioural risk taking), and neurobiological (cortisol stress response) characteristics were gathered and contrasted. Results Compared to controls, group SPEED showed greater sensation seeking, disinhibition, disadvantageous decision making, and risk taking. Group MIXED exhibited more substance misuse, and antisocial, sensation seeking and reward sensitive personality features. Group DWI showed greater disinhibition and more severe alcohol misuse, and compared to the other RD groups, the lowest level of risk taking when sober. All RD groups exhibited less cortisol increase in response to stress compared to controls. Discussion Each RD group exhibited a distinct personality and cognitive profile, which was consistent with stimulation seeking in group SPEED, fearlessness in group MIXED, and poor behavioural regulation associated with alcohol in group DWI. As these group differences were uniformly accompanied by blunted cortisol stress responses, they may reflect the disparate behavioural consequences of dysregulation of the stress system. In sum, RD preference appears to be a useful marker for clarifying explanatory pathways to risky driving, and for research into developing more personalized prevention efforts.
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Affiliation(s)
- Thomas G. Brown
- Research Centre of the Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Foster Addiction Rehabilitation Centre, St. Philippe de Laprairie, Quebec, Canada
- * E-mail:
| | - Marie Claude Ouimet
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada
| | - Manal Eldeb
- Research Centre of the Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Jacques Tremblay
- Research Centre of the Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Evelyn Vingilis
- Department of Family Medicine and Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada
| | - Louise Nadeau
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Jens Pruessner
- Research Centre of the Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Antoine Bechara
- Department of Psychology, University of Southern California, Los Angeles, California, United States of America
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Barrio P, Gual A. Patient-centered care interventions for the management of alcohol use disorders: a systematic review of randomized controlled trials. Patient Prefer Adherence 2016; 10:1823-1845. [PMID: 27695301 PMCID: PMC5029836 DOI: 10.2147/ppa.s109641] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
ISSUES Patient-centered care (PCC) is increasingly accepted as an integral component of good health care, including addiction medicine. However, its implementation has been controversial in people with alcohol use disorders. APPROACH A systematic search strategy was devised to find completed randomized controlled trials enrolling adults (>18 years) with alcohol use disorders. Studies had to use a PCC approach such that they should have been individualized, respectful to the patients' own goals, and empowering. Studies until September 2015 were searched using PubMed, Scopus, the Cochrane Library, PsychINFO, and Web of Knowledge. KEY FINDINGS In total, 40 studies enrolling 16,020 patients met the inclusion criteria. Assessment revealed two main categories of study: psychosocial (n=35 based on motivational interviewing) and pharmacological (n=5 based on an as needed dosing regimen). Psychosocial interventions were further classified according to the presence or absence of an active comparator. When no active comparator was present, studies were classified according to the number of sessions (≥1). Results from single sessions of motivational interviewing showed no clear benefit on alcohol consumption outcomes, with few studies indicating benefit of PCC versus control. Although the results for studies of multiple sessions of counseling were also mixed, many did show a significant benefit of the PCC intervention. By contrast, studies consistently demonstrated a benefit of pharmacologically supported PCC interventions, with most of the differences reaching statistical significance. IMPLICATIONS PCC-based interventions may be beneficial for reducing alcohol consumption in people with alcohol use disorders.
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Affiliation(s)
- Pablo Barrio
- Neurosciences Institute, Hospital Clinic, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer, Barcelona, Spain
- Correspondence: Pablo Barrio, Neurosciences Institute, Hospital Clinic, IDIBAPS, Carrer de Villlarroel 170, 08036 Barcelona, Spain, Tel +34 932 275 400 ext 3167, Email
| | - Antoni Gual
- Neurosciences Institute, Hospital Clinic, Institut d’Investigacions Biomèdiques Agustí Pi i Sunyer, Barcelona, Spain
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Steinka-Fry KT, Tanner-Smith EE, Hennessy EA. Effects of Brief Alcohol Interventions on Drinking and Driving among Youth: A Systematic Review and Meta-analysis. JOURNAL OF ADDICTION & PREVENTION 2015; 3:11. [PMID: 26221619 PMCID: PMC4515415 DOI: 10.13188/2330-2178.1000016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Alcohol-impaired driving persists as a major cause of traffic fatalities and injuries among young drivers. This meta-analysis examined whether brief alcohol interventions were effective in reducing driving after drinking among adolescents and young adults. METHOD Our systematic search identified 12 experimental/quasi-experimental evaluations (16 intervention groups) that measured driving while intoxicated and related consequences and provided data for effect size calculation (N = 5,664; M age =17 years; 57% male). The studies were published between 1991 and 2011. Three-level random-effects meta-analyses using a structural equation modeling approach were used to summarize the effects of the interventions. RESULTS Compared with controls, participants in brief alcohol interventions reported reduced drinking and driving and related consequences (ḡ = 0.15, 95% CI [0.08, 0.21]). Supplemental analyses indicated that reductions in driving while intoxicated were positively associated with the reduced post-intervention heavy use of alcohol. These findings were not attenuated by study design or implementation factors. CONCLUSIONS Brief alcohol interventions under 5 hours of contact may constitute a promising preventive approach targeting drinking and driving among adolescents and young adults. Reducing heavy episodic alcohol consumption appeared to be a major factor in reducing drunk-driving instances. Interpretation of the findings must be made with caution, however, given the possibility of publication bias and the small observed effect size. Future research should focus on the exact mechanisms of behavior change leading to beneficial outcomes of brief alcohol interventions and the potential effectiveness of combined brief interventions and other preventive approaches.
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Affiliation(s)
| | - Emily E. Tanner-Smith
- Peabody Research Institute, Vanderbilt University, USA
- Department of Human and Organizational Development, Vanderbilt University, USA
| | - Emily A. Hennessy
- Department of Human and Organizational Development, Vanderbilt University, USA
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Beadnell B, Crisafulli MA, Stafford PA, Rosengren DB, DiClemente CC. Operating under the influence: Three year recidivism rates for motivation-enhancing versus standard care programs. ACCIDENT; ANALYSIS AND PREVENTION 2015; 80:48-56. [PMID: 25879708 DOI: 10.1016/j.aap.2015.03.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 11/17/2014] [Accepted: 03/21/2015] [Indexed: 06/04/2023]
Abstract
Operating a motor vehicle under the influence of alcohol (OUI) is an international problem. In the United States, one intervention strategy is to require offenders to attend group-delivered interventions. We compared three year rearrest rates among 12,267 individuals in Maine receiving either a motivation-enhancing (ME) program, Prime For Life(®), or historical standard care (SC) programs. We created two cohorts, one when Maine used SC (9/1/1999-8/31/2000) and one after the ME program was implemented (9/1/2002-8/31/2003). Adjusted for control variables, rearrest rates among people not completing an assigned program did not differ for the ME versus SC cohorts (12.1% and 11.6%, respectively; OR=1.05, ns). In contrast, ME compared to SC program completers had lower rearrest rates (7.4% versus 9.9%, OR=0.73, p<.05). The same pattern occurred for people required to take these programs plus substance use treatment (12.1% versus 14.7%, OR=0.82, p<.01). For those rearrested, time to rearrest did not differ between ME and SC cohorts. Among those required to have substance abuse treatment, ME and SC arrest rates did not differ for younger individuals; otherwise, the ME cohort's lower rearrest rates occurred across gender, age, having a previous OUI, and having completed a previous intervention program.
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Affiliation(s)
- Blair Beadnell
- Prevention Research Institute, 841 Corporate Drive, Suite 300, Lexington, KY 40503, USA.
| | - Michele A Crisafulli
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
| | - Pamela A Stafford
- Prevention Research Institute, 841 Corporate Drive, Suite 300, Lexington, KY 40503, USA.
| | - David B Rosengren
- Prevention Research Institute, 841 Corporate Drive, Suite 300, Lexington, KY 40503, USA.
| | - Carlo C DiClemente
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
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Hansen MB, Kloster S, Danquah IH, Nielsen AS, Becker U, Tjørnhøj-Thomsen T, Tolstrup JS. "A welfare recipient may be drinking, but as long as he does as told--he may drink himself to death": a qualitative analysis of project implementation barriers among Danish job consultants. BMC Public Health 2015; 15:264. [PMID: 25886200 PMCID: PMC4379594 DOI: 10.1186/s12889-015-1620-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 03/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper is embedded in a randomised controlled trial (Alcohol and Employment) that investigated whether welfare-to-work schemes combined with alcohol treatment were more effective than welfare-to-work schemes alone for helping unemployed welfare recipients with alcohol problems get back to employment and reduce their alcohol problems. The implementation of Alcohol and Employment turned out to be challenging, and fewer welfare recipients than expected were enrolled. The aim of this paper was to identify and investigate obstacles to the implementation of Alcohol and Employment. Our main objective was to study the job consultants' role in the implementation process as they were key personnel in conducting the trial. METHODS The process evaluation was conducted in four Danish municipalities in 2011-2012. Data for identifying factors important for the implementation were collected through observations and focus group interviews with job consultants. Data were analysed thematically and thoroughly discussed among members of the project team; emerging themes were then grouped and read again repeatedly until the themes were consistent. RESULTS Three themes emerged as the main factors influencing the degree of implementation of Alcohol and Employment: (1) The job consultants' personal attitudes toward alcohol were an important factor. The job consultants generally did not consider a high alcohol intake to be an impediment to employment, or they thought that alcohol problems were only symptoms of more profound problems. (2) The job consultants' perception of their own roles and responsibilities in relation to the welfare recipients was a barrier: they felt that addressing alcohol problems and at the same time sustaining trust with the welfare recipient was difficult. Also, they did not consider alcohol problems to be their responsibility. (3) Shortage of time and resources among the job consultants was determined to be an influential factor. CONCLUSIONS We identified important factors at the individual level among the job consultants who threatened the implementation of Alcohol and Employment. Future studies in similar settings can take advantage of these findings when preparing interventions that are implemented by job consultants or similar professionals. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT01416103.
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Affiliation(s)
- Maja Bæksgaard Hansen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen, DK-1353, Denmark.
| | - Stine Kloster
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen, DK-1353, Denmark.
| | - Ida Høgstedt Danquah
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen, DK-1353, Denmark.
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, JB Winsløwsvej 20, Entrance 220B, 1st floor, Odense, C DK-5000, Denmark.
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen, DK-1353, Denmark.
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen, DK-1353, Denmark.
| | - Janne Schurmann Tolstrup
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, Copenhagen, DK-1353, Denmark.
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Okamura K, Kosuge R, Kihira M, Fujita G. Typology of driving-under-the-influence (DUI) offenders revisited: Inclusion of DUI-specific attitudes. Addict Behav 2014; 39:1779-83. [PMID: 25123346 DOI: 10.1016/j.addbeh.2014.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 06/13/2014] [Accepted: 07/02/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Much work remains to improve rehabilitative interventions for driving-under-the-influence (DUI) offenders. There is heterogeneity of patterns of alcohol use, personality, and driving behaviour within DUI offenders, but little is known about how their appraisal of DUI differs. This study investigated within-offender variability in DUI-specific attitudinal variables. METHOD Convicted male DUI offenders (N=219) living in greater Tokyo were interviewed. Cluster analysis was undertaken using age, psychological distress, personality trait, alcohol use, and attitudes towards DUI. Discriminant function analysis explored the relative explanatory power of the grouping variables. RESULT Many offenders reported current excessive alcohol consumption. About 26-36% of the participants were potentially alcohol-dependent based on screening instruments/biomarkers. Cluster analysis identified five subgroups. The biggest subgroup considered their DUI a singular mistake and reported strong self-efficacy for avoiding further DUI (clusters 1 and 2). A small subgroup manifested alcohol dependence, psychological distress, higher impulsivity, and lower self-efficacy for avoiding DUI (cluster 3). Another subgroup exhibited a tendency to rationalise DUI, higher likelihood of future DUI, and lower self-efficacy for avoiding DUI (cluster 4). Most participants in another small subgroup abstained from alcohol use temporarily after their convictions (cluster 5). CONCLUSION The majority of DUI offenders regarded their DUI conviction as an exceptional mishap, while they continued consuming hazardous amounts of alcohol. DUI-specific attitudinal variables, including DUI rationalisation and self-efficacy for avoiding future DUI incidents, constituted a distinct aspect of the problem, suggesting the need to address this issue in addition to the underlying alcohol use problem.
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Schulte B, O’Donnell AJ, Kastner S, Schmidt CS, Schäfer I, Reimer J. Alcohol screening and brief intervention in workplace settings and social services: a comparison of literature. Front Psychiatry 2014; 5:131. [PMID: 25339914 PMCID: PMC4186263 DOI: 10.3389/fpsyt.2014.00131] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 09/05/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The robust evidence base for the effectiveness of alcohol screening and brief interventions (ASBIs) in primary health care (PHC) suggests that a widespread expansion of ASBI in non-medical settings could be beneficial. Social service and criminal justice settings work frequently with persons with alcohol use disorders, and workplace settings can be an appropriate setting for the implementation of alcohol prevention programs, as a considerable part of their social interactions takes place in this context. METHODS Update of two systematic reviews on ASBI effectiveness in workplaces, social service, and criminal justice settings. Review to identify implementation barriers and facilitators and future research needs of ASBI in non-medical settings. RESULTS We found a limited number of randomized controlled trials in non-medical settings with an equivocal evidence of effectiveness of ASBI. In terms of barriers and facilitators to implementation, the heterogeneity of non-medical settings makes it challenging to draw overarching conclusions. In the workplace, employee concerns with regard to the consequences of self-disclosure appear to be key. For social services, the complexity of certain client needs suggest that a stepped and carefully tailored approach is likely to be required. DISCUSSION Compared to PHC, the reviewed settings are far more heterogeneous in terms of client groups, external conditions, and the focus on substance use disorders. Thus, future research should try to systematize these differences, and consider their implications for the deliverability, acceptance, and potential effectiveness of ASBI for different target groups, organizational frameworks, and professionals.
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Affiliation(s)
- Bernd Schulte
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg University, Hamburg, Germany
| | | | - Sinja Kastner
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg University, Hamburg, Germany
| | - Christiane Sybille Schmidt
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg University, Hamburg, Germany
| | - Ingo Schäfer
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg University, Hamburg, Germany
| | - Jens Reimer
- Centre for Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Hamburg University, Hamburg, Germany
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The effect on problematic drinking behavior of a brief motivational interview shortly after a first arrest for driving under the influence of alcohol. J Trauma Acute Care Surg 2014; 76:661-70; discussion 670-1. [DOI: 10.1097/ta.0000000000000144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ouimet MC, Dongier M, Di Leo I, Legault L, Tremblay J, Chanut F, Brown TG. A randomized controlled trial of brief motivational interviewing in impaired driving recidivists: a 5-year follow-up of traffic offenses and crashes. Alcohol Clin Exp Res 2013; 37:1979-85. [PMID: 23895363 PMCID: PMC4352330 DOI: 10.1111/acer.12180] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 04/04/2013] [Indexed: 11/27/2022]
Abstract
Background In a previously published randomized controlled trial (Brown et al. Alcohol Clin Exp Res 2010; 34, 292–301), our research team showed that a 30-minute brief motivational interviewing (BMI) session was more effective in reducing percentages of risky drinking days in drunk driving recidivists than a control information–advice intervention at 12-month follow-up. In this sequel to the initial study, 2 main hypotheses were tested: (i) exposure to BMI increases the time to further arrests and crashes compared with exposure to the control intervention (CTL) and (ii) characteristics, such as age, moderate the benefit of BMI. Methods A sample of 180 community-recruited recidivists who had drinking problems participated in the study. Participants gave access to their provincial driving records at baseline and were followed up for a mean of 1,684.5 days (SD = 155.7) after randomization to a 30-minute BMI or CTL session. Measured outcomes were driving arrests followed by convictions including driving while impaired (DWI), speeding, or other moving violations as well as crashes. Age, readiness to change alcohol consumption, alcohol misuse severity, and number of previous DWI convictions were included as potential moderators of the effect of the interventions. Results For arrests, Cox proportional hazards modeling revealed no significant differences between the BMI and the CTL group. When analyses were adjusted to age tertile categories, a significant effect of BMI in the youngest age tertile (<43 years old) emerged. For crashes, no between-group differences were detected. Conclusions BMI was better at delaying DWI and other dangerous traffic violations in at-risk younger drivers compared with a CTL similar to that provided in many remedial programs. BMI may be useful as an opportunistic intervention for DWI recidivism prevention in settings such as DWI courts. Treatment effectiveness studies are needed to ascertain how the present findings generalize to the real-world conditions of mandated relicensing programs.
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Affiliation(s)
- Marie Claude Ouimet
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, Canada; Charles LeMoyne Research Center, Longueuil, Quebec, Canada
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Espada JP, Griffin KW, Carballo JL, McCarthy DM. Spanish version of the Positive Expectancies for Drinking and Driving for Youth. THE SPANISH JOURNAL OF PSYCHOLOGY 2012; 15:1495-502. [PMID: 23156951 DOI: 10.5209/rev_sjop.2012.v15.n3.39433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In most developed countries, motor vehicle accidents are a leading cause of death among young people, and a large proportion of motor vehicle accidents are alcohol-related. In Spain there are no currently available instruments for assessing positive expectancies related to drinking and driving behavior. Attempting to modify these expectancies may be an effective prevention approach, so there is a need for a valid and reliable scale to measure the construct. The aims of the present study were to translate, culturally adapt, and examine the psychometric properties of a Spanish-language version of the Positive Expectancies for Drinking and Driving for Youth (PEDD-Y) in a sample of Spanish young adults. A total of 352 college students with drivers licenses were recruited at a university in southeast Spain. We examined the factor structure, psychometric properties (reliability and validity) and temporal stability of the Spanish version of the PEDD-Y among Spanish young adult drivers. Findings indicated that the Spanish version of the PEDD-Y demonstrated satisfactory psychometric properties and was shown to significantly predict lifetime prevalence and future intentions to drink and drive as well as riding with a drunk driver. The Convenience factor performed with the most consistent reliability and predictive validity. Limitations and future research questions are discussed.
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Affiliation(s)
- José P Espada
- Departamento de Psicología de la Salud, Universidad Miguel Hernández. Av. de la Universidad, s/n. 03202 Elche, Alicante, Spain.
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Mechtcheriakov S, Rettenbacher M. [Motivational interviewing in psychiatry]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2012; 26:187-191. [PMID: 23132685 DOI: 10.1007/s40211-012-0042-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 08/27/2012] [Indexed: 06/01/2023]
Abstract
Motivational Interviewing and associated communication techniques and intervention methods have been widely applied in patients with substance use disorder and other psychiatric disorders in the last twenty years. Intensive research on effectiveness and underlying mechanisms as well as the increasing efforts to apply MI in other psychiatric disorders has lead to a large number of scientific publications in this field. MI has been shown to be effective in situations where the patient's ambivalence seems to impede the therapeutic process. Communication skills and the ability of the care taker to induce the so called "change talk" by the patient play a particularly important role and correlate with the positive effects of MI. Those groups of patients in which other factors than ambivalence affect the therapeutic process seem to benefit much less from this intervention method. MI hallmarks the substantial change that gradually took place during the last two decades in caretakers' attitude towards patients with dependence and other psychiatric patients: away from "prescriptive" towards "supportive" treatment and communication style. Therefore, it seems to be reasonable to implement the basics of MG in the training curricula for psychiatrists.
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Affiliation(s)
- Sergei Mechtcheriakov
- Department Psychiatrie und Psychotherapie, Universitätsklinik für Biologische Psychiatrie, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich,
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Seilonen ML, Wahlström J, Aaltonen J. Agency displays in stories of drunk driving: Subjectivity, authorship, and reflectivity. COUNSELLING PSYCHOLOGY QUARTERLY 2012. [DOI: 10.1080/09515070.2012.711299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Jarl Wahlström
- b Department of Psychology , University of Jyväskylä , Jyväskylä , Finland
| | - Jukka Aaltonen
- b Department of Psychology , University of Jyväskylä , Jyväskylä , Finland
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Wells SA, Smyth T, Brown TG. Patient attitudes towards change in adapted motivational interviewing for substance abuse: a systematic review. Subst Abuse Rehabil 2012; 3:61-72. [PMID: 24474867 PMCID: PMC3886678 DOI: 10.2147/sar.s23287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Adapted motivational interviewing (AMI) represents a category of effective, directive and client-centered psychosocial treatments for substance abuse. In AMI, patients' attitudes towards change are considered critical elements for treatment outcome as well as therapeutic targets for alteration. Despite being a major focus in AMI, the role of attitudes towards change in AMI's action has yet to be systematically reviewed in substance abuse research. A search of PsycINFO, PUBMED/MEDLINE, and Science Direct databases and a manual search of related article reference lists identified 416 published randomized controlled trials that evaluated AMI's impact on the reduction of alcohol and drug use. Of those, 54 met the initial inclusion criterion by evaluating AMI's impact on attitudes towards change and/or testing hypotheses about attitudes towards change as moderators or mediators of outcome. Finally, 19 studies met the methodological quality inclusion criterion based upon a Newcastle-Ottawa Quality Assessment Scale score ≥ 7. Despite the conceptual importance of attitudes towards change in AMI, the empirical support for their role in AMI is inconclusive. Future research is warranted to investigate both the contextual factors (ie, population studied) as well as deployment characteristics of AMI (ie, counselor characteristics) likely responsible for equivocal findings.
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Affiliation(s)
- Samantha Ashley Wells
- Department of Psychiatry, Douglas Mental Health University Institute, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Tanya Smyth
- Department of Psychiatry, Douglas Mental Health University Institute, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Thomas G Brown
- Department of Psychiatry, Douglas Mental Health University Institute, Montréal, Québec, Canada
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
- Foster Addiction Rehabilitation Centre, St. Philippe de Laprairie, Québec, Canada
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Palmer EJ, Hatcher RM, McGuire J, Bilby CAL, Hollin CR. The effect on reconviction of an intervention for drink-driving offenders in the community. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2012; 56:525-538. [PMID: 21518698 DOI: 10.1177/0306624x11403894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study reports an evaluation of the Drink-Impaired Drivers program in the English and Welsh probation service. Participants were adult male offenders who had been convicted of a drink-driving offence and were serving community sentences. The 1-year drink-drive reconviction rates were compared for offenders who completed the program, offenders who started but did not complete the program, and a comparison group who were not allocated to the program. At 1-year follow-up, there was no reconviction among offenders who had completed the program. Multivariate analysis showed that the noncompleters had a significantly higher rate of reconviction than the completers and comparison group.
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Bouchard SM, Brown TG, Nadeau L. Decision-making capacities and affective reward anticipation in DWI recidivists compared to non-offenders: a preliminary study. ACCIDENT; ANALYSIS AND PREVENTION 2012; 45:580-587. [PMID: 22269545 DOI: 10.1016/j.aap.2011.09.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Revised: 09/06/2011] [Accepted: 09/11/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Impaired decision making is seen in several problem behaviours including alcoholism and problem gambling. Decision-making style may contribute to driving while impaired with alcohol (DWI) in some offenders as well. The Somatic Marker Framework theorizes that decision making is the product of two interacting affective neural systems, an impulsive, rapid, amygdala-dependent process for emotionally signalling the immediate negative or positive consequences of an option, and a reflective, longer-lasting, ventral medial prefrontal cortex dependent system for emotionally signalling the future negative or positive prospects of an option. This study tested the hypothesis that offenders who showed disadvantageous decision-making would be at higher risk for recidivism than those who showed more advantageous decision-making. In addition, in line with the Somatic Marker Hypothesis, offenders who showed disadvantageous decision-making would exhibit a distinct pattern of somatic activation compared to offenders who showed more advantageous decision-making. METHODS A sample of 21 DWI offenders with from 2 to 7 past DWI convictions and a reference group consisting of 19 non-offender (N-O) drivers were recruited and administered the Iowa Gambling Task (IGT), as well as evaluated on sociodemographic, driving and alcohol use dimensions. In addition, anticipatory skin conductance response (aSCR) was measured in the 5s prior to each of a 100 card draws on the IGT. RESULTS Median split of the DWI offender sample based upon overall performance on the IGT yielded two subgroups (IGT-R Hi and IGT-R Lo). Hypothesis 1 was supported, as the IGT-R Lo group possessed significantly greater frequency of past DWI convictions and severity of past drinking. Descriptive analyses revealed that on the IGT, IGT-R Hi group performed similarly to the N-O reference group while the IGT-R Lo group performed significantly worse. Hypothesis 2 was not supported. CONCLUSIONS Decision making is a plausible explanatory neurocognitive pathway to severer forms of DWI. The role of emotional processing in DWI risk is uncertain. Subtyping DWI offenders using neurocognitive criteria seems a promising avenue for improving clinically meaningful methods of DWI risk assessment and intervention.
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Beadnell B, Nason M, Stafford PA, Rosengren DB, Daugherty R. Short-term outcomes of a motivation-enhancing approach to DUI intervention. ACCIDENT; ANALYSIS AND PREVENTION 2012; 45:792-801. [PMID: 22269571 DOI: 10.1016/j.aap.2011.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 10/31/2011] [Accepted: 11/04/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE We compared a group-delivered, theory-based, motivation-enhancing program (PRIME For Life(®) - PFL, n=450) to an intervention as usual (IAU, n=72). METHOD Individuals convicted of a substance related offense in North Carolina, typically first offense alcohol and drug-impaired driving, participated in a PFL or IAU group. We compare the interventions on program satisfaction and changes made from preintervention to postintervention, and examined the moderating effects of demographics and alcohol dependence level. RESULTS When significant, findings varied in magnitude from small to medium effects. Participants in both interventions showed intentions to use statistically significantly less alcohol and drugs in the future compared to their previous use, and differences between the groups were not statistically significant. Otherwise, findings favored PFL. PFL exhibited greater benefit than IAU on understanding tolerance, perceived risk for addiction, problem recognition, and program satisfaction. Additionally, IAU perceived less risk for negative consequences postintervention than they had at preintervention. Moderation analyses showed that the between-condition findings occurred regardless of gender, age, education, and number of alcohol dependence indicators. Additionally, younger people and those with more dependence indicators - groups of particular concern - showed the greatest change. CONCLUSIONS Findings suggest that a motivation-enhancing approach can be effective in producing short-term change in factors that can help facilitate and sustain behavioral change. This is consistent with previous research on the use of motivational approaches, and extends such findings to suggest promise in group-based settings and with people across demographic categories and dependence levels. Future research should focus on larger studies looking at long-term behavioral change, including recidivism.
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Affiliation(s)
- Blair Beadnell
- Prevention Research Institute, 841 Corporate Dr., Suite 300, Lexington, KY 40503, United States.
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Mopeds: the legal loophole for repeat driving while intoxicated offenders. Am J Surg 2012; 202:697-700; discussion 700. [PMID: 22137136 DOI: 10.1016/j.amjsurg.2011.06.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 06/11/2011] [Accepted: 06/28/2011] [Indexed: 11/21/2022]
Abstract
BACKGROUND Mopeds have less stringent licensing laws than automobiles. Moped operators in motorized vehicle collisions (MVCs) exhibit significantly higher rates of driving while intoxicated (DWI) and higher blood alcohol levels than automobile or motorcycle operators. This study evaluates the public safety issue of DWI recidivism among moped operators. METHODS Moped operators evaluated after MVCs were identified from 2007 to 2009. Demographics, hospital data, and Department of Motor Vehicles records were reviewed. RESULTS Sixty-five moped operators were evaluated. Thirty-two (49%) had a positive blood alcohol level, 29 (45%) had a previous DWI, and 21 (72%) of those were repeat offenders. Twenty-five (38%) had a revoked license at the time of injury. Of these, 19 (76%) incurred multiple revocations. Twenty-two (34%) showed prior charges of driving with a revoked license (DWRL), with 15 (68%) incurring multiple DWRL charges. CONCLUSIONS Moped operators are often intoxicated at the time of injury and represent a public safety hazard. The majority are recidivists with multiple alcohol-related traffic charges. Current laws allow repeat offenders the sustained opportunity to operate motorized vehicles. Re-evaluation of current moped laws is needed to keep habitual offenders off the road.
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Lapham S, England-Kennedy E. Convicted driving-while-impaired offenders' views on effectiveness of sanctions and treatment. QUALITATIVE HEALTH RESEARCH 2012; 22:17-30. [PMID: 21490294 PMCID: PMC3137706 DOI: 10.1177/1049732311406450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In this article we analyze qualitative data from a multiple-method, longitudinal study drawn from 15-year follow-up interviews with a subsample of 82 individuals arrested for driving while intoxicated in a southwestern state (1989-1995). We explore reactions to the arrest and court-mandated sanctions, including legal punishments, mandated interventions, and/or participation in programs aimed at reducing recidivism. Key findings include experiencing certain negative emotional reactions to the arrest, reactions to being jailed, experiencing other court-related sanctions as deterring driving-while-intoxicated behavior, and generally negative opinions regarding court-mandated interventions. We discuss interviewees' complex perspectives on treatment and program participation and their effects on lessening recidivism, and we offer suggestions for reducing recidivism based on our findings.
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Affiliation(s)
- Sandra Lapham
- Behavioral Health Research Center of the Southwest, Albuquerque, New Mexico 87102, USA.
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The role of demographic characteristics and readiness to change in 12-month outcome from two distinct brief interventions for impaired drivers. J Subst Abuse Treat 2011; 42:383-91. [PMID: 22119179 DOI: 10.1016/j.jsat.2011.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Revised: 08/27/2011] [Accepted: 09/15/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study tested specific intervention responsivity to brief intervention in driving while impaired by alcohol and/or drugs recidivists based upon their demographic, substance use, and initial readiness to change characteristics. METHODS A nonclinical community-based sample of 184 male and female recidivists was randomly assigned to receive one of two 30-minute interventions: brief motivational interviewing (n = 92) or an information-advice session (n = 92). Dependent variables were change at the 6- and 12-month follow-ups from baseline in percentage of risky drinking days and blood assay biomarkers of alcohol misuse. Independent variables were age, gender, education, past convictions for impaired driving, and baseline alcohol and drug misuse severity and readiness to change. RESULTS Recidivists who were younger, male, and exhibited more negative consequences and ambivalence towards their problem drinking improved more on alcohol-related outcomes, irrespective of intervention type. CONCLUSIONS The results do not convincingly indicate specific intervention responsivity based upon participant characteristics but provide preliminary guidance about which recidivists are most apt to benefit from these brief approaches.
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Smedslund G, Berg RC, Hammerstrøm KT, Steiro A, Leiknes KA, Dahl HM, Karlsen K. Motivational interviewing for substance abuse. Cochrane Database Syst Rev 2011; 2011:CD008063. [PMID: 21563163 PMCID: PMC8939890 DOI: 10.1002/14651858.cd008063.pub2] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There are 76.3 million people with alcohol use disorders worldwide and 15.3 million with drug use disorders. Motivational interviewing (MI) is a client-centred, semi-directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. The intervention is used widely, and therefore it is important to find out whether it helps, harms or is ineffective. OBJECTIVES To assess the effectiveness of motivational interviewing for substance abuse on drug use, retention in treatment, readiness to change, and number of repeat convictions. SEARCH STRATEGY We searched 18 electronic databases, 5 web sites, 4 mailing lists, and reference lists from included studies and reviews. Search dates were November 30, 2010 for Cochrane Library, Medline, Embase and PsychINFO. SELECTION CRITERIA Randomized controlled trials with persons dependent or abusing substance. Interventions were MI or motivational enhancement therapy. The outcomes were extent of substance abuse, retention in treatment, motivation for change, repeat conviction. DATA COLLECTION AND ANALYSIS Three authors independently assessed studies for inclusion, and two authors extracted data. Results were categorized into (1) MI versus no-treatment control, (2) MI versus treatment as usual, (3) MI versus assessment and feedback, and (4) MI versus other active treatment. Within each category, we computed meta-analyses separately for post-intervention, short, medium and long follow-ups. MAIN RESULTS We included 59 studies with a total of 13,342 participants. Compared to no treatment control MI showed a significant effect on substance use which was strongest at post-intervention SMD 0.79, (95% CI 0.48 to 1.09) and weaker at short SMD 0.17 (95% CI 0.09 to 0.26], and medium follow-up SMD 0.15 (95% CI 0.04 to 0.25]). For long follow-up, the effect was not significant SMD 0.06 (95% CI-0.16 to 0.28). There were no significant differences between MI and treatment as usual for either follow-up post-intervention, short and medium follow up. MI did better than assessment and feedback for medium follow-up SMD 0.38 (95% CI 0.10 to 0.66). For short follow-up, there was no significant effect . For other active intervention there were no significant effects for either follow-up.There was not enough data to conclude about effects of MI on the secondary outcomes. AUTHORS' CONCLUSIONS MI can reduce the extent of substance abuse compared to no intervention. The evidence is mostly of low quality, so further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
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Affiliation(s)
- Geir Smedslund
- Norwegian Knowledge Centre for the Health ServicesPostboks 7004St. Olavs plassOsloN‐0130Norway
| | - Rigmor C Berg
- Norwegian Knowledge Centre for the Health ServicesPostboks 7004St. Olavs plassOsloN‐0130Norway
| | - Karianne T Hammerstrøm
- Norwegian Knowledge Centre for the Health ServicesPostboks 7004St. Olavs plassOsloN‐0130Norway
| | - Asbjørn Steiro
- Norwegian Knowledge Centre for the Health ServicesPostboks 7004St. Olavs plassOsloN‐0130Norway
| | - Kari A Leiknes
- Norwegian Knowledge Centre for the Health ServicesPostboks 7004St. Olavs plassOsloN‐0130Norway
| | - Helene M Dahl
- Institute of Clinical MedicineDepartment of Clinical PsychiatryUniversity of Tromsø, Asgard,TromsøNorway9291
| | - Kjetil Karlsen
- Institute of Clinical MedicineDepartment of Clinical PsychiatryUniversity of Tromsø, Asgard,TromsøNorway9291
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Ouimet MC, Brown TG, Bédard JP, Bergeron J. Measurement of readiness to reduce driving speed: a pilot study. Psychol Rep 2011; 107:749-61. [PMID: 21323134 DOI: 10.2466/13.20.pr0.107.6.749-761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Speeding is a preventable risky behavior that contributes to risk of accident. Readiness to change reflects an individual's recognition of and desire to change behavior. No measure to identify readiness to change has yet been validated for speeding. The Readiness to Change Questionnaire appraises readiness to change drinking behavior. The questionnaire was adapted to speeding and its psychometric properties examined. Participants (N = 112) completed the questionnaire and reported their usual driving speed. A clear component structure and acceptable internal consistency and test-retest reliability were found. Convergent validity was indicated by an association between higher readiness to change and lower driving speed. Results support the questionnaire's potential as a measure of readiness to change speeding, and advance research into the role of motivation in speeding behavior.
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Affiliation(s)
- Marie Claude Ouimet
- Faculty of Medicine and Health Sciences, University of Sherbrooke, 150, Charles-Le Moyne PL, Room 200, Longueuil, Quebec, Canada J4K 0A8.
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