Bidirectional Influence: A Longitudinal Analysis of Size of Drug Network and Depression Among Inner-City Residents in Baltimore, Maryland

Success4life youth empowerment for promoting well-being and boosting mental health: Protocol for an experimental study

Background

There is an increasingly alarming worsening of mental health among the youth. There remain significant unmet needs for developing innovative, evidence-based technology–enhanced, positive psychology interventions (PPIs) all-inclusive in targeting psychological distress and risk factors related to high-risk behavior commonly encountered in adolescents.

Objective

We aim to assess the effectiveness of a hybrid (incorporating both synchronous and asynchronous learning) and holistic (targeting social and emotional learning and tackling risk factors unique for this age group) PPI, “success4life youth empowerment,” in improving well-being in the youth.

Methods

Students’ well-being will be assessed by the 5-item World Health Organization Well-Being Index, and hope will be assessed by the 6-item Children’s Hope Scale at week 0, week 8, and week 10, month 6, and month 12. Any improvement in well-being and hope will be measured, estimating the difference in postintervention (week 8 and week 10) and preintervention (week 0) scores by determining the P value and effect size using appropriate statistical tests.

Results

This study includes 2 phases: pilot phase 1, delivered by the creators of the succcess4life youth empowerment modules and platform, and phase 2, which will consist of the estimation of scalability through the recruitment of trainers. We hope to start student recruitment by 2022 and aim to complete the results for phase 1 pilot testing by 2023.

Conclusions

We anticipate that a primarily web-based, 10-week holistic PPI can support improvement in the mental wellness of the youth and has the potential for effective scalability.

International Registered Report Identifier (IRRID)

PRR1-10.2196/38463

The role of perceived friend depression and perceived stigma on self-reported depression among individuals who use drugs

Depression and substance use are highly comorbid, and stigmatized, mental health conditions influenced by social network factors. The objective of this study was to explore the role of perceived depression and perceived mental health stigma among friends on self-reported depression over time. Between 2009 and 2012, 527 participants who used drugs completed baseline and 6-month follow-up surveys in Baltimore, Maryland. Logistic regression was used to assess whether perceived depression and stigma among friends were associated with personal depressive status before and after accounting for depressive status at baseline. A total of 309 participants (58.6%) had depressive symptoms at baseline, while 207 participants (39.3%) had depressive symptoms at follow-up. Not accounting for baseline depression, perceiving friends as being depressed (adjusted odds ratio [AOR] = 1.32, 95% confidence interval [CI] [1.12, 1.56]) and as having stigmatizing attitudes toward mental health conditions (AOR = 1.92, 95% CI [1.31, 2.79]) were associated with increased odds of personal depression. After accounting for baseline depression, the relationship between personal depression and perceived stigma was marginally significant, while the relationship between personal depression and perceived depression among friends was attenuated. These results suggest that baseline depression is the largest predictor of follow-up depression. Future research should explore whether specific aspects of perceived stigma independently account for personal depression.

Injection Drug Network Characteristics Are Important Markers of HIV Risk Behavior and Lack of Viral Suppression

BACKGROUND

People who inject drugs (PWID) who are highly connected within their injection drug networks may be important HIV transmission nodes if they frequently share syringes with other PWID and are not engaged in HIV care. In India, HIV transmission fueled by injection drug use is increasing; however, little is known about the associations between injection network size and syringe sharing and viral suppression.

METHODS

We recruited 14,481 PWID between October 2012 and December 2013 by respondent-driven sampling across 15 sites in India. Interviewer-administered questionnaires assessed network characteristics, substance use, HIV testing experience, and access to health services. We used multilevel logistic regression modeling to evaluate the relationship between injection drug network size and (1) syringe sharing at last injection and (2) viral suppression among HIV-positive participants (<150 copies/mL).

FINDINGS

The median injection network size was 3 (interquartile range: 1-5), and 7% of participants injected with >10 members in the past 30 days. PWID who had >10 members in their network were 1.65 times (95% confidence interval: 1.12 to 2.42, P = 0.0111) more likely to have shared a syringe at last injection compared with those in the 0-1 members in their drug networks. In addition, individuals with the largest injection drug networks were 31% (95% confidence interval: 0.53 to 0.90, P = 0.006) less likely to be virally suppressed compared with those in the smallest injection drug networks.

DISCUSSION

Individuals with larger networks may be important in HIV transmission within injection drug networks because they were the most likely to engage in recent syringe sharing and least likely to be virally suppressed.