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Bogart AR, Richards M, Sheeder J. Youth and Guardian Expectations of Privacy in Adolescent Health Care. J Adolesc Health 2024:S1054-139X(24)00175-7. [PMID: 38739058 DOI: 10.1016/j.jadohealth.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/29/2024] [Accepted: 03/29/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Adolescent access to confidential care is codified by most states with age-specific laws; however, adolescent and guardian awareness of these laws are poorly understood. In this study, we assessed adolescent and guardian perceptions of conditional confidentiality in health care. METHODS We surveyed youth aged 11-18 years, and guardians accompanying youth seeking care at an urban adolescent outpatient clinic that provides adolescent primary and subspecialty care. Participants completed brief True/False surveys which queried whether a parent would be notified for common, hypothetical scenarios. We analyzed adolescent responses by age group and compared responses of adolescents and guardians. RESULTS Two hundred seventy nine adolescents and 178 guardians completed the survey. Among participants, 86% of adolescents and 67% of guardians believed they understood which health topics were confidential. Adolescent and guardian answers aligned with mandatory reporting laws for scenarios concerning safety and suicidality. Younger adolescents consistently underestimated their legal right to privacy for all hypothetical scenarios. Many adolescents anticipated disclosure to parents for confidential services, including contraception, pregnancy, and sexually transmitted infection testing. Guardians expected disclosure about sexual health services at higher rates than they did about substance use. DISCUSSION We identified age-associated knowledge gaps among participants pertaining to adolescent privacy in the clinical setting. These deficits were found in a setting where adolescent privacy is routinely discussed, and our findings may underestimate the knowledge gap in the general pediatric population where confidentiality may not be discussed as often. Providers caring for adolescents share the responsibility of educating both youth and families about the importance of adolescent confidentiality.
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Affiliation(s)
- Amanda R Bogart
- Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Children's Hospital Colorado, Aurora, Colorado.
| | - Molly Richards
- Section of Adolescent Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado; Children's Hospital Colorado, Aurora, Colorado
| | - Jeanelle Sheeder
- Division of Complex Family Planning, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado
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Mulligan T, Barker-Collo S, Gibson K, Jones K. You only get one brain: adult reflections on coping and recovery after traumatic brain injury in adolescence. Brain Inj 2023; 37:1221-1230. [PMID: 37545139 DOI: 10.1080/02699052.2023.2243824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 06/26/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND TBI during adolescence can result in significant acute symptoms that can persist into adulthood. This research analyzed retrospective qualitative accounts of young adults who had sustained a TBI in adolescence to explore coping and recovery processes specific to this developmental stage. METHODS Thirteen adults (aged 20-25 years; mean 23 years) who sustained a mild (n = 12) or moderate (n = 1) TBI during adolescence (aged 13-17 years at injury), approximately 7.7 years (range = 6.7-8.0 years) prior, participated. Semi-structured individual interviews, analyzed using thematic analysis, explored participants' experiences following their TBIs. RESULTS Thematic data analysis produced two key categories of themes relating to recovery processes: (1) Individual factors impacting coping, with themes of learning to cope with difficulties, seeking acceptance and balance, and finding meaning; and (2) Social factors impacting coping, which included themes of feeling included, relying on family, professionals didn't get it, and lacking someone who understands. CONCLUSIONS Recovery following TBI sustained during adolescence could be maximized by facilitating greater understanding of specific impacts on young people among clinicians and family, longer term monitoring of symptoms including emotional reactions to symptoms, and the provision of emotional support.
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Affiliation(s)
- Therese Mulligan
- Clinical Training Programme, School of Psychology, University of Auckland, Auckland, New Zealand
| | - Suzanne Barker-Collo
- Clinical Training Programme, School of Psychology, University of Auckland, Auckland, New Zealand
| | - Kerry Gibson
- Clinical Training Programme, School of Psychology, University of Auckland, Auckland, New Zealand
| | - Kelly Jones
- National Institute of Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
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Snowdon N, Allan J, Shakeshaft A, Courtney RJ. "I didn't even know headspace had the drug thing until today": A socio-ecological analysis of access to drug and alcohol interventions in integrated youth health care services. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 146:208959. [PMID: 36880903 DOI: 10.1016/j.josat.2023.208959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/11/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND With 150 centers Australia-wide, the headspace National Youth Mental Health Foundation is an exemplary integrated youth health service. Headspace centers provide medical care, mental health interventions, alcohol and other drug (AOD) services, and vocational support to Australian young people (YP) aged 12 to 25 years. Co-located headspace salaried youth workers, private health care practitioners (e.g. psychologists, psychiatrists, and medical practitioners) and in-kind community service providers (e.g. AOD clinicians) form coordinated multidisciplinary teams. This article aims to identify the factors influencing the access to AOD interventions for YP, in the Australian rural headspace setting; as perceived by YP, their family and friends, and headspace staff. METHODS The study purposively recruited YP (n = 16), their family and friends (n = 9), and headspace staff (n = 23) and management (n = 7) in four headspace centers in rural New South Wales, Australia. Recruited individuals participated in semistructured focus groups about the access to YP AOD interventions in the headspace setting. The study team thematically analyzed the data through the lens of the socio-ecological model. RESULTS The study identified convergent themes across groups and found several barriers to the access of AOD interventions; 1) YP's personal factors, 2) YP's family and peer attitudes, 3) practitioner skills, 4) organizational processes and 5) societal attitudes were all identified as negatively impacting access to YP AOD interventions. Practitioners' client-centered stance, and the youth-centric headspace model were factors that were considered as enablers of engagement of YP with an AOD concern. INTERPRETATION While this Australian example of an integrated youth health care model is well placed to provide YP AOD interventions, a mismatch existed between practitioner capability and YP needs. The sampled practitioners described limited AOD knowledge, and low confidence in providing AOD interventions. At the organizational level, multiple AOD intervention supply and utilization issues occurred. Taken together, these problems likely underlie previous findings of poor service utilization and low user satisfaction. CONCLUSION Clear enablers exist for AOD interventions to be better integrated into headspace services. Future work should determine how this integration can be achieved and what early intervention means in relation to AOD interventions.
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Affiliation(s)
- Nicole Snowdon
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW 2031, Australia.
| | - Julaine Allan
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW 2031, Australia; School of Health and Society, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW 2031, Australia; Poche Centre for Indigenous Health, University of Queensland, 74 High St, Toowong, Queensland, 4066, Australia
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW 2031, Australia
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Xia W, Li HCW, Liang T, Luo Y, Ho LLK, Cheung AT, Song P. Structured online training for university students to deliver peer-led addiction counselling for young drug abusers in China: Effect on improving knowledge, attitude, confidence, and skills. PATIENT EDUCATION AND COUNSELING 2022; 105:1009-1017. [PMID: 34334262 DOI: 10.1016/j.pec.2021.07.038] [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: 03/25/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To measure the effect of a structured online training programme on improving the knowledge, attitude, confidence, and skills of university students to deliver peer-led addiction counselling to young drug abusers. METHODS A structured training programme was designed for university students with a background in health-related disciplines. Pre- and post-training evaluations were conducted for 245 university students with health-related backgrounds who completed the training programme. The participants' knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were evaluated and compared before and after the training. Counselling skills were assessed using a simulated standardised case. RESULTS A paired test indicated that after attending the training programme, the participants' knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were significantly improved. Most of the trained participants demonstrated satisfactory counselling skills. CONCLUSION Participation in a one-day structured addiction training programme significantly improved students' knowledge of and attitudes towards drug abuse and their confidence and skills to deliver addiction counselling. PRACTICE IMPLICATION Future research should elucidate the implementation of the counselling skills in terms of the counselling outcomes and successful referral. The clients' health outcomes should be assessed to reflect the peer counsellors' skills.
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Affiliation(s)
- Wei Xia
- School of Nursing, Sun Yat-Sen University, Guangzhou, China; School of Nursing, The University of Hong Kong, Hong Kong SAR.
| | | | - Tingna Liang
- School of Nursing, The University of Hong Kong, Hong Kong SAR.
| | - Yuanhui Luo
- School of Nursing, The University of Hong Kong, Hong Kong SAR.
| | | | | | - Peige Song
- Zhejiang University School of Medicine, Hangzhou, China; Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
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Dadaczynski K, Krah V, Frank D, Zügel-Hintz E, Pöhlmann F. Promoting Navigation Health Literacy at the Intersection of Schools and Communities. Development of the Game-Based Intervention Nebolus. Front Public Health 2021; 9:752183. [PMID: 34869169 PMCID: PMC8635644 DOI: 10.3389/fpubh.2021.752183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Emerging empirical evidence indicates a limited health literacy for a substantial proportion of children and adolescents. Although it is generally agreed upon promoting health literacy as early as possible in the lifespan, there is a lack of interventions addressing children and adolescents and their primary living environments. This article describes the development of Nebolus, a game-based intervention aiming to promote navigation health literacy at the intersection of schools and communities. Its intervention foundation lies in a socio-ecological understanding of health as well as in the Entertainment Education approach. Following an extensive literature search on health-related location-based games, a co-creation process was initiated that involved adolescents, community stakeholders, and design/IT professionals in all phases of the intervention development. The final Nebolus intervention includes three core activities: (1) a Nebolus rally app for adolescents aged 12 to 16 years, (2) an online planning tool allowing local health service providers/professionals to set up own Nebolus rallies, and (3) accompanying teaching material on health literacy in the school setting to be used before and after the Nebolus rallies. This article provides an overview of the intervention layout and discusses strengths and challenges of its development and implementation.
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Affiliation(s)
- Kevin Dadaczynski
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
- Centre for Applied Health Science, Leuphana University Lueneburg, Lueneburg, Germany
| | - Verena Krah
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
| | - Demian Frank
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
| | - Elisabeth Zügel-Hintz
- Department of Nursing and Health Science, Fulda University of Applied Sciences, Fulda, Germany
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Yonek JC, Velez S, Satre DD, Margolis K, Whittle A, Jain S, Tolou-Shams M. Addressing adolescent substance use in an urban pediatric federally qualified health center. J Subst Abuse Treat 2021; 135:108653. [PMID: 34840042 DOI: 10.1016/j.jsat.2021.108653] [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: 02/23/2021] [Revised: 09/24/2021] [Accepted: 10/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Screening, brief intervention, and referral to treatment (SBIRT) is a systematic approach to identification and intervention for individuals at risk for substance use disorders. Prior research indicates that SBIRT is underutilized in pediatric primary care. Yet few studies have examined procedures for identifying and addressing substance use in clinics that serve publicly insured adolescents (i.e., federally qualified health centers [FQHC]). This descriptive, multi-method study assessed adolescent substance use frequency and provider perspectives to inform SBIRT implementation in an urban pediatric FQHC in California. METHODS A medical record review assessed substance use frequency and correlates among publicly insured adolescents aged 12-17 years who completed a well-child visit in pediatric primary care between 2014 and 2017 (N = 2252). Data on substance use (i.e., alcohol, illicit drugs, and tobacco) were from a health assessment tool mandated by Medicaid. Semi-structured interviews with 12 providers (i.e., pediatricians, nurse practitioners, behavioral health clinicians) elicited information about the current clinic workflow for adolescent substance use and barriers and facilitators to SBIRT implementation. RESULTS Of 1588 adolescents who completed the assessment (70.5%), 6.8% reported current substance use. Self-reported use was highest among non-Hispanic Black (15.2%) adolescents and those with co-occurring depressive symptoms (14.4%). Provider-reported challenges to implementing SBIRT included a lack of space for confidential screening and a lack of referral options. Providers favored implementing technology-based tools such as tablets for adolescent pre-visit screening and electronic medical record-based decision support to facilitate brief intervention and treatment referrals. CONCLUSIONS This study fills a substantial research gap by examining factors that impede and support SBIRT implementation in pediatric FQHC settings. Successful SBIRT implementation in these settings could significantly reduce the unmet need for substance use treatment among uninsured and publicly insured adolescents. Pediatric primary care and urgent care providers perceived SBIRT to be feasible, and health information and digital technologies may facilitate the integration of SBIRT into clinic workflows. Ensuring confidentiality for screening and expanding referral options for adolescents in need of community-based addiction treatment are also critical to increasing SBIRT uptake.
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Affiliation(s)
- Juliet C Yonek
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States; Department of Psychiatry and Behavioral Sciences at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 7M, San Francisco, CA 94110, United States.
| | - Sarah Velez
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States; Department of Psychiatry and Behavioral Sciences at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 7M, San Francisco, CA 94110, United States.
| | - Derek D Satre
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States; Division of Research, Kaiser Permanente Northern California Region, 2000 Broadway, Oakland, CA 94612, United States.
| | - Kathryn Margolis
- Department of Pediatrics at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 6B, San Francisco, CA 94110, United States; Department of Psychiatry and Behavioral Sciences at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 7M, San Francisco, CA 94110, United States.
| | - Amy Whittle
- Department of Pediatrics at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 6B, San Francisco, CA 94110, United States; Department of Psychiatry and Behavioral Sciences at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 7M, San Francisco, CA 94110, United States.
| | - Shonul Jain
- Department of Pediatrics at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 6B, San Francisco, CA 94110, United States; Department of Psychiatry and Behavioral Sciences at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 7M, San Francisco, CA 94110, United States.
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, United States; Department of Psychiatry and Behavioral Sciences at Zuckerberg San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 7M, San Francisco, CA 94110, United States.
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Roberts M, Jones J, Garcia L, Techau A. Adolescents' perceptions of barriers and facilitators to engaging in mental health treatment: A qualitative meta-synthesis. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 35:113-125. [PMID: 34609034 DOI: 10.1111/jcap.12354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/11/2021] [Accepted: 09/26/2021] [Indexed: 11/27/2022]
Abstract
PROBLEM One in seven children, aged 3-17, have a mental health diagnosis with suicide being the second leading cause of death in the United States in persons aged 10-24. Adolescents are at high risk for mental health disorders, substance use, and risky behaviors, yet most adolescents never receive treatment. Research is needed to answer the question, "What are adolescents' perceived barriers and facilitators to engaging in mental health treatment?" METHODS A four-step qualitative meta-synthesis design included: A structured research question and search strategy, data immersion through quality appraisal, thematic synthesis of primary research studies, and reciprocal translation of derived themes. FINDINGS Eight studies met inclusion criteria. Autonomy was the primary theme that emerged. Meta-synthesis produced five subthemes: (a) choice as integral to engagement, (b) stigma as barrier to engagement, (c) quality of the therapeutic relationship as integral to engagement, (d) systemic influences as both barrier and facilitator to engagement, and (e) mental health literacy as crucial factor in decision to engage. CONCLUSION Adolescents require autonomy to engage in mental health treatment. Improving treatment engagement in adolescents requires interventions that address their ability to be autonomous.
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Affiliation(s)
- Mia Roberts
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jacqueline Jones
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Lorraine Garcia
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Aimee Techau
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, Colorado, USA
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Crane ME, Atkins MS, Becker SJ, Purtle J, Olino TM, Kendall PC. The effect of caregiver key opinion leaders on increasing caregiver demand for evidence-based practices to treat youth anxiety: protocol for a randomized control trial. Implement Sci Commun 2021; 2:107. [PMID: 34556182 PMCID: PMC8460198 DOI: 10.1186/s43058-021-00213-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background Research has identified cognitive behavioral therapy with exposures (CBT) as an effective treatment for youth anxiety. Despite implementation efforts, few anxious youth receive CBT. Direct-to-consumer marketing offers a different approach to address the unmet need for youth receiving effective treatments. Involving a local caregiver key opinion leader in direct-to-consumer initiatives may be an effective strategy to increase caregiver demand for CBT. Research indicates that key opinion leaders improve health promotion campaigns, but key opinion leaders have not been studied in the context of increasing caregiver demand for evidence-based treatments. Method Project CHAT (Caregivers Hearing about Anxiety Treatments) will test the role of key opinion leader participation in conducting outreach presentations to increase caregiver desire to seek CBT for their youth’s anxiety. Caregiver attendees (N = 180) will be cluster randomized by school to receive one of two different approaches for presentations on CBT for youth anxiety. Both approaches will involve community outreach presentations providing information on recognizing youth anxiety, strategies caregivers can use to decrease youth anxiety, and how to seek CBT for youth anxiety. The researcher-only condition will be co-facilitated by two researchers. In the key opinion leader condition, a caregiver key opinion leader from each local community will be involved in tailoring the content of the presentation to the context of the community, co-facilitating the presentation with a researcher, and endorsing strategies in the presentation that they have found to be helpful. In line with the theory of planned behavior, caregiver attendees will complete measures assessing their knowledge of, attitudes towards, perceived subjective norms about, and intention to seek CBT pre- and post-presentation; they will indicate whether they sought CBT for their youth at 3-month follow-up. Results will be analyzed using a mixed method approach to assess the effectiveness of a key opinion leader to increase caregiver demand for CBT. Discussion This study will be the first to examine the potential of key opinion leaders to increase caregiver demand for CBT. If proven effective, the use of key opinion leaders could serve as a scalable dissemination strategy to increase the reach of evidence-based treatments. Trial registration This trial was registered on clinicaltrials.gov (NCT04929262) on June 18, 2021. At the time of trial registration, pre/post-presentation data had been collected from 17 participants; thus, it was retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-021-00213-x.
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Affiliation(s)
- Margaret E Crane
- Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA, 19122, USA.
| | - Marc S Atkins
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois, Chicago, 1747 West Roosevelt Road, Suite 155, Chicago, IL, 60608, USA
| | - Sara J Becker
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-5, Providence, RI, 02912, USA
| | - Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Nesbitt Hall, Room 351, 3215 Market St, Philadelphia, PA, 19104, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA, 19122, USA
| | - Philip C Kendall
- Department of Psychology, Temple University, Weiss Hall, 1701 North 13th Street, Philadelphia, PA, 19122, USA
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Murchison GR, Rosenbach SB, Poteat VP, Yoshikawa H, Calzo JP. Gender-sexuality alliance membership and activities: associations with students' comfort, confidence and awareness regarding substance use resources. HEALTH EDUCATION RESEARCH 2021; 36:295-308. [PMID: 33544834 PMCID: PMC8487662 DOI: 10.1093/her/cyab007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
Belonging to a school Gender and Sexuality Alliance (GSA) is associated with lower substance use among LGBTQ+ youth. However, it is unknown whether GSA participation facilitates access to resources for substance use concerns. Using longitudinal data from 38 Massachusetts high schools, we compared sources of support for substance use concerns listed by GSA members (n = 361) and nonmembers (n = 1539). Subsequently, we tested whether GSA membership was associated with comfort, confidence and awareness regarding substance use resources in school and the community. Finally, we assessed whether specific GSA activities and discussions (e.g. social support) were associated with these outcomes. Among students with recent substance use, GSA membership was associated with greater comfort, confidence and awareness regarding school-based substance use resources in the spring semester, adjusted for fall semester levels and non-GSA club involvement. Furthermore, students in GSAs where members reported more advocacy and social support activities reported higher levels of comfort, confidence and awareness regarding community-based substance use resources. These results indicate that among students using alcohol or nicotine products, GSA members may be more receptive to school-based substance use prevention efforts. Furthermore, GSA-based social support and activism experiences may promote access to community-based substance use resources.
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Affiliation(s)
- Gabriel R Murchison
- Department of Social & Behavioral Sciences, Harvard University, Boston, MA, USA
| | - Sarah B Rosenbach
- Department of Applied Psychology, New York University, New York, NY, USA
| | - V Paul Poteat
- Department of Counseling, Developmental & Educational Psychology, Boston College, Chestnut Hill, MA, USA
| | - Hirokazu Yoshikawa
- Department of Applied Psychology, New York University, New York, NY, USA
| | - Jerel P Calzo
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
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Li WHC, Xia W, Ho LLK, Cheung AT, Leong QKI, Liang T. A medical peer-delivered intervention comprising brief motivational interviewing via instant-messaging interaction to reduce drug misuse among youth in Hong Kong: A protocol for a randomised controlled trial. Addict Sci Clin Pract 2021; 16:32. [PMID: 34022949 PMCID: PMC8141248 DOI: 10.1186/s13722-021-00241-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/15/2021] [Indexed: 11/10/2022] Open
Abstract
AIMS Youth are frequently exposed to drugs, and most youth who misuse drugs are reluctant to seek help from services due to the worry of others being judgmental, lacking expertise, exposing their personal information, or informing their parents. Considering these concerns, we propose to evaluate the effectiveness of a medical peer-delivered intervention comprising brief motivational interviewing via instant-messaging interaction in reducing drug misuse among youth in Hong Kong. METHODS A two-group single-blind, randomised controlled trial will be conducted. Multiple approaches, including online and face-to-face methods, will be used to recruit the participants. The participants, aged 25 years or younger and reporting any drugs that they have taken within the past 30 days, will be recruited and randomised to receive either brief motivational interviewing via interactive instant-messaging (the intervention) or general health text-messages (comparator). The primary outcome will be the change in the participants' reductions in self-reported drug consumption at 12 months compared to that at baseline. The secondary outcomes will be the changes in the drug-abusing participants' reductions in self-reported drug consumption at 6 months, the changes in the drug-quitting participants' 6- and 12-month contemplation stages and relapse risk compared to that at baseline, 30 days' self-reported drug abstinence at 6 and 12 months, and the treatment needs and motivation at 6 and 12 months compared to that at baseline. The effectiveness of the proposed intervention will be examined with adjusted regression models, with adjustment for baseline characteristics and the use of an intention-to-treat approach. DISCUSSION This proposed study will be the first randomised controlled trial to assess the effectiveness of a medical peer-delivered interactive intervention to reduce drug misuse among youth in Hong Kong. The proposed intervention has the potential to increase the help-seeking behaviour and intention to quit among youth who misuse drugs. As a result, more youth misusing drugs may be helped to abstain from drugs. This proposed study will inform decisions on whether it is worthwhile to invest resources in large-scale implementation of such an intervention.
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Affiliation(s)
- William Ho Cheung Li
- School of Nursing, The University of Hong Kong, HKSAR, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Wei Xia
- School of Nursing, The University of Hong Kong, HKSAR, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China.,School of Nursing, Sun Yat-Sen University, Guangdong, China
| | - Laurie Long Kwan Ho
- School of Nursing, The University of Hong Kong, HKSAR, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Ankie Tan Cheung
- School of Nursing, The University of Hong Kong, HKSAR, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Queenie Kuai I Leong
- School of Nursing, The University of Hong Kong, HKSAR, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Tingna Liang
- School of Nursing, The University of Hong Kong, HKSAR, 4/F, William M. W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China
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Steele ML, Meurk C, Schess J, Yap L, Jones J, Harden S, Davison S, Butler T, Heffernan E. Substance use and help-seeking among justice-involved young people in Queensland and Western Australia: A cross-sectional survey of 14-17-year-olds. Drug Alcohol Rev 2021; 40:617-626. [PMID: 33529459 DOI: 10.1111/dar.13238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study investigated substance use and help-seeking among justice-involved young people to inform and improve service provision during and after contact with the justice system. METHODS Young people (14-17 years) in the community with current or prior contact with the justice system were recruited in Queensland and Western Australia, Australia using purposive sampling between 2016 and 2018. A cross-sectional survey was delivered by computer-assisted telephone interview. Information was collected on sociodemographic and health factors; lifetime and frequency of use of alcohol, tobacco and other drugs; and use of health services related to substance use and mental health. RESULTS Of the 465 justice-involved young people surveyed, most had used alcohol (89%), tobacco (86%) or other drugs (81%). Of the latter, cannabis use was most prevalent (79%), followed by ecstasy (26%) and amphetamine (22%). Young people engaging in higher risk drug use (daily use, injecting use) were more likely to also have an alcohol use disorder, be disengaged from education, unemployed, have attempted suicide and experienced incarceration. Of the cohort, 24% had received treatment at an alcohol and drug service in the past year and 30% had seen a health professional about emotional/behavioural problems. Males and Aboriginal and Torres Strait Islander young people were less likely to have sought professional help. CONCLUSION The high levels of substance use and disproportionate levels of help-seeking observed in this study illustrate the importance of delivering tailored, comprehensive and coordinated trauma-informed and culturally safe alcohol and drug services to justice-involved young people.
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Affiliation(s)
- Megan L Steele
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Carla Meurk
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Jaclyn Schess
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Brisbane, Australia.,Yale University, New Haven, USA
| | - Lorraine Yap
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Jocelyn Jones
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Scott Harden
- Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Forensic Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, Australia
| | - Sophie Davison
- Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia.,Office of the Chief Psychiatrist, Perth, Australia.,North Metropolitan Heath Service, Perth, Australia
| | - Tony Butler
- School of Population Health, UNSW Sydney, Sydney, Australia
| | - Ed Heffernan
- Forensic Mental Health Group, Queensland Centre for Mental Health Research, Brisbane, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia.,Queensland Forensic Mental Health Service, Queensland Health, Brisbane, Australia
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12
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Blanco C, Ali MM, Beswick A, Drexler K, Hoffman C, Jones CM, Wiley TRA, Coukell A. The American Opioid Epidemic in Special Populations: Five Examples. NAM Perspect 2020; 2020:202010b. [PMID: 35291746 PMCID: PMC8916817 DOI: 10.31478/202010b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Mir M Ali
- Office of the Assistant Secretary of Planning and Evaluation
| | - Aaron Beswick
- Health Resources and Services Administration, Federal Office of Rural Health Policy
| | | | - Cheri Hoffman
- Office of the Assistant Secretary for Planning and Evaluation
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Kahl BL, Miller HM, Cairns K, Giniunas H, Nicholas M. Evaluation of ReachOut.com, an Unstructured Digital Youth Mental Health Intervention: Prospective Cohort Study. JMIR Ment Health 2020; 7:e21280. [PMID: 33055066 PMCID: PMC7596653 DOI: 10.2196/21280] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/06/2020] [Accepted: 09/09/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Young people experience a disproportionate burden associated with mental illness that Australia's mental health care system is ill-equipped to handle. Despite improvements in the provision of mental health services, the rates of service utilization among young people remain suboptimal, and there are still considerable barriers to seeking help. Digital mental health services can overcome a number of barriers and connect young people requiring support; however, the evidence base of digital interventions is limited. OBJECTIVE The aim of this study is to examine the effectiveness of a brief, self-directed, unstructured digital intervention, ReachOut.com (hereafter ReachOut), in reducing depression, anxiety, stress, and risk of suicide. METHODS A cohort of 1982 ReachOut users participated in a 12-week longitudinal study, with a retention rate of 81.18% (1609/1982) across the duration of the study. Participants completed web-based surveys, with outcome measures of mental health status and suicide risk assessed at 3 time points across the study period. RESULTS The results demonstrated that over the 12-week study period, young people using ReachOut experienced modest yet significant reductions in symptoms of depression, anxiety, and stress. Significant, albeit modest, reductions in the proportion of participants at high risk of suicide were also observed. CONCLUSIONS The findings of this research provide preliminary evidence of the promise of an unstructured digital mental health intervention, ReachOut, in alleviating symptoms of mental ill-health and promoting well-being in young people. These findings are particularly important given that digital services are not only acceptable and accessible but also have the potential to cater to the diverse mental health needs of young people at scale, in a way that other services cannot.
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Christie GIG, Cheetham A, Lubman DI. Interventions for Alcohol and Drug Use Disorders in Young People: 10 Key Evidence-Based Approaches to Inform Service Delivery. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00336-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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15
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Sarkar S, Thakur A, Sood E, Mandal P. Barriers and Facilitators of Addiction Treatment: a Qualitative Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00394-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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McKetin R, Voce A, Burns RA, Quinn B. The Short Barriers Questionnaire (SBQ): Validity, factor structure and correlates in an out-of-treatment sample of people dependent on methamphetamine. J Subst Abuse Treat 2020; 116:108029. [PMID: 32741495 DOI: 10.1016/j.jsat.2020.108029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/09/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION AND AIMS We validate a brief questionnaire to assess barriers to help-seeking for illicit substance use, and explore the factor structure and correlates of scale scores, among people dependent on methamphetamine. DESIGN AND METHODS We administered a modified version of 27 items from the Barriers Questionnaire to 145 adults who had used methamphetamine in the past month and who screened positive for methamphetamine dependence on the Mini International Neuropsychiatric Interview. We used an exploratory factor analysis to identify the scale's dimensions. We examined correlates of the scale scores, their internal consistency, and their concurrent validity against help-seeking intentions on the General Help Seeking Questionnaire (GHSQ). RESULTS A three factor model (χ2 = 308.6 df=168; RMSEA 0.08 [95% CI 0.06-0.09]; comparative fit index = 0.92) identified low perceived need for treatment (9 items), stigma (6 items), and apprehension about treatment (7 items) with Eigenvalues of 5.7, 3.8 and 2.3 respectively. The final 22-item scale had good internal consistency (Cronbach's alpha 0.83) and correlated negatively with help-seeking intentions on the GHSQ (rs = -0.24 p < .001) and positively with the GHSQ item, "I would not seek help from anyone" (rs = 0.38 p < .001). The scale dimensions of low perceived need, stigma, and apprehension had adequate to good internal consistency (Cronbach's alpha of 0.83, 0.79 and 0.69 respectively) but only low perceived need for treatment correlated significantly with the GHSQ scores. Low perceived need was also related to less severe methamphetamine dependence, not having children, and not having received professional help for methamphetamine use. Stigma was associated with specific demographics (being employed, having children), polysubstance use, and having attended sessions with a counselor or psychologist. Apprehension was associated with poor mental health, more severe substance use, being a woman, and having received help from an ambulance. DISCUSSION AND CONCLUSIONS This short version of the Barriers Questionnaire (the Short Barriers Questionnaire; SBQ) is an internally consistent and valid scale for assessing low perceived need for treatment among people who use methamphetamine. Further work is needed to capture and validate other barriers to help-seeking for this population.
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Affiliation(s)
- Rebecca McKetin
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Alexandra Voce
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Richard A Burns
- Research School of Population Health, Australian National University, Canberra, Australia
| | - Brendan Quinn
- Longitudinal and Lifecourse Studies, Australian Institute of Family Studies, Southbank, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
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Helseth SA, Escobar KI, Clark MA, Spirito A, Becker SJ. Marketing therapy to parents concerned about adolescent substance use: Association of adolescent problems and parent preferences for direct-to-consumer marketing. ACTA ACUST UNITED AC 2020; 51:68-76. [PMID: 32161430 DOI: 10.1037/pro0000255] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Parent-directed marketing strategies have great potential to promote the utilization of therapy by adolescents with or at risk of substance-related problems. The extent to which marketing strategies should be tailored to parents of adolescents with various presenting problems - such as substance use, mental health, and legal involvement - is unknown. The current study represents a secondary analysis of a direct-to-consumer (DTC) marketing survey, which used a well-established framework called the Marketing Mix to solicit parent preferences about marketing across three dimensions: Promotion (i.e., how parents prefer to receive information); Place (i.e., where parents prefer to receive therapy); and Price (i.e., how much parents are willing to pay and how far parents are willing to travel). Four-hundred eleven parents of 12- to 19-year-old adolescents (51% girls, 82% Non-Hispanic White) completed the survey and answered five questions spanning Promotion, Price, and Place dimensions of the Marketing Mix. A subsample of 158 parents also reported on their actual therapy-seeking behavior, allowing us to report on both parents' ideal and actual experiences. We explored the extent to which parent preferences varied as a function of adolescent substance use, externalizing, internalizing, and legal problems. Bivariate analyses and multivariate logistic regressions were used to examine which of these variables were associated with parents' responses to specific survey items. Analyses confirmed that both parent preferences and parents' actual therapy-seeking behavior varied as a function of adolescent problems. Recommendations are offered for professional psychologists to use DTC marketing strategies to connect with adolescents in need of services.
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Elkington KS, Lee J, Brooks C, Watkins J, Wasserman GA. Falling between two systems of care: Engaging families, behavioral health and the justice systems to increase uptake of substance use treatment in youth on probation. J Subst Abuse Treat 2020; 112:49-59. [PMID: 32199546 DOI: 10.1016/j.jsat.2020.01.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/16/2020] [Accepted: 01/19/2020] [Indexed: 12/12/2022]
Abstract
Justice-involved youth (JIY) in the US have high rates of substance use (SU) problems, yet 50%-80% of these youth do not receive necessary services. There has been no systematic exploration of the use of treatment services for JIY that examines viewpoints across stakeholders in justice- and treatment-systems as well as the families. We conducted qualitative interviews and focus groups with n = 58, youth, their caregivers, SU treatment providers and probation officers in a Northeastern state. Interviews explored how families, staff- and system-level factors influence uptake of and retention in SU treatment services in youth on probation. We conducted a thematic analysis of all interview texts. Caregiver engagement is essential for youth treatment uptake and retention. Difficulties achieving caregiver engagement and agreement that treatment was necessary stemmed from distrust in the "system"; denial or minimization of youth's SU problem; relational barriers; and overburden and chaos within the family system. Structural barriers to service uptake were lack of available treatment options, SU agency practices and policies, and interagency collaboration between SU treatment agencies and probation. Enhancing family engagement at the point of referral to SU treatment is essential. Improvements in interagency collaboration and communication between SU treatment and probation agencies are necessary. Implications for policy and intervention are discussed.
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Affiliation(s)
- Katherine S Elkington
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, United States of America.
| | - Jacqueline Lee
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, United States of America
| | - Catherine Brooks
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, United States of America
| | - Jillian Watkins
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, United States of America
| | - Gail A Wasserman
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, United States of America
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Lubman DI, Cheetham A, Sandral E, Wolfe R, Martin C, Blee F, Berridge BJ, Jorm AF, Wilson C, Allen NB, McKay-Brown L, Proimos J. Twelve-month outcomes of MAKINGtheLINK: A cluster randomized controlled trial of a school-based program to facilitate help-seeking for substance use and mental health problems. EClinicalMedicine 2020; 18:100225. [PMID: 31922118 PMCID: PMC6948229 DOI: 10.1016/j.eclinm.2019.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Young people experiencing mental health problems are often reluctant to seek help, particularly from professionals (i.e., doctors or mental health workers). MAKINGtheLINK is a school-based intervention that aims to help adolescents overcome barriers to seeking professional help for mental health and substance use problems. METHODS A cluster randomised controlled trial was conducted to evaluate the 12-month outcomes of MAKINGtheLINK among 2447 participants (Mean age=14.9 years, SD=0.5 years, 50% male). Randomisation resulted in 1130 students from 11 schools allocated to receive the intervention, and 1317 students from 10 schools allocated to the wait-list control group. After the baseline assessment, follow-ups were conducted at 6-weeks (n = 2045), 6-months (n = 1874), and 12-months (n = 1827). The primary outcome measure was help-seeking behaviour, from both formal (e.g., health professionals) and informal (e.g., friends, family members) sources. The trial was registered with the Australia and New Zealand Clinical Trials Register (ANZCTR) on the 27th of February 2013 (registration number ACTRN12613000235707). FINDINGS The intervention was not associated with overall help-seeking at the 12-month follow-up (p = 0.99, odds ratio [OR]=1.00, 95% CI for OR = 0.70-1.42), or help-seeking for depression (p = 0.28, OR = 1.21, 95%CI =0.86-1.69), stress and anxiety (p = 0.73, OR = 1.04, 95%CI = 0.74-1.47), or alcohol/other drugs (p = 0.84, OR=1.12, CI=0.37-3.37). However, the intervention was associated with increased help-seeking from formal sources (compared to informal sources) both overall (p = 0.005, OR = 1.81, 95%CI = 1.19-2.75), as well as for depression (p = 0.01, OR=2.09, 95%CI=1.19-3.67), and stress and anxiety (p < 0.006, OR = 1.72, 95%CI = 1.17-2.54). INTERPRETATION Rates of help-seeking remained unchanged following the intervention. However, MAKINGtheLINK effectively improved the quality of adolescent help-seeking behaviour by increasing help-seeking from formal sources. As prompt treatment is essential in reducing the long-term impact of early onset mental health problems, MAKINGtheLINK has the potential to make a significant contribution to existing early intervention and prevention efforts. FUNDING National Health and Medical Research Council (APP1047492).
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
- Corresponding author at: Turning Point, 100 Church St, Richmond, Victoria 3121, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Emma Sandral
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Catherine Martin
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Fiona Blee
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Bonita J Berridge
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Anthony F. Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Coralie Wilson
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
- Graduate Medicine, School of Medicine University of Wollongong, Wollongong, NSW 2522, Australia
- Centre for Personal and Professional Development (CPPD), Wollongong 2517, Australia
| | - Nicholas B. Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria 3052, Australia
- Department of Psychology, University of Oregon, Eugene 6200, United States
| | - Lisa McKay-Brown
- Travancore School, Victorian Department of Education and Training, Travancore, Victoria 6200, Australia
- Melbourne Graduate School of Education, The University of Melbourne, Victoria 6200, Australia
| | - Jenny Proimos
- Victorian Department of Education and Training, Melbourne, Victoria 6200, Australia
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Snowdon N, Allan J, Shakeshaft A, Rickwood D, Stockings E, Boland VC, Courtney RJ. Outpatient psychosocial substance use treatments for young people: An overview of reviews. Drug Alcohol Depend 2019; 205:107582. [PMID: 31778903 DOI: 10.1016/j.drugalcdep.2019.107582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/12/2019] [Accepted: 08/16/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Systematic reviews and meta-analyses (reviews) conflict regarding the efficacy and feasibility of substance disorder treatments for young people (YP). This overview of reviews, synthesizes, and methodologically assesses reviews examining substance disorder interventions for YP in outpatient settings. METHODS Reviews published between 1990 and March 2018 were searched using EBM Reviews, PsycINFO, Embase, Ovid Medline, and Campbell Collaboration. Reviews investigating efficacy and/or feasibility of YP substance disorder treatments in outpatient settings were included. FORTY-THREE REVIEWS MET ALL INCLUSION CRITERIA To appraise methodological biases, 40 reviews were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) and 3 were narratively assessed. One reviewer (NS) extracted study data and evaluated all 43 reviews. For inter-rater reliability, 13 (30%) reviews were extracted and appraised in duplicate by a second reviewer (JA, RC or ES). Agreement on AMSTAR2 ratings reached 100%. Agreement was moderate; κ = .52 (p < .05), 95% CI (.20, .84). RESULTS All high quality methodological reviews (n = 6) focused on intervention efficacy and none on treatment feasibility. One (n = 1) high quality review reported evidence for an intervention. Multidimensional Family Therapy (MDFT) has possible efficacy in reducing YP substance use when compared to treatment as usual, Cognitive Behavior Therapy, Adolescent Community Reinforcement Approach and Multifamily Educational Therapy. CONCLUSIONS Methodological and reporting quality of reviews require improvement. High quality reviews focused on intervention efficacy but treatments commonly lacked evidence. One high quality review found MDFT demonstrated promising outcomes. Reviews examining feasibility of interventions were of low methodological quality.
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Affiliation(s)
- Nicole Snowdon
- Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia; National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia.
| | - Julaine Allan
- Lives Lived Well Research Team, Lives Lived Well, P.O. Box 9374, Orange, NSW, 2800, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia
| | - Debra Rickwood
- Research and Evaluation, headspace, The National Youth Mental Health Foundation, South Tower, Level 2, 485 La Trobe St, Melbourne VIC 3000, Australia; Faculty of Health, Allawoona St, University of Canberra, Bruce, Canberra, ACT, 2617, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
| | - Veronica C Boland
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
| | - Ryan J Courtney
- National Drug and Alcohol Research Centre, 22 - 32 King Street, The University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
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Halladay J, Scherer J, MacKillop J, Woock R, Petker T, Linton V, Munn C. Brief interventions for cannabis use in emerging adults: A systematic review, meta-analysis, and evidence map. Drug Alcohol Depend 2019; 204:107565. [PMID: 31751868 DOI: 10.1016/j.drugalcdep.2019.107565] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE This systematic review summarizes and critically appraises the existing literature on brief interventions (BIs) for cannabis use among emerging adults. METHODS Eligible BIs were operationalized as 1-2 sessions focused exclusively on cannabis use for samples with mean ages between 15 and 30. Outcomes related to cannabis use, other substance use, mental health, help-seeking, or functional status were included. Two independent reviewers screened a total of 3638 records, identifying 244 studies for full-text screening. In total, 32 BIs in 26 primary studies with 6318 participants were included. RESULTS Participants were typically not seeking treatment and using cannabis at least once a month. Most interventions were motivational, single sessions, and delivered in person. Few discussed concurrent psychiatric conditions. Pooling results at 1-3 months post-intervention, BIs compared to passive control slightly reduced symptoms of cannabis use disorder (SMD -0.14 [95% CI -0.26 to -0.01]) and increased the odds of abstinence (OR 1.73 [95% CI 1.13-2.66]). Other outcome results often favored BIs but were not significant. Results of studies comparing types of BIs (k = 8) or BIs to longer interventions (k = 1) are discussed narratively. Quality assessment suggested low to very low-quality evidence. CONCLUSIONS This review indicates that BIs targeting non-treatment seeking emerging adults result in significant reductions in symptoms of cannabis use disorder and an increased likelihood of cannabis abstinence, however evidence is of low quality.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada.
| | - Justin Scherer
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, L8N 3K7, Canada.
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, L8N 3K7, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada.
| | - Rachel Woock
- Department of Health, Aging, and Society, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada.
| | - Tashia Petker
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, L8N 3K7, Canada.
| | - Vanessa Linton
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada.
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4S4, Canada.
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Patterson C, Perlman D, Moxham L, Burns S. Do Help-Seeking Behaviors Influence the Recovery of People With Mental Illness? J Psychosoc Nurs Ment Health Serv 2019; 57:33-38. [PMID: 31566704 DOI: 10.3928/02793695-20190920-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/13/2019] [Indexed: 11/20/2022]
Abstract
Personal recovery is a primary focus for health care professionals and people with mental illness, with current research focused on understanding the concepts and factors that facilitate a positive recovery journey. A person's ability to seek help is an area that has demonstrated promise. Although there is a wealth of literature that exists on the barriers to someone seeking help, there is little empirical evidence to demonstrate the connection between help-seeking behaviors and personal recovery for people with mental illness. The current study used quantitative measures to examine whether help-seeking behaviors would facilitate personal recovery. One hundred twenty people with mental illness completed two valid and reliable surveys that measured help-seeking behaviors and personal recovery. Using multiple linear regression analysis, results revealed that help-seeking behaviors significantly influenced the personal recovery of participants. Understanding the constructs that facilitate a positive personal recovery journey for a person with mental illness may be viewed as a critical area of inquiry. These results allow for future inquiry into the connection between intention and behavior, as there has been an identified disparity between the need for assistance and use of services. [Journal of Psychosocial Nursing and Mental Health Services, 57(12), 33-38.].
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Benfer I, Zahnow R, Barratt MJ, Maier L, Winstock A, Ferris J. The impact of drug policy liberalisation on willingness to seek help for problem drug use: A comparison of 20 countries. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 56:162-175. [DOI: 10.1016/j.drugpo.2018.03.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/20/2018] [Accepted: 03/26/2018] [Indexed: 10/17/2022]
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