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Kennedy N, Win TL, Bandyopadhyay A, Kennedy J, Rowe B, McNerney C, Evans J, Hughes K, Bellis MA, Jones A, Harrington K, Moore S, Brophy S. Insights from linking police domestic abuse data and health data in South Wales, UK: a linked routine data analysis using decision tree classification. Lancet Public Health 2023; 8:e629-e638. [PMID: 37516479 DOI: 10.1016/s2468-2667(23)00126-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Exposure to domestic abuse can lead to long-term negative impacts on the victim's physical and psychological wellbeing. The 1998 Crime and Disorder Act requires agencies to collaborate on crime reduction strategies, including data sharing. Although data sharing is feasible for individuals, rarely are whole-agency data linked. This study aimed to examine the knowledge obtained by integrating information from police and health-care datasets through data linkage and analyse associated risk factor clusters. METHODS This retrospective cohort study analyses data from residents of South Wales who were victims of domestic abuse resulting in a Public Protection Notification (PPN) submission between Aug 12, 2015 and March 31, 2020. The study links these data with the victims' health records, collated within the Secure Anonymised Information Linkage databank, to examine factors associated with the outcome of an Emergency Department attendance, emergency hospital admission, or death within 12 months of the PPN submission. To assess the time to outcome for domestic abuse victims after the index PPN submission, we used Kaplan-Meier survival analysis. We used multivariable Cox regression models to identify which factors contributed the highest risk of experiencing an outcome after the index PPN submission. Finally, we created decision trees to describe specific groups of individuals who are at risk of experiencing a domestic abuse incident and subsequent outcome. FINDINGS After excluding individuals with multiple PPN records, duplicates, and records with a poor matching score or missing fields, the resulting clean dataset consisted of 8709 domestic abuse victims, of whom 6257 (71·8%) were female. Within a year of a domestic abuse incident, 3650 (41·9%) individuals had an outcome. Factors associated with experiencing an outcome within 12 months of the PPN included younger victim age (hazard ratio 1·183 [95% CI 1·053-1·329], p=0·0048), further PPN submissions after the initial referral (1·383 [1·295-1·476]; p<0·0001), injury at the scene (1·484 [1·368-1·609]; p<0·0001), assessed high risk (1·600 [1·444-1·773]; p<0·0001), referral to other agencies (1·518 [1·358-1·697]; p<0·0001), history of violence (1·229 [1·134-1·333]; p<0·0001), attempted strangulation (1·311 [1·148-1·497]; p<0·0001), and pregnancy (1·372 [1·142-1·648]; p=0·0007). Health-care data before the index PPN established that previous Emergency Department and hospital admissions, smoking, smoking cessation advice, obstetric codes, and prescription of antidepressants and antibiotics were associated with having a future outcome following a domestic abuse incident. INTERPRETATION The results indicate that vulnerable individuals are detectable in multiple datasets before and after involvement of the police. Operationalising these findings could reduce police callouts and future Emergency Department or hospital admissions, and improve outcomes for those who are vulnerable. Strategies include querying previous Emergency Department and hospital admissions, giving a high-risk assessment for a pregnant victim, and facilitating data linkage to identify vulnerable individuals. FUNDING National Institute for Health Research.
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Affiliation(s)
- Natasha Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea, UK.
| | | | | | - Jonathan Kennedy
- National Centre for Population Health and Wellbeing Research, Swansea, UK; Administrative Data Research Wales, Swansea, UK; Data Lab, National Centre for Population Health and Wellbeing Research, Swansea University Medical School, Swansea, UK
| | - Benjamin Rowe
- South Wales Police, South Wales Police Head Quarters Cowbridge Road, Bridgend, UK
| | - Cynthia McNerney
- Administrative Data Research Wales, Swansea, UK; SAIL Databank, Swansea, UK
| | | | | | - Mark A Bellis
- WHO Collaborating Centre for Violence Prevention, Liverpool John Moores University, Liverpool, UK
| | | | - Karen Harrington
- National Centre for Population Health and Wellbeing Research, Swansea, UK
| | - Simon Moore
- Security, Crime & Intelligence Innovation Institute and Violence Research Group, School of Dentistry, Cardiff University, Heath Park, Cardiff, UK
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing Research, Swansea, UK; Health Data Research UK, Swansea, UK; Administrative Data Research Wales, Swansea, UK
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Le Grande M, Borland R, Yong HH, McNeill A, Fong G, Cummings KM. Age-Related Interactions on Key Theoretical Determinants of Smoking Cessation: Findings from the ITC Four Country Smoking and Vaping Surveys (2016-2020). Nicotine Tob Res 2021; 24:679-689. [PMID: 34755869 PMCID: PMC9122748 DOI: 10.1093/ntr/ntab230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/24/2021] [Accepted: 11/02/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND This paper explores whether plans to quit, wanting to quit, and quit efficacy add predictive value over measures of habit strength and dependence in making quit attempts and/or attaining smoking abstinence. AIMS AND METHODS We used three waves of the International Tobacco Control (ITC) Four Country Smoking and Vaping Survey conducted in 2016, 2018, and 2020. Baseline daily smokers (N = 6710) who provided data for at least one wave-to-wave transition (W1 to W2, N = 3511 or W2 to W3, N = 3199) and provided outcome data at the next wave (follow-up) formed the analytic sample. Generalized estimating equations (GEE) logistic regression analyses examined predictors of quit attempts and abstinence at follow-up (1- and 6-month sustained abstinence). RESULTS Wanting and planning to quit were significantly positively associated with making quit attempts, but negatively associated with smoking abstinence. A significant interaction between the Heaviness of Smoking Index and age warranted an age-stratified analysis for both abstinence outcomes. Lower HSI predicted abstinence in only the younger smokers Motivation and plans to quit were positively associated with abstinence in younger smokers, but surprisingly were negatively associated with abstinence in older smokers. Quit efficacy was associated with abstinence in the older, but not the younger smokers. CONCLUSIONS Models of smoking abstinence are significantly improved by including motivational predictors of smoking. Age was an important moderator of the association between abstinence for both dependence and motivational variables. IMPLICATIONS The findings from this large cohort study indicate there are age-related differences in predictors of smoking abstinence but not quit attempts. These associations may reflect differential experiences of older and younger cohorts of smokers, which may have implications for interventions to motivate and assist smokers in quitting.
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Affiliation(s)
- Michael Le Grande
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia,Corresponding Author: Michael Le Grande, MPH, Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, 7th floor Redmond Barry Building, Parkville Campus, Melbourne, VIC 3010, Australia. Telephone/Fax: +61 434884121; E-mail:
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Hua-Hie Yong
- School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Denmark Hill, London, UK,Shaping Public Health Policies to Reduce Inequalities and Harm (SPECTRUM) Consortium, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Geoffrey Fong
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON,Canada,Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA,Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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Rogers E, Palacios J, Vargas E, Wysota C, Rosen M, Kyanko K, Elbel BD, Sherman S. Financial Hardship, Motivation to Quit and Post-Quit Spending Plans among Low-Income Smokers Enrolled in a Smoking Cessation Trial. Subst Abuse 2019; 13:1178221819878765. [PMID: 31636481 PMCID: PMC6785910 DOI: 10.1177/1178221819878765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 11/24/2022]
Abstract
Background: Tobacco spending may exacerbate financial hardship in low-income populations by using funds that could go toward essentials. This study examined post-quit spending plans among low-income smokers and whether financial hardship was positively associated with motivation to quit in the sample. Methods: We analyzed data from the baseline survey of a randomized controlled trial testing novel a smoking cessation intervention for low-income smokers in New York City (N = 410). Linear regression was used to examine the relationship between financial distress, food insecurity, smoking-induced deprivation (SID) and motivation to quit (measured on a 0-10 scale). We performed summative content analyses of open-ended survey questions to identify the most common plans among participants with and without SID for how to use their tobacco money after quitting. Results: Participants had an average level of motivation to quit of 7.7 (SD = 2.5). Motivation to quit was not significantly related to having high financial distress or food insecurity (P > .05), but participants reporting SID had significantly lower levels of motivation to quit than those without SID (M = 7.4 versus 7.9, P = .04). Overall, participants expressed an interest in three main types of spending for after they quit: Purchases, Activities, and Savings/Investing, which could be further conceptualized as spending on Oneself or Family, and on Needs or Rewards. The top three spending plans among participants with and without SID were travel, clothing and savings. There were three needs-based spending plans unique to a small number of participants with SID: housing, health care and education. Conclusions: Financial distress and food insecurity did not enhance overall motivation to quit, while smokers with SID were less motivated to quit. Most low-income smokers, including those with SID, did not plan to use their tobacco money on household essentials after quitting.
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Affiliation(s)
- Erin Rogers
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,VA NY Harbor Healthcare System, New York, NY, USA
| | - Jose Palacios
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Elizabeth Vargas
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Christina Wysota
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Marc Rosen
- Department of Psychiatry, Yale University, West Haven, CT, USA.,VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kelly Kyanko
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Brian D Elbel
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,Wagner Graduate School of Public Service, New York University, New York, NY, USA
| | - Scott Sherman
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,VA NY Harbor Healthcare System, New York, NY, USA
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Sharma-Kumar R, Meurk C, Ford P, Beere D, Gartner C. Are Australian smokers with mental illness receiving adequate smoking cessation and harm reduction information? Int J Ment Health Nurs 2018; 27:1673-1688. [PMID: 29718549 DOI: 10.1111/inm.12465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 02/05/2023]
Abstract
Provision of smoking cessation support in the form of advice and information is central to increasing quit rates, including among people with mental illness (MI), who have 3-5 times higher odds of smoking than those without MI. This study investigated the extent and perceived utility of quit smoking advice and information available to Australian smokers with MI through face-to-face, semi-structured, in-depth interviews with 29 current smokers with MI. Qualitative analysis identified four major sources of quit smoking advice and information: (i) mental health practitioners; (ii) Quitline; (iii) social networks; and (iv) Internet and media. All identified sources, including formal sources (mental health practitioners and Quitline), were perceived as providing inadequate information about quitting smoking, particularly regarding optimal usage of nicotine replacement therapy (NRT). Social networks emerged as a substantial source of quit smoking advice and information, especially for nontraditional methods such as vaping. Participants showed high interest in receiving support from peer-led smoking cessation groups. A minority of participants reported that they had received quit smoking information from Internet and media; this was largely restricted to negative reports about e-cigarettes and short advertisements for nicotine replacement therapy. Our findings suggest that more can be done to provide smokers with MI with practical smoking cessation advice and support. Comprehensive information resources tailored for smokers with MI should be developed and disseminated via multiple pathways. We also recommend a number of policy and practice reforms to promote smoking cessation among those with MI.
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Affiliation(s)
- Ratika Sharma-Kumar
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Carla Meurk
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Pauline Ford
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Diana Beere
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane, QLD, Australia
| | - Coral Gartner
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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