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Bruffaerts R, Axinn WG, Ghimire DJ, Benjet C, Chardoul S, Scott KM, Kessler RC, Schulz P, Smoller JW. Community exposure to armed conflict and subsequent onset of alcohol use disorder. Addiction 2024; 119:248-258. [PMID: 37755324 PMCID: PMC10872606 DOI: 10.1111/add.16343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/17/2023] [Indexed: 09/28/2023]
Abstract
AIMS To measure the independent consequences of community-level armed conflict beatings on alcohol use disorders (AUD) among males in Nepal during and after the 2000-2006 conflict. DESIGN A population-representative panel study from Nepal, with precise measures of community-level violent events and subsequent individual-level AUD in males. Females were not included because of low AUD prevalence. SETTING Chitwan, Nepal. PARTICIPANTS Four thousand eight hundred seventy-six males from 151 neighborhoods, systematically selected and representative of Western Chitwan. All residents aged 15-59 were eligible (response rate 93%). MEASUREMENTS Measures of beatings in the community during the conflict (2000-2006), including the date and distance away, were gathered through neighborhood reports, geo-location and official resources, then linked to respondents' life histories of AUD (collected in 2016-2018) using the Nepal-specific Composite International Diagnostic Interview with life history calendar. Beatings nearby predict the subsequent onset of AUD during and after the armed conflict. Data were analyzed in 2021-2022. FINDINGS Cohort-specific, discrete-time models revealed that within the youngest cohort (born 1992-2001), those living in neighborhoods where armed conflict beatings occurred were more likely to develop AUD compared with those in other neighborhoods (odds ratio = 1.66; 95% confidence interval = 1.02-2.71). In this cohort, a multilevel matching analysis designed to simulate a randomized trial showed the post-conflict incidence of AUD for those living in neighborhoods with any armed conflict beatings was 9.5% compared with 5.3% in the matched sample with no beatings. CONCLUSIONS Among male children living in Chitwan, Nepal during the 2000-2006 armed conflict, living in a neighborhood where armed conflict beatings occurred is associated with increased odds of developing subsequent alcohol use disorder. This association was independent of personal exposure to beatings and other mental disorders.
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Affiliation(s)
- Ronny Bruffaerts
- Center for Public Health Psychiatry, Universitair Psychiatrisch Centrum KU Leuven, Leuven, Belgium
| | - William G Axinn
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Dirgha J Ghimire
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Corina Benjet
- Department of Epidemiology and Psychosocial Research, National Institute of Psychiatry Instituto Nacional de Psiquiatría Ramón de La Fuente Muñiz, Mexico City, Mexico
| | - Stephanie Chardoul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Kate M Scott
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Schulz
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordan W Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
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Kim SH, Jang Y, Kim H. Concept and risk factors of alcohol relapse in liver transplant recipients with alcohol-related aetiologies: A scoping review. Int J Ment Health Nurs 2023; 32:1583-1597. [PMID: 37475208 DOI: 10.1111/inm.13196] [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] [Received: 04/10/2023] [Revised: 06/26/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
Alcohol relapse in those who received liver transplantation (LT) for alcohol-related liver disease can lead to poor graft function, low medication adherence rates and decreased chances of survival. Numerous studies have evaluated on this topic; however, discrepancies in the meaning and measurement of 'alcohol relapse' lead to heterogeneous results. This scoping review aimed to explore the conceptual and operational definitions of alcohol relapse in LT recipients with alcohol-related aetiologies and to examine newly reported risk factors of alcohol relapse. Following the Arksey and O'Malley scoping review method and PRISMA guidelines, structured searches for articles published from 2012 to 2022 were conducted in PubMed, CINAHL, Embase, Cochrane and PsycINFO. Twenty-eight studies were included in the final review. Alcohol relapse was either defined as 'any alcohol consumption' or 'a certain degree of alcohol drinking' after transplantation. Discrepancies in the incidence rates persisted even within studies that shared the same conceptual definition. Commonly reported risk factors for alcohol relapse were younger age, social isolation and shorter abstinence periods before LT. Self-efficacy and post-transplant complications were newly identified risk factors in recent studies; whereas environmental factors such as external stressors were rarely included. The variance in the definition of alcohol relapse and inconsistent identification methods make it difficult to organize a structured interventional study. A standardized stratification of post-LT alcohol relapse behaviour is needed to prior to implementing interventions that employ a harm minimization approach. Cost-effective interventions promoting self-efficacy could enable the prevention and management of alcohol relapse after LT.
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Affiliation(s)
| | - Yeonsoo Jang
- College of Nursing·Mo-im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Hyunji Kim
- College of Nursing, Yonsei University, Seoul, Korea
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Lavilla-Gracia M, Pueyo-Garrigues M, Calavia Gil D, Esandi-Larramendi N, Alfaro-Diaz C, Canga-Armayor N. Peer-led BASICS intervention to reduce alcohol consumption and alcohol-related consequences among university students: a randomized controlled trial. Front Public Health 2023; 11:1280840. [PMID: 38026297 PMCID: PMC10644667 DOI: 10.3389/fpubh.2023.1280840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Alcohol consumption is the main substance abused during university and is associated with physical, legal, emotional, social, and cognitive consequences. The peer-led BASICS intervention has been shown to be effective in decreasing the quantity and frequency of drinking, the estimated peak blood alcohol concentration (BAC), and the number of binge drinking episodes among this population. Objective This study evaluated the effectiveness of the peer-led BASICS intervention to reduce risky alcohol consumption among university students in the Spanish context. Materials and methods A two-arm randomized controlled trial in a university in northern Spain including 308 first- and second-year university students recruited between October 2022 to March 2023. The intervention was a 30-min in-person peer-led motivational interview. Participants were assessed at baseline and 1-month postintervention. The primary outcome was the quantity and frequency of alcohol consumption during a typical week. The intervention effect was verified using a mixed factorial ANOVA model. Results Compared with students in the control group, students who received the intervention reduced the number of drinks per week by 5.7 (95% CI 5.54, 5.86); the number of drinks consumed in a typical weekend by 5.2 (95% CI 5.07, 5.33); the number of drinks consumed on the occasion of greatest consumption by 4.9 (95% CI 4.78, 5.02); the number of binge drinking episodes by 1.4 (95% CI 1.37, 1.43); the peak BAC on a typical week and on the occasion of greatest consumption decreased by 0.06 (95% CI 0.058, 0.062) and 0.09 (95% CI 0.088, 0.092); the number of alcohol-related consequences by 5.8 (95% CI 5.67, 5.93); and the motivation to change their alcohol use increased by -0.8 (95% CI -0.85, -0.75). Conclusion The peer-led BASICS intervention is effective in changing alcohol consumption and its related consequences among Spanish university students in the short term. The action of nursing students as counselors positively impacted drinking patterns among their peers. Clinical trial registration https://clinicaltrials.gov/study/NCT05639374?intr=Effectiveness%20of%20a%20Peer-led%20Program%20to%20Prevent%20Alcohol%20Consumption&rank=1&page=1&limit=10, identifier: NCT05639374.
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Affiliation(s)
- María Lavilla-Gracia
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - María Pueyo-Garrigues
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Diego Calavia Gil
- Department of Otorhinolaryngology, Clinica University of Navarra, Pamplona, Spain
| | - Nuria Esandi-Larramendi
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Nursing Care for Adult Patients, School of Nursing, University of Navarra, Pamplona, Spain
| | - Cristina Alfaro-Diaz
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Department of Nursing Care for Adult Patients, School of Nursing, University of Navarra, Pamplona, Spain
| | - Navidad Canga-Armayor
- Department of Community, Maternity and Pediatric Nursing, School of Nursing, University of Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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Ahlner F, Erhag HF, Johansson L, Samuelsson J, Wetterberg H, Fässberg MM, Waern M, Skoog I. The effect of alcohol consumption on all-cause mortality in 70-year-olds in the context of other lifestyle risk factors: results from the Gothenburg H70 birth cohort study. BMC Geriatr 2023; 23:523. [PMID: 37641022 PMCID: PMC10464006 DOI: 10.1186/s12877-023-04227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND In this study, we examined the effect of alcohol, as well as the combined effect of seven lifestyle factors, on all-cause mortality in older adults (baseline age 70 years). METHODS Data was derived from the population-based Gothenburg H70 Birth Cohort study, including 1124 participants from the 2014-16 examination. Risk consumption was defined as > 98 g alcohol per week, and hazardous drinking was based on the Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Cox regression models were used to examine the individual effect of alcohol consumption, as well as the combined effect of seven lifestyle risk factors (high alcohol consumption, lifetime smoking, unhealthy Body Mass Index, insufficient physical activity, sedentary behavior, insufficient/prolonged sleep, unhealthy dietary pattern) on all-cause mortality. RESULTS During a mean follow-up of 7.7 years, 81 (7.2%) participants died. Neither risk consumption nor hazardous drinking were associated with elevated mortality, but hazardous drinking was associated with an increased risk of mortality in those with insufficient physical activity. Those with at least five lifestyle risk factors had an increased all-cause mortality compared to those fulfilling criteria for a maximum of one lifestyle risk factor. High alcohol consumption showed a relatively minor impact on this risk, while physical activity and unhealthy dietary pattern had an independent effect on mortality. CONCLUSIONS In this particular sample, there was no independent effect of alcohol on the risk of 8-year all-cause mortality. However, an interaction effect of physical activity was observed. It may be that high alcohol consumption per se is less important for mortality among older adults. However, a combination of several unhealthy lifestyle behaviors was linked to a substantial increase in the risk of mortality in Swedish older adults. Also, it has to be emphasized that high alcohol consumption may have other adverse health effects apart from mortality among older adults.
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Affiliation(s)
- Felicia Ahlner
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden.
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden.
| | - Hanna Falk Erhag
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Lena Johansson
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Addiction Clinic, Gothenburg, Sweden
| | - Jessica Samuelsson
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Hanna Wetterberg
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Margda Waern
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy at the University of Gothenburg, Wallinsgatan 6, 431 41, Gothenburg, SE, Sweden
- Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
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Schouten MJE, ten Have M, Tuithof M, de Graaf R, Dekker JJM, Goudriaan AE, Blankers M. Alcohol use as a predictor of the course of major depressive disorder: a prospective population-based study. Epidemiol Psychiatr Sci 2023; 32:e14. [PMID: 36847267 PMCID: PMC9971850 DOI: 10.1017/s2045796023000070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
AIMS There are indications that problematic alcohol use may negatively impact the course of major depressive disorder (MDD). However, most studies on alcohol use and adverse MDD outcomes are conducted amongst MDD populations with (severe) alcohol use disorder in psychiatric treatment settings. Therefore, it remains unclear whether these results can be generalised to the general population. In light of this, we examined the longitudinal relationship between alcohol use and MDD persistence after a 3-year follow-up amongst people with MDD from the general population. METHODS Data were derived from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a psychiatric epidemiological prospective study comprising four waves amongst the adult Dutch general population (n = 6.646). The study sample (n = 642) consisted of those with 12-month MDD who participated at the follow-up wave. The outcome was 12-month MDD persistence after the 3-year follow-up, which was assessed via the Composite International Diagnostic Interview version 3.0. Weekly alcohol consumption was operationalised as non-drinking (0 drinks), low-risk drinking (⩽7 drinks; reference), at-risk drinking (women 8-13 drinks, men 8-20 drinks) and high-risk drinking (women ⩾14, men ⩾21 drinks). We performed univariate and multiple logistic regression analyses, which were adjusted for various socio-demographic and health-related factors. RESULTS The majority (67.4%) of the MDD sample were female, while the mean age was 47.1 years. Amongst these, 23.8% were non-drinkers, 52.0% were low-risk drinkers and 14.3% and 9.4% were at-risk and high-risk drinkers, respectively. Around one-quarter of the sample (23.6%) met the criteria for a persistent MDD after 3-year follow-up. No statistically significant association was found between alcohol use and MDD persistence, either for the crude model or the adjusted models. In comparison to low-risk drinking, the full adjusted model showed no statistically significant associations between MDD persistence and non-drinking (odds ratio (OR) = 1.15, p = 0.620), at-risk drinking (OR = 1.25, p = 0.423), or high-risk drinking (OR = 0.74, p = 0.501). CONCLUSIONS Contrary to our expectations, our findings showed that alcohol use was not a predictor of MDD persistence after 3-year follow-up amongst people with MDD from the general population.
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Affiliation(s)
- Maria J. E. Schouten
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Amsterdam Public Health research institute, Amsterdam, the Netherlands
- Author for correspondence: Maria J. E. Schouten, E-mail:
| | - Margreet ten Have
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marlous Tuithof
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Ron de Graaf
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Jack J. M. Dekker
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Anna E. Goudriaan
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Matthijs Blankers
- Department of Research, Arkin Institute for Mental Health Care, Amsterdam, the Netherlands
- Trimbos Institute – Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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Ding C, O'Neill D, Britton A. Trajectories of alcohol consumption in relation to all-cause mortality in patients with cardiovascular disease: a 35-year prospective cohort study. Addiction 2022; 117:1920-1930. [PMID: 35188300 PMCID: PMC9314067 DOI: 10.1111/add.15850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 02/04/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Research into alcohol consumption and cardiovascular disease (CVD) patients' prognosis has largely ignored the longitudinal dynamics in drinking behaviour. This study measured the association between alcohol consumption trajectories and mortality risk in CVD patients. DESIGN Prospective cohort study. SETTING UK-based Whitehall II Study. PARTICIPANTS A total of 1306 participants with incident non-fatal CVD (coronary heart disease/stroke) events. MEASUREMENTS Up to eight repeated measures of alcohol intake were available for each patient from the most recent assessment phase pre-incident CVD and all subsequent phases post-incident CVD, spanning up to three decades. Six trajectory groups of alcohol consumption were identified using group-based trajectory modelling and related to the risk of all-cause mortality, adjusting for demographics and changes in life-style and health status. FINDINGS Three hundred and eighty deaths were recorded during a median follow-up of 5 years after patients' last alcohol assessment. Compared with patients who consistently drank moderately (≤ 14 units/week), former drinkers had a greater risk of mortality (hazard ratio = 1.74, 95% confidence interval = 1.19-2.54) after adjustment for covariates. There was no significantly increased risk of mortality in long-term abstainers, reduced moderate drinkers, stable or unstable heavy drinkers. Cross-sectional analyses based only on drinking information at patients' last assessment found no significant differences in mortality risk for abstainers, former or heavy drinkers versus moderate drinkers. CONCLUSIONS Cardiovascular disease patients who consistently drink ≤ 14 units/week appear to have a similar risk of mortality to those who are long-term abstainers, which does not support a protective effect of moderate drinking on total mortality. Cardiovascular disease patients who stop drinking appear to have increased mortality risk compared with continuous moderate drinkers, but this may be linked to poor self-rated health before cardiovascular disease onset.
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Affiliation(s)
- Chengyi Ding
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - Dara O'Neill
- CLOSER, UCL Social Research InstituteUniversity College LondonLondonUK
| | - Annie Britton
- Research Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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Wiemker V, Neufeld M, Bunova A, Danquah I, Ferreira-Borges C, Konigorski S, Rastogi A, Probst C. Digital Assessment Tools Using Animation Features to Quantify Alcohol Consumption: Systematic App Store and Literature Review. J Med Internet Res 2022; 24:e28927. [PMID: 35319472 PMCID: PMC8987963 DOI: 10.2196/28927] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 11/08/2021] [Accepted: 12/06/2021] [Indexed: 01/28/2023] Open
Abstract
Background Accurate and user-friendly assessment tools for quantifying alcohol consumption are a prerequisite for effective interventions to reduce alcohol-related harm. Digital assessment tools (DATs) that allow the description of consumed alcoholic drinks through animation features may facilitate more accurate reporting than conventional approaches. Objective This review aims to identify and characterize freely available DATs in English or Russian that use animation features to support the quantitative assessment of alcohol consumption (alcohol DATs) and determine the extent to which such tools have been scientifically evaluated in terms of feasibility, acceptability, and validity. Methods Systematic English and Russian searches were conducted in iOS and Android app stores and via the Google search engine. Information on the background and content of eligible DATs was obtained from app store descriptions, websites, and test completions. A systematic literature review was conducted in Embase, MEDLINE, PsycINFO, and Web of Science to identify English-language studies reporting the feasibility, acceptability, and validity of animation-using alcohol DATs. Where possible, the evaluated DATs were accessed and assessed. Owing to the high heterogeneity of study designs, results were synthesized narratively. Results We identified 22 eligible alcohol DATs in English, 3 (14%) of which were also available in Russian. More than 95% (21/22) of tools allowed the choice of a beverage type from a visually displayed selection. In addition, 36% (8/22) of tools enabled the choice of a drinking vessel. Only 9% (2/22) of tools allowed the simulated interactive pouring of a drink. For none of the tools published evaluation studies were identified in the literature review. The systematic literature review identified 5 exploratory studies evaluating the feasibility, acceptability, and validity of 4 animation-using alcohol DATs, 1 (25%) of which was available in the searched app stores. The evaluated tools reached moderate to high scores on user rating scales and showed fair to high convergent validity when compared with established assessment methods. Conclusions Animation-using alcohol DATs are available in app stores and on the web. However, they often use nondynamic features and lack scientific background information. Explorative study data suggest that such tools might enable the user-friendly and valid assessment of alcohol consumption and could thus serve as a building block in the reduction of alcohol-attributable health burden worldwide. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020172825; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172825
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Affiliation(s)
- Veronika Wiemker
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Maria Neufeld
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Ina Danquah
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Carina Ferreira-Borges
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Stefan Konigorski
- Digital Health Center, Hasso Plattner Institute for Digital Engineering, University of Potsdam, Potsdam, Germany.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ankit Rastogi
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Probst
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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8
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Schmengler H, Peeters M, Kunst AE, Oldehinkel AJ, Vollebergh WAM. Educational level and alcohol use in adolescence and early adulthood-The role of social causation and health-related selection-The TRAILS Study. PLoS One 2022; 17:e0261606. [PMID: 35045096 PMCID: PMC8769339 DOI: 10.1371/journal.pone.0261606] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022] Open
Abstract
Both social causation and health-related selection may influence educational gradients in alcohol use in adolescence and young adulthood. The social causation theory implies that the social environment (e.g. at school) influences adolescents’ drinking behaviour. Conversely, the health-related selection hypothesis posits that alcohol use (along other health-related characteristics) predicts lower educational attainment. From past studies it is unclear which of these mechanisms predominates, as drinking may be both a cause and consequence of low educational attainment. Furthermore, educational gradients in alcohol use may reflect the impact of ‘third variables’ already present in childhood, such as parental socioeconomic status (SES), effortful control, and IQ. We investigated social causation and health-related selection in the development of educational gradients in alcohol use from adolescence to young adulthood in a selective educational system. We used data from a Dutch population-based cohort (TRAILS Study; n = 2,229), including measurements of educational level and drinking at ages around 14, 16, 19, 22, and 26 years (waves 2 to 6). First, we evaluated the directionality in longitudinal associations between education and drinking with cross-lagged panel models, with and without adjusting for pre-existing individual differences using fixed effects. Second, we assessed the role of childhood characteristics around age 11 (wave 1), i.e. IQ, effortful control, and parental SES, both as confounders in these associations, and as predictors of educational level and drinking around age 14 (wave 2). In fixed effects models, lower education around age 14 predicted increases in drinking around 16. From age 19 onward, we found a tendency towards opposite associations, with higher education predicting increases in alcohol use. Alcohol use was not associated with subsequent changes in education. Childhood characteristics strongly predicted education around age 14 and, to a lesser extent, early drinking. We mainly found evidence for the social causation theory in early adolescence, when lower education predicted increases in subsequent alcohol use. We found no evidence in support of the health-related selection hypothesis with respect to alcohol use. By determining initial educational level, childhood characteristics also predict subsequent trajectories in alcohol use.
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Affiliation(s)
- Heiko Schmengler
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
- * E-mail:
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
| | - Anton E. Kunst
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Albertine J. Oldehinkel
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center of Groningen, University of Groningen, Groningen, the Netherlands
| | - Wilma A. M. Vollebergh
- Department of Interdisciplinary Social Science, Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
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Ranson JM, Rittman T, Hayat S, Brayne C, Jessen F, Blennow K, van Duijn C, Barkhof F, Tang E, Mummery CJ, Stephan BCM, Altomare D, Frisoni GB, Ribaldi F, Molinuevo JL, Scheltens P, Llewellyn DJ. Modifiable risk factors for dementia and dementia risk profiling. A user manual for Brain Health Services-part 2 of 6. Alzheimers Res Ther 2021; 13:169. [PMID: 34635138 PMCID: PMC8507172 DOI: 10.1186/s13195-021-00895-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/26/2021] [Indexed: 12/14/2022]
Abstract
We envisage the development of new Brain Health Services to achieve primary and secondary dementia prevention. These services will complement existing memory clinics by targeting cognitively unimpaired individuals, where the focus is on risk profiling and personalized risk reduction interventions rather than diagnosing and treating late-stage disease. In this article, we review key potentially modifiable risk factors and genetic risk factors and discuss assessment of risk factors as well as additional fluid and imaging biomarkers that may enhance risk profiling. We then outline multidomain measures and risk profiling and provide practical guidelines for Brain Health Services, with consideration of outstanding uncertainties and challenges. Users of Brain Health Services should undergo risk profiling tailored to their age, level of risk, and availability of local resources. Initial risk assessment should incorporate a multidomain risk profiling measure. For users aged 39-64, we recommend the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) Dementia Risk Score, whereas for users aged 65 and older, we recommend the Brief Dementia Screening Indicator (BDSI) and the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI). The initial assessment should also include potentially modifiable risk factors including sociodemographic, lifestyle, and health factors. If resources allow, apolipoprotein E ɛ4 status testing and structural magnetic resonance imaging should be conducted. If this initial assessment indicates a low dementia risk, then low intensity interventions can be implemented. If the user has a high dementia risk, additional investigations should be considered if local resources allow. Common variant polygenic risk of late-onset AD can be tested in middle-aged or older adults. Rare variants should only be investigated in users with a family history of early-onset dementia in a first degree relative. Advanced imaging with 18-fluorodeoxyglucose positron emission tomography (FDG-PET) or amyloid PET may be informative in high risk users to clarify the nature and burden of their underlying pathologies. Cerebrospinal fluid biomarkers are not recommended for this setting, and blood-based biomarkers need further validation before clinical use. As new technologies become available, advances in artificial intelligence are likely to improve our ability to combine diverse data to further enhance risk profiling. Ultimately, Brain Health Services have the potential to reduce the future burden of dementia through risk profiling, risk communication, personalized risk reduction, and cognitive enhancement interventions.
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Affiliation(s)
- Janice M Ranson
- College of Medicine and Health, University of Exeter, Exeter, UK
- Deep Dementia Phenotyping (DEMON) Network, Exeter, UK
| | - Timothy Rittman
- Deep Dementia Phenotyping (DEMON) Network, Exeter, UK
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Shabina Hayat
- Department of Public Health and Primary Care, Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Cornelia van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Frederik Barkhof
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Eugene Tang
- Deep Dementia Phenotyping (DEMON) Network, Exeter, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine J Mummery
- Deep Dementia Phenotyping (DEMON) Network, Exeter, UK
- Dementia Research Centre, Institute of Neurology, University College London, and National Hospital for Neurology and Neurosurgery, University College London Hospital, London, UK
| | - Blossom C M Stephan
- Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, Nottingham University, Nottingham, UK
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Life Science Partners, Amsterdam, The Netherlands
| | - David J Llewellyn
- College of Medicine and Health, University of Exeter, Exeter, UK.
- Deep Dementia Phenotyping (DEMON) Network, Exeter, UK.
- Alan Turing Institute, London, UK.
- 2.04 College House, St Luke's Campus, University of Exeter Medical School, Exeter, EX1 2 LU, UK.
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Fong M, Scott S, Albani V, Adamson A, Kaner E. 'Joining the Dots': Individual, Sociocultural and Environmental Links between Alcohol Consumption, Dietary Intake and Body Weight-A Narrative Review. Nutrients 2021; 13:2927. [PMID: 34578805 PMCID: PMC8472815 DOI: 10.3390/nu13092927] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Alcohol is energy-dense, elicits weak satiety responses relative to solid food, inhibits dietary fat oxidation, and may stimulate food intake. It has, therefore, been proposed as a contributor to weight gain and obesity. The aim of this narrative review was to consolidate and critically appraise the evidence on the relationship of alcohol consumption with dietary intake and body weight, within mainstream (non-treatment) populations. Publications were identified from a PubMed keyword search using the terms 'alcohol', 'food', 'eating', 'weight', 'body mass index', 'obesity', 'food reward', 'inhibition', 'attentional bias', 'appetite', 'culture', 'social'. A snowball method and citation searches were used to identify additional relevant publications. Reference lists of relevant publications were also consulted. While limited by statistical heterogeneity, pooled results of experimental studies showed a relatively robust association between acute alcohol intake and greater food and total energy intake. This appears to occur via metabolic and psychological mechanisms that have not yet been fully elucidated. Evidence on the relationship between alcohol intake and weight is equivocal. Most evidence was derived from cross-sectional survey data which does not allow for a cause-effect relationship to be established. Observational research evidence was limited by heterogeneity and methodological issues, reducing the certainty of the evidence. We found very little qualitative work regarding the social, cultural, and environmental links between concurrent alcohol intake and eating behaviours. That the evidence of alcohol intake and body weight remains uncertain despite no shortage of research over the years, indicates that more innovative research methodologies and nuanced analyses are needed to capture what is clearly a complex and dynamic relationship. Also, given synergies between 'Big Food' and 'Big Alcohol' industries, effective policy solutions are likely to overlap and a unified approach to policy change may be more effective than isolated efforts. However, joint action may not occur until stronger evidence on the relationship between alcohol intake, food intake and weight is established.
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Affiliation(s)
- Mackenzie Fong
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne NE1 4LP1, UK; (S.S.); (V.A.); (A.A.); (E.K.)
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11
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Debenham J, Birrell L, Champion K, Newton N. Study protocol for a cluster randomised controlled trial of The Illicit Project, a digital, neuroscience-based substance use intervention for secondary school students. Contemp Clin Trials 2021; 107:106467. [PMID: 34098037 DOI: 10.1016/j.cct.2021.106467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
Older adolescence (16-19 years) is characterised by an increase in alcohol and illicit substance use, however limited age-appropriate prevention programs exist to target this critical group. Schools are increasingly opting for web-based programs to deliver health education due to their effectiveness, accessibility and scalability. This study outlines the web-based adaptation of a neuroscience-based harm reduction program targeting older adolescents known as, The Illicit Project, and the study protocol to evaluate its effectiveness. A cluster randomised controlled trial will be conducted with Year 10, 11 and/or 12 students (aged 16-19 years) from 8 secondary schools across New South Wales, Australia. Participating schools will be randomised into the control group (health education as usual) or the intervention group (The Illicit Project program; a three-lesson, web-based program delivered fortnightly over 6 weeks) and will complete four web-based assessments at baseline, 6-, 12- and 24-months post baseline. Primary outcomes are the quantity and frequency of substance use, alcohol-related harms and drug literacy levels, with the 12-month follow-up, the primary end point. Secondary outcomes include intentions to use alcohol and other drugs in the future and risk perceptions. This trial has been registered with Australia and New Zealand Clinical Trials Registry (ACTRN12620000805976). Intervention effects will be estimated using multilevel mixed effects models with an intention-to-treat sample. This is the first evaluation of a web-based, age-appropriate neuroscience-based prevention program for substance use targeting older adolescents.
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Affiliation(s)
- Jennifer Debenham
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia.
| | - Louise Birrell
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use Level 6, University of Sydney, Sydney, Australia
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12
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Krueger RF, Hobbs KA, Conway CC, Dick DM, Dretsch MN, Eaton NR, Forbes MK, Forbush KT, Keyes KM, Latzman RD, Michelini G, Patrick CJ, Sellbom M, Slade T, South S, Sunderland M, Tackett J, Waldman I, Waszczuk MA, Wright AG, Zald DH, Watson D, Kotov R. Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum. World Psychiatry 2021; 20:171-193. [PMID: 34002506 PMCID: PMC8129870 DOI: 10.1002/wps.20844] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co-occurrence in the modal case, heterogeneity of presentation within dis-orders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and "Cluster B" personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self-assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.
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Affiliation(s)
| | - Kelsey A. Hobbs
- Department of PsychologyUniversity of MinnesotaMinneapolisMNUSA
| | | | - Danielle M. Dick
- Department of PsychologyVirginia Commonwealth UniversityRichmondVAUSA
| | - Michael N. Dretsch
- US Army Medical Research Directorate ‐ WestWalter Reed Army Institute of Research, Joint Base Lewis‐McChordWAUSA
| | | | - Miriam K. Forbes
- Centre for Emotional Health, Department of PsychologyMacquarie UniversitySydneyNSWAustralia
| | | | | | | | - Giorgia Michelini
- Semel Institute for Neuroscience and Human BehaviorUniversity of California Los AngelesLos AngelesCAUSA
| | | | - Martin Sellbom
- Department of PsychologyUniversity of OtagoDunedinNew Zealand
| | - Tim Slade
- Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | - Susan C. South
- Department of Psychological SciencesPurdue UniversityWest LafayetteINUSA
| | - Matthew Sunderland
- Matilda Centre for Research in Mental Health and Substance UseUniversity of SydneySydneyNSWAustralia
| | | | - Irwin Waldman
- Department of PsychologyEmory UniversityAtlantaGAUSA
| | | | | | - David H. Zald
- Department of PsychologyVanderbilt UniversityNashvilleTNUSA
| | - David Watson
- Department of PsychologyUniversity of Notre DameNotre DameINUSA
| | - Roman Kotov
- Department of PsychiatryStony Brook UniversityStony BrookNYUSA
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13
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Kenny E, O'Malley R, Roche K, Morrissey E, Dinneen SF, Byrne M, Casey B. Diabetes distress instruments in adults with Type 1 diabetes: A systematic review using the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) checklist. Diabet Med 2021; 38:e14468. [PMID: 33230846 DOI: 10.1111/dme.14468] [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] [Received: 06/29/2020] [Revised: 11/05/2020] [Accepted: 11/20/2020] [Indexed: 11/29/2022]
Abstract
AIMS To identify all extant instruments used to measure diabetes distress in adults with Type 1 diabetes and to evaluate the evidence for the measurement properties of these instruments. METHODS Medline, Embase, CINAHL plus and PsycINFO were systematically searched from inception up until 12 March 2020 for all publications which evaluated the psychometric properties of diabetes distress measurement instruments. The quality of the methodology and the measurement properties in the identified studies were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. RESULTS Seven out of the 7656 articles retrieved in the search were included in the final review. Four diabetes distress measurement instruments were identified, none of which displayed evidence for all measurement properties specified in the COSMIN guidelines. The Problem Areas in Diabetes-11 (PAID-11) demonstrated the best psychometric properties, displaying strong evidence for structural validity, internal consistency, hypothesis testing, responsiveness and criterion validity. The Problem Areas in Diabetes scale (PAID) was the most frequently investigated instrument, demonstrating good relevance and hypothesis testing across four studies; however, concerns remain over its factor structure. CONCLUSION The PAID-11 appears to be the most psychometrically sound instrument for measuring diabetes distress in adults with Type 1 diabetes, displaying strong evidence for a range of measurement properties. However, as only one study evaluated this instrument and its content validity has yet to be assessed, further validation is warranted. Additional qualitative work is needed to assess the content validity of these instruments among individuals with Type 1 diabetes.
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Affiliation(s)
- Eanna Kenny
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Galway, Republic of Ireland
| | - Róisín O'Malley
- School of Psychology, National University of Ireland, Galway, Galway, Republic of Ireland
| | - Kevin Roche
- School of Psychology, National University of Ireland, Galway, Galway, Republic of Ireland
| | - Eimear Morrissey
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Galway, Republic of Ireland
- School of Medicine, National University of Ireland, Galway, Galway, Republic of Ireland
| | - Sean F Dinneen
- School of Medicine, National University of Ireland, Galway, Galway, Republic of Ireland
- Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Republic of Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Galway, Republic of Ireland
| | - Bláthín Casey
- Health Research Institute, University of Limerick, Limerick, Republic of Ireland
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14
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Mun EY, Li X, Businelle MS, Hébert ET, Tan Z, Barnett NP, Walters ST. Ecological Momentary Assessment of Alcohol Consumption and Its Concordance with Transdermal Alcohol Detection and Timeline Follow-Back Self-report Among Adults Experiencing Homelessness. Alcohol Clin Exp Res 2021; 45:864-876. [PMID: 33583057 PMCID: PMC8252787 DOI: 10.1111/acer.14571] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/07/2021] [Accepted: 02/03/2021] [Indexed: 12/13/2022]
Abstract
Background Studies of alcohol use presume valid assessment measures. To evaluate this presumption, we examined the concordance of alcohol use as measured by ecological momentary assessment (EMA) self‐reports, transdermal alcohol concentration readings via the Secure Continuous Remote Alcohol Monitor (SCRAM), and retrospective self‐reports via the Timeline Follow‐Back (TLFB) among adults experiencing homelessness. Methods Forty‐nine adults who reported alcohol misuse (mean age = 47, SD = 9; 57% Black; 82% men) were recruited from a homeless shelter. For 4 weeks, alcohol use was assessed: (i) 5 times or more per day by EMA, (ii) every 30 minutes by a SCRAM device worn on the ankle, and (iii) by TLFB for the past month at the end of the study period. There were 1,389 days of observations of alcohol use and alcohol use intensity for 49 participants. Results EMA and SCRAM alcohol use data agreed on 73% of days, with an interrater agreement Kappa = 0.46. A multilevel analysis of concordance of 3 measures for alcohol use yielded statistically significant correlations of 0.40 (day level) and 0.63 (person level) between EMA and SCRAM. Alcohol use was detected on 49, 38, and 33% of days by EMA, SCRAM, and TLFB, respectively. For alcohol use intensity, EMA and SCRAM resulted in statistically significant correlations of 0.46 (day level) and 0.78 (person level). The concordance of TLFB with either EMA or SCRAM was weak, especially at the day level. Conclusions This is the first study to examine concordance of alcohol use estimates using EMA, SCRAM, and TLFB methods in adults experiencing homelessness. EMA is a valid approach to quantifying alcohol use, especially given its relatively low cost, low participant burden, and ease of use. Furthermore, any stigma associated with wearing the SCRAM or reporting alcohol use in person may be attenuated by using EMA, which may be appealing for use in studies of stigmatized and underserved populations.
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Affiliation(s)
- Eun-Young Mun
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Xiaoyin Li
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Michael S Businelle
- Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA.,Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Emily T Hébert
- UTHealth School of Public Health in Austin, Austin, OK, USA
| | - Zhengqi Tan
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Nancy P Barnett
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University, RI, USA
| | - Scott T Walters
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, TX, USA
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15
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Kilmer JR, Fossos-Wong N, Geisner IM, Yeh JC, Larimer ME, Cimini MD, Vincent KB, Allen HK, Barrall AL, Arria AM. Nonmedical Use of Prescription Stimulants as a "Red Flag" for Other Substance Use. Subst Use Misuse 2021; 56:941-949. [PMID: 33769195 PMCID: PMC8174530 DOI: 10.1080/10826084.2021.1901926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nonmedical use of prescription stimulants (NMPS) has increased on college campuses during the past two decades. NMPS is primarily driven by academic enhancement motives, and normative misperceptions exist as well. However, large, nationwide studies have not yet been conducted to generalize findings more broadly and gain a deeper understanding of the relationship between NMPS and other substance use (e.g. alcohol use, marijuana, etc.). The present study was conducted to lay the foundation for prevention efforts related to NMPS by establishing NMPS prevalence, practices surrounding NMPS, and other substance use. METHODS N = 2,989 students from seven universities around the U.S. completed a web-based survey assessing NMPS practices and related behaviors. Prevalence and factors associated with NMPS were explored. RESULTS Analyses revealed a 17% past-year prevalence of NMPS with associated widespread misperceptions of peer use. NMPS was significantly related to alcohol use, binge drinking, and marijuana use, as well as skipped classes and affiliation with Greek life. CONCLUSIONS Although most college students do not report NMPS, those who do also are more likely to report alcohol use, binge drinking, and marijuana use, and NMPS could be a "red flag" for other risk behaviors worth exploring. Implications for prevention and intervention are discussed.
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Affiliation(s)
- Jason R Kilmer
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Nicole Fossos-Wong
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Irene M Geisner
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Jih-Cheng Yeh
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - Mary E Larimer
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
| | - M Dolores Cimini
- Center for Behavioral Health Promotion and Applied Research, University at Albany, Albany, New York, USA
| | - Kathryn B Vincent
- Center on Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Hannah K Allen
- Center on Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Angelica L Barrall
- Center on Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Amelia M Arria
- Center on Young Adult Health and Development, Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, USA
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16
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Belita E, Squires JE, Yost J, Ganann R, Burnett T, Dobbins M. Measures of evidence-informed decision-making competence attributes: a psychometric systematic review. BMC Nurs 2020; 19:44. [PMID: 32514242 PMCID: PMC7254762 DOI: 10.1186/s12912-020-00436-8] [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] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/19/2020] [Indexed: 11/10/2022] Open
Abstract
Background The current state of evidence regarding measures that assess evidence-informed decision-making (EIDM) competence attributes (i.e., knowledge, skills, attitudes/beliefs, behaviours) among nurses is unknown. This systematic review provides a narrative synthesis of the psychometric properties and general characteristics of EIDM competence attribute measures in nursing. Methods The search strategy included online databases, hand searches, grey literature, and content experts. To align with the Cochrane Handbook of Systematic Reviews, psychometric outcome data (i.e., acceptability, reliability, validity) were extracted in duplicate, while all remaining data (i.e., study and measure characteristics) were extracted by one team member and checked by a second member for accuracy. Acceptability data was defined as measure completion time and overall rate of missing data. The Standards for Educational and Psychological Testing was used as the guiding framework to define reliability, and validity evidence, identified as a unified concept comprised of four validity sources: content, response process, internal structure and relationships to other variables. A narrative synthesis of measure and study characteristics, and psychometric outcomes is presented across measures and settings. Results A total of 5883 citations were screened with 103 studies and 35 unique measures included in the review. Measures were used or tested in acute care (n = 31 measures), public health (n = 4 measures), home health (n = 4 measures), and long-term care (n = 1 measure). Half of the measures assessed a single competence attribute (n = 19; 54.3%). Three measures (9%) assessed four competence attributes of knowledge, skills, attitudes/beliefs and behaviours. Regarding acceptability, overall missing data ranged from 1.6–25.6% across 11 measures and completion times ranged from 5 to 25 min (n = 4 measures). Internal consistency reliability was commonly reported (21 measures), with Cronbach’s alphas ranging from 0.45–0.98. Two measures reported four sources of validity evidence, and over half (n = 19; 54%) reported one source of validity evidence. Conclusions This review highlights a gap in the testing and use of competence attribute measures related to evidence-informed decision making in community-based and long-term care settings. Further development of measures is needed conceptually and psychometrically, as most measures assess only a single competence attribute, and lack assessment and evidence of reliability and sources of established validity evidence. Registration PROSPERO #CRD42018088754.
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Affiliation(s)
- Emily Belita
- McMaster University, School of Nursing, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON L8P 0A1 Canada
| | - Janet E Squires
- University of Ottawa/Université d'Ottawa, School of Nursing/École des sciences infirmières, Room RGN 3038, Guindon Hall, 451 Smyth Road, Ottawa, ON Canada
| | - Jennifer Yost
- Villanova University, M. Louise Fitzpatrick College of Nursing, Driscoll Hall, Room 330, 800 Lancaster Avenue, Villanova, PA 19085 USA
| | - Rebecca Ganann
- McMaster University, School of Nursing, 1280 Main St. W., HSC 3N25F, Hamilton, ON Canada
| | - Trish Burnett
- McMaster University, School of Nursing, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON L8P 0A1 Canada
| | - Maureen Dobbins
- McMaster University, School of Nursing, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON L8P 0A1 Canada
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17
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Ferguson TF, Theall KP, Brashear M, Maffei V, Beauchamp A, Siggins RW, Simon L, Mercante D, Nelson S, Welsh DA, Molina PE. Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study. Alcohol Clin Exp Res 2020; 44:1261-1272. [PMID: 32441814 DOI: 10.1111/acer.14336] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND High frequency of alcohol use among people living with HIV (PLWH) warrants careful assessment and screening to better understand its impact on HIV disease progression and development of comorbidities. Due to the limitations of the tools used to measure alcohol use, the links to health consequences are not fully understood. METHODS We completed a cross-sectional analysis to examine the prevalence of alcohol consumption using multiple alcohol assessment tools and their correlation and consistency in a cohort of PLWH (N = 365) enrolled in the New Orleans Alcohol Use in HIV (NOAH) Study. Alcohol use was assessed with the Alcohol Use Disorders Identification Test (AUDIT), timeline followback (TLFB) Calendar, lifetime drinking history, Alcohol and Drug Addiction Severity Index, and blood levels of phosphatidylethanol (PEth). Spearman's correlations were estimated for continuous measures of alcohol consumption; Wilcoxon rank-sum tests were used to compare means; and logistic regression was used to estimate odds of alcohol use by demographic characteristics. RESULTS Self-report of current alcohol use varied from 58.9 to 73.7% depending on the assessment. All the self-reported alcohol measures showed statistically significant correlations with the biological marker PEth. The highest correlation was with TLFB grams (r = 0.67, p < 0.001). Using TLFB, 73.7% of the cohort reported using alcohol in the last 30 days, and 61.6% had a positive PEth value. The prevalence of risky drinkers, meeting the TLFB > 3 (women) or >4 (men) drinks/day or>7 (women) or>14 (men) drinks/week, was 49.0%. Medium-risk drinking defined as an AUDIT score ≥ 8 was reported in 40.3%, and high-risk drinkers/probable AUD (AUDIT score ≥ 16) was met by 17.0% of the cohort. CONCLUSIONS Our results demonstrate the importance of comprehensive assessments for alcohol use, including self-report via multiple assessment tools administered by trained staff, as well as the addition of biomarkers for improved classification of subjects into different drinking categories.
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Affiliation(s)
- Tekeda F Ferguson
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Katherine P Theall
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Meghan Brashear
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Vincent Maffei
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Microbiology, Immunology, & Parasitology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans,, Louisiana
| | - Alaina Beauchamp
- Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Robert W Siggins
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Liz Simon
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Donald Mercante
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Steve Nelson
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Pulmonology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - David A Welsh
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Pulmonology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Patricia E Molina
- From the Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana.,Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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18
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Gonzalez Y, Kozachik SL, Hansen BR, Sanchez M, Finnell DS. Nurse-Led Delivery of Brief Interventions for At-Risk Alcohol Use: An Integrative Review. J Am Psychiatr Nurses Assoc 2020; 26:27-42. [PMID: 31509044 DOI: 10.1177/1078390319872536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND: Nurses are in key positions to reduce the global burden associated with alcohol, yet many are ill-prepared to screen for alcohol use and intervene accordingly. The purpose of this integrative review was to identify best practices for educating nurses to work with patients who are at risk for alcohol-related adverse consequences, implement alcohol screening, and deliver alcohol brief interventions (ABIs). AIMS: To identify and synthesize findings from randomized control trials of ABIs delivered by nurses to patients identified through screening to be at risk because of alcohol use. METHOD: The results of 11 published randomized control trials identified from a multi-database search were synthesized. RESULTS: The Alcohol Use Disorder Identification Test was used for alcohol screening in more than half of the studies. Most of the ABIs were based on motivational interviewing and delivered in 30 minutes or less. While there was limited information on the characteristics of nurses who delivered the interventions and how nurses were prepared to deliver the ABIs, the exemplar was a full day workshop teaching nurses on an evidence-based framework for the ABI. All studies measured alcohol consumption as an outcome, yet few used rigorous methods for obtaining this self-reported data. CONCLUSIONS: A 1-day workshop is recommended as an educational modality to prepare nurses to implement the Alcohol Use Disorder Identification Test for identification of persons who are at risk because of alcohol use, deliver a structured brief intervention in less than 30 minutes, and utilize a standard measure of alcohol consumption for evaluation.
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Affiliation(s)
- Yovan Gonzalez
- Yovan Gonzalez, DNP, FNP-BC, New York City Health and Hospitals/Gouverneur, New York, NY, USA
| | - Sharon L Kozachik
- Sharon L. Kozachik, PhD, RN, FAAN, Johns Hopkins University, Baltimore, MD, USA
| | - Bryan R Hansen
- Bryan R. Hansen, PhD, RN, APRN-CNS, ACNS-BC, Johns Hopkins University, Baltimore, MD, USA
| | - Michael Sanchez
- Michael Sanchez, DNP, ARNP, NP-C, FNP-BC, AAHIVS, Johns Hopkins University, Baltimore, MD, USA
| | - Deborah S Finnell
- Deborah S. Finnell, DNS, RN, CARN-AP, FAAN, Johns Hopkins University, Baltimore, MD, USA
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19
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Gilligan C, Anderson KG, Ladd BO, Yong YM, David M. Inaccuracies in survey reporting of alcohol consumption. BMC Public Health 2019; 19:1639. [PMID: 31805923 PMCID: PMC6896737 DOI: 10.1186/s12889-019-7987-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alcohol consumption estimates in public health predominantly rely on self-reported survey data which is likely to underestimate consumption volume. Surveys tend to ask specifically about standard drinks and provide a definition or guide in an effort to gather accurate estimates. This study aimed to investigate whether the inclusion of the term standard drinks with pictorial guide is associated with an adjustment in self-reported alcohol volume. METHODS A web-based survey was administered with AUDIT-C questions repeated at the beginning and end of the survey with and without the standard drink term and guide. The order in which respondents were presented with the different question types was randomised. Two cohorts of university/college students in NSW Australia (n = 122) and the US Pacific Northwest (n = 285) completed the survey online. RESULTS Australian students did not adjust their responses to questions with and without the standard drink term and pictorial guide. The US students were more likely to adjust their responses based on the detail of the question asked. Those US students who drank more frequently and in greater volume were less likely to adjust/apply a conversion to their consumption. CONCLUSIONS This study supports previous findings of the inaccuracy of alcohol consumption volume in surveys, but also demonstrates that an assumption of underestimation cannot be applied to all individual reports of consumption. Using additional questions to better understand drink types and serving sizes is a potential approach to enable accurate calculation of underestimation in survey data.
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Affiliation(s)
- Conor Gilligan
- University of Newcastle, School of Medicine and Public Health, University Drive Callaghan, Newcastle, NSW, 2308, Australia.
| | | | - Benjamin O Ladd
- Department of Psychology, Washington State University, 14204 NE Salmon Creek Ave, Vancouver, WA, 98686, Canada
| | - Yun Ming Yong
- University of Newcastle, School of Medicine and Public Health, University Drive Callaghan, Newcastle, NSW, 2308, Australia
| | - Michael David
- University of Newcastle, School of Medicine and Public Health, University Drive Callaghan, Newcastle, NSW, 2308, Australia
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20
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Reed MB, Woodruff SI, Holt M, DeMers G, Mattuecci M, Hurtado SL. The relationship between self-efficacy, readiness to change, and AUDIT risk levels in a sample of active duty emergency department patients. MILITARY PSYCHOLOGY 2019. [DOI: 10.1080/08995605.2019.1579607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Mark B. Reed
- School of Social Work, San Diego State University, San Diego, California
| | - Susan I. Woodruff
- School of Social Work, San Diego State University, San Diego, California
| | - Megan Holt
- Center for Alcohol and Drug Research Studies and Services, San Diego State University, San Diego, California
| | - Gerard DeMers
- Department of Emergency Medicine-EMS Division, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Michael Mattuecci
- Department of Emergency Medicine, US Naval Hospital Rota, Cádiz, Spain
| | - Suzanne L. Hurtado
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, Calilfornia
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21
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Zill JM, Christalle E, Meyer B, Härter M, Dirmaier J. The Effectiveness of an Internet Intervention Aimed at Reducing Alcohol Consumption in Adults. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 116:127-133. [PMID: 30940341 DOI: 10.3238/arztebl.2019.0127] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 03/05/2018] [Accepted: 12/18/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND In 2012, approximately 3.38 million people in Germany had an alcoholrelated disorder. Internet interventions can help lower alcohol consumption, albeit with mostly small effect sizes. It is still unclear whether the effectiveness of programs aimed at lowering alcohol consumption can be improved by individually adjusting program content for each participant. We studied the effectiveness of Vorvida, a new cognitive-behavioral internet intervention with individual adjustment of content. METHODS A randomized controlled trial was conducted on 608 adults with problematic alcohol consumption. The primary outcome was self-reported alcohol con - sumption in the past 30 days (as determined by the Quantity-Frequency-Index, QFI) and in the past 7 days (using the Timeline Follow-Back method, TFB). The secondary outcomes were drinking behavior (binge drinking/drunkenness) and satisfaction with Vorvida. Data were collected at three time points: at baseline (t0) and three and six months later (t1, t2). Trial registration: DRKS00006104. RESULTS The intention-to-treat (ITT) analysis revealed significant differences between groups at time t1 with respect to alcohol consumption (QFI: d = 0.28; TFB: d = 0.42), binge drinking (d = 0.87), and drunkenness (d = 0.39). Satisfaction with the intervention was high (27.4 [standard deviation, SD: 5.3] out of 32 points). All effects persisted, or were stronger, at time t2. Alcohol consumption, as measured by the QFI, declined over the interval from t0 to t2 in both groups: from 63.69 g/day (SD: 61.4) to 32.67 g/day (SD: 39.78) in the intervention group, and from 61.64 g/day (SD: 58.84) to 43.75 g/day (SD: 43.68) in the control group. CONCLUSION Vorvida was found to be effective in persons with risky, problematic alcohol consumption. Further studies should determine which elements of the program contribute most to effectiveness in routine clinical practice, and what long-term effects can be achieved.
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Affiliation(s)
- Jördis M Zill
- Institute and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf; GAIA AG, Hamburg, and Department of Psychology, City, University of London
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22
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Tapp D, Chenacher S, Gérard NPA, Bérubé-Mercier P, Gelinas C, Douville F, Desbiens JF. Observational Pain Assessment Instruments for Use With Nonverbal Patients at the End-of-life: A Systematic Review. J Palliat Care 2019; 34:255-266. [DOI: 10.1177/0825859718816073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To review studies pertaining to the reliability and validity of observational pain assessment tools for use with nonverbal patients at the end-of-life, a field of research not documented by previous systematic reviews. Methods: Databases (PubMed, Embase, Epistemonikos, the Cochrane Library, and CINAHL) were systematically searched for studies from study inception to February 21, 2016 (update in May 9, 2018). Two independent reviewers screened study titles, abstracts, and full texts according to inclusion and exclusion criteria. Disagreements were resolved through consensus. Reviewers also extracted the psychometrics properties of studies of observational pain assessment instruments dedicated to a noncommunicative population in palliative care or at the end-of-life. A comprehensive quality assessment was conducted using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) to derive poor, fair, good or excellent ratings for the psychometric tests reported in each study. Results: Four studies linked to 4 different tools met the inclusion criteria. Study populations included dementia, palliative care and severe illness in the context of intensive care. All the studies included in this review obtained poor COSMIN ratings overall. Conclusions: At this point, it is impossible to recommend any of the tools evaluated given the low number and quality of the studies. Other analyses and studies need to be conducted to develop, adapt, or further validate observational pain instruments for the end-of-life population, regardless of the disease.
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Affiliation(s)
- Diane Tapp
- Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada
- Quebec Heart and Lung Institute Research Center, Quebec City, Quebec, Canada
| | - Sara Chenacher
- Faculty of Pharmacy, Université Laval, Québec City, Quebec, Canada
| | | | - Philippe Bérubé-Mercier
- Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada
- Quebec Heart and Lung Institute Research Center, Quebec City, Quebec, Canada
| | - Celine Gelinas
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Frédéric Douville
- Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada
- Quebec Heart and Lung Institute Research Center, Quebec City, Quebec, Canada
| | - Jean-François Desbiens
- Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada
- Centre de recherche du centre hospitalier universitaire de Québec-Université Laval, Quebec City, Quebec, Canada
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23
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Dekker MR, Jongenelis MI, Wakefield M, Kypri K, Hasking P, Pettigrew S. A longitudinal examination of protective behavioral strategies and alcohol consumption among adult drinkers. Addict Behav 2018; 87:1-7. [PMID: 29936323 DOI: 10.1016/j.addbeh.2018.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/05/2018] [Accepted: 06/13/2018] [Indexed: 11/19/2022]
Abstract
Previous studies suggest that employing specific behavioral strategies when drinking can prevent excessive alcohol consumption and related harms. However, these studies have typically examined these 'protective behavioral strategies' (PBSs) in combination, limiting understanding of whether individual strategies differ in their effectiveness. Further, most existing research is cross-sectional in design, precluding the determination of causal relationships between PBS use and alcohol consumption. To address these research gaps, the present study sought to longitudinally (i) identify which individual PBSs are significantly related to reduced alcohol consumption over time and (ii) explore the effectiveness of individual PBSs among specific population groups. The sample comprised 1328 Australian adult drinkers (47% male) who completed an online survey assessing engagement in PBSs and alcohol consumption at two time points approximately four weeks apart. Reported enactment of the PBS 'Count your drinks' was associated with a significant reduction in alcohol consumption between T1 and T2. In contrast, enactment of the PBSs 'Ask a friend to let you know when you have had enough to drink', 'Put extra ice in your drink', 'Use a designated driver', and 'Leave drinking venues at a pre-determined time' was associated with an increase in alcohol consumption. The results thus suggest that many PBSs may not be effective in reducing alcohol consumption and that some may be associated with higher levels of intake. The results have implications for the development of harm-minimization campaigns designed to encourage drinkers to reduce their alcohol consumption.
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Affiliation(s)
- Maria R Dekker
- School of Psychology, Curtin University, Bentley, Western Australia 6102, Australia.
| | - Michelle I Jongenelis
- School of Psychology, Curtin University, Bentley, Western Australia 6102, Australia.
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria 3004, Australia.
| | - Kypros Kypri
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales 2308, Australia.
| | - Penelope Hasking
- School of Psychology, Curtin University, Bentley, Western Australia 6102, Australia.
| | - Simone Pettigrew
- School of Psychology, Curtin University, Bentley, Western Australia 6102, Australia.
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24
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Belita E, Yost J, Squires JE, Ganann R, Burnett T, Dobbins M. Measures assessing attributes of evidence-informed decision-making (EIDM) competence among nurses: a systematic review protocol. Syst Rev 2018; 7:181. [PMID: 30390711 PMCID: PMC6215345 DOI: 10.1186/s13643-018-0849-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/19/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There are growing professional expectations for nurses to engage in and develop competence in evidence-informed decision-making (EIDM) due to opportunities for improved client and community outcomes and provision of the highest quality of care. However, EIDM is underdeveloped, with low implementation rates among nurses. The use of indicators to assess EIDM performance has potential to encourage nurses' engagement in EIDM through competence recognition and support assessment of strengths and competency gaps for individual nurses and organizations. Currently, the state of evidence regarding measures that assess EIDM competence attributes (i.e., knowledge, skills, beliefs/values, behaviors) among nurses is unknown. This systematic review aims to address this gap through a narrative synthesis of the characteristics and psychometric properties of EIDM competence measures. METHODS The search strategy, developed in consultation with a Health Sciences Librarian, consists of online databases, contacting experts, hand searching reference lists, key journals, websites, conference proceedings, and grey literature. Studies will be included if the following criteria are met: (1) sample includes practicing nurses and data for nurses are reported separately; (2) conducted in any healthcare setting; (3) quantitative or mixed-methods design; (4) reports use or testing of a measure assessing EIDM competence attributes (i.e., knowledge, skills, attitudes/values, and/or behaviors); and (5) published in English. Screening will be conducted independently by two reviewers using a two-stage process: (1) title and abstract level; and (2) full-text level. Data extraction of study characteristics (e.g., sample, setting) will be conducted by a single reviewer and checked for accuracy by a second reviewer. Psychometric properties of acceptability, reliability, and validity evidence for each measure will be independently extracted by two reviewers. Data on measures will be synthesized narratively according to acceptability, number of validity evidence sources established, and reliability of scores. Data pertaining to population and healthcare setting will also be reported for each measure. DISCUSSION This systematic review will provide a current understanding about the state of evidence with respect to EIDM competence measures in nursing to assist in determining potentially relevant and robust measures for use in different nursing practice settings. SYSTEMATIC REVIEW REGISTRATION Protocol registered in PROSPERO Registration #: CRD42018088754.
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Affiliation(s)
- Emily Belita
- School of Nursing, McMaster University, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON, L8P 0A1, Canada.
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Janet E Squires
- School of Nursing/École des sciences infirmières, University of Ottawa/Université d'Ottawa, Ottawa, ON, Canada
| | - Rebecca Ganann
- School of Nursing, McMaster University, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Trish Burnett
- School of Nursing, McMaster University, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, McMaster Innovation Park (MIP), 175 Longwood Road South, Suite 210a, Hamilton, ON, L8P 0A1, Canada.,National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada
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