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Freisthler B, Wolf JP. Effects of the Sacramento Neighborhood Alcohol Prevention Project on rates of child abuse and neglect 7 years post-implementation (1999-2010). Drug Alcohol Rev 2024; 43:848-852. [PMID: 38288946 PMCID: PMC11052668 DOI: 10.1111/dar.13811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/07/2023] [Accepted: 01/07/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Evaluations of alcohol environmental prevention efforts examine short-term effects of these interventions on alcohol-related problems. We examine whether the effects of the Sacramento Neighborhood Alcohol Prevention Project (SNAPP), an alcohol environmental intervention aimed to reduce alcohol-related problems in two neighbourhoods, on child abuse and neglect remained 7 years post-implementation. METHODS SNAPP used a quasi-experimental non-equivalent control group design, where intervention activities occurred in the South area, followed by those in the North area 2 years later. Our sample size is 3912 space-time units (326 census block groups × 12 years [1999-2010]). Outcomes were measured at the household level and included: (i) all foster care entries total; and (ii) the subset of foster care entries that were alcohol related. Data were analysed using Bayesian conditionally autoregressive space-time models. RESULTS We find that the decreases in total (relative rate [RR] = 0.882, 95% credible interval [CrI] 0.795, 0.980) and alcohol-related (RR = 0.888, 95% CrI 0.791, 0.997) foster care entries remain in the North intervention area although the magnitude of those changes are smaller than immediately post-intervention. Increases found in alcohol-related foster care entries in the South area immediately post-intervention were not significant 7 years later (RR = 1.128, 95% CrI 0.975, 1.307). DISCUSSION AND CONCLUSIONS Reductions in child abuse and neglect due to an alcohol environmental intervention can be maintained. Environmental interventions that provide community-level primary prevention strategies could be more easily sustained and more cost effective than individual-level interventions, although more research is needed to identify why interventions may be successful in specific contexts and not others.
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Glasgow L, Douglas C, Sprunger JG, Campbell ANC, Chandler R, Dasgupta A, Holloway J, Marks KR, Roberts SM, Martinez LS, Thompson K, Weiss RD, Aldridge A, Asman K, Barbosa C, Blevins D, Chassler D, Cogan L, Fanucchi L, Hall ME, Hunt T, Jadovich E, Levin FR, Lincourt P, Lofwall MR, Loukas V, McAlearney AS, Nunes E, Oga E, Oller D, Rudorf M, Sullivan AM, Talbert J, Taylor A, Teater J, Vandergrift N, Woodlock K, Zarkin GA, Freisthler B, Samet JH, Walsh SL, El-Bassel N. Effect of the Communities that HEAL intervention on receipt of behavioral therapies for opioid use disorder: A cluster randomized wait-list controlled trial. Drug Alcohol Depend 2024; 259:111286. [PMID: 38626553 DOI: 10.1016/j.drugalcdep.2024.111286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND The U.S. opioid overdose crisis persists. Outpatient behavioral health services (BHS) are essential components of a comprehensive response to opioid use disorder and overdose fatalities. The Helping to End Addiction Long-Term® (HEALing) Communities Study developed the Communities That HEAL (CTH) intervention to reduce opioid overdose deaths in 67 communities in Kentucky, Ohio, New York, and Massachusetts through the implementation of evidence-based practices (EBPs), including BHS. This paper compares the rate of individuals receiving outpatient BHS in Wave 1 intervention communities (n = 34) to waitlisted Wave 2 communities (n = 33). METHODS Medicaid data included individuals ≥18 years of age receiving any of five BHS categories: intensive outpatient, outpatient, case management, peer support, and case management or peer support. Negative binomial regression models estimated the rate of receiving each BHS for Wave 1 and Wave 2. Effect modification analyses evaluated changes in the effect of the CTH intervention between Wave 1 and Wave 2 by research site, rurality, age, sex, and race/ethnicity. RESULTS No significant differences were detected between intervention and waitlisted communities in the rate of individuals receiving any of the five BHS categories. None of the interaction effects used to test the effect modification were significant. CONCLUSIONS Several factors should be considered when interpreting results-no significant intervention effects were observed through Medicaid claims data, the best available data source but limited in terms of capturing individuals reached by the intervention. Also, the 12-month evaluation window may have been too brief to see improved outcomes considering the time required to stand-up BHS. TRIAL REGISTRATION Clinical Trials.gov http://www. CLINICALTRIALS gov: Identifier: NCT04111939.
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Affiliation(s)
| | | | - Joel G Sprunger
- University of Cincinnati College of Medicine, University of Cincinnati Center for Addiction Research, Cincinnati, OH, USA
| | - Aimee N C Campbell
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY, USA
| | - Redonna Chandler
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Anindita Dasgupta
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY, USA
| | | | - Katherine R Marks
- Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities, Frankfort, KY, USA
| | - Sara M Roberts
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Katherine Thompson
- University of Kentucky, Dr. Bing Zhang Department of Statistics, Lexington, KY, USA
| | - Roger D Weiss
- McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | | | - Kat Asman
- RTI International, Research Triangle Park, NC, USA
| | | | - Derek Blevins
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Lindsay Cogan
- New York State Department of Health, Office of Quality and Patient Safety, New York, NY, USA
| | - Laura Fanucchi
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - Megan E Hall
- RTI International, Research Triangle Park, NC, USA
| | - Timothy Hunt
- Columbia University School of Social Work, New York, NY, USA
| | | | - Frances R Levin
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Patricia Lincourt
- New York State Office of Addiction Services and Supports, Albany, NY, USA
| | | | | | | | - Edward Nunes
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY, USA
| | - Emmanuel Oga
- RTI International, Research Triangle Park, NC, USA
| | - Devin Oller
- University of Kentucky College of Medicine, Lexington, KY, USA
| | | | | | - Jeffery Talbert
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - Angela Taylor
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - Julie Teater
- Ohio State University College of Medicine, Columbus, OH, USA
| | | | | | | | | | - Jeffrey H Samet
- Boston University and Boston Medical Center, Boston, MA, USA
| | - Sharon L Walsh
- University of Kentucky College of Medicine, Lexington, KY, USA
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Sarabia JR, Dellor E, Freisthler B, Kieninger K. Exploring the association between post-critical incident intervention preferences and self-reported coping self-efficacy among firefighters. J Trauma Stress 2024. [PMID: 38476048 DOI: 10.1002/jts.23029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/14/2024]
Abstract
Critical incident stress debriefing (CISD) is a commonly utilized intervention in the fire service that aims to minimize psychological harm and adverse mental health outcomes after a potentially traumatic incident. This study aimed to explore firefighter preferences regarding CISD and alternative post-critical incident interventions in relation to firefighter coping self-efficacy (FFCSE) and trauma coping self-efficacy (CSE-T). Firefighters (N = 241) completed an online survey and provided complete data. Most participants were White (n = 203, 84.2%), non-Hispanic (n = 221, 91.7%) men (94.2%; n = 227). CISD was the most preferred intervention among firefighters (n = 113, 46.9%) as compared to informal peer support (n = 31, 12.9%), formal one-on-one counseling (n = 29, 12.0%), and no intervention (n = 68, 28.2%). Firefighters who preferred CISD had statistically significant lower levels of FFCSE, R2 = .033-.044, ps = .012-.030, and CSE-T, R2 = .035-.061 ps = .017-.024, compared to those who preferred no intervention. Firefighters who preferred formal one-on-one counseling had statistically significantly lower levels of FFCSE, R2 = .033-.044, ps = .003-.011, and CSE-T, R2 = .035-0.061, p < .001-p = .002, compared to those who preferred no intervention. The findings from this study may guide future research to increase knowledge on firefighter intervention preferences and the association between preference and coping self-efficacy.
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Affiliation(s)
- Joselyn R Sarabia
- College of Social Work, The Ohio State University, Colombus, Ohio, USA
| | - Elinam Dellor
- College of Social Work, The Ohio State University, Colombus, Ohio, USA
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Stopka TJ, Babineau DC, Gibson EB, Knott CE, Cheng DM, Villani J, Wai JM, Blevins D, David JL, Goddard-Eckrich DA, Lofwall MR, Massatti R, DeFiore-Hyrmer J, Lyons MS, Fanucchi LC, Harris DR, Talbert J, Hammerslag L, Oller D, Balise RR, Feaster DJ, Soares W, Zarkin GA, Glasgow L, Oga E, McCarthy J, D’Costa L, Chahine R, Gomori S, Dalvi N, Shrestha S, Garner C, Shadwick A, Salsberry P, Konstan MW, Freisthler B, Winhusen J, El-Bassel N, Samet JH, Walsh SL. Impact of the Communities That HEAL Intervention on Buprenorphine-Waivered Practitioners and Buprenorphine Prescribing: A Prespecified Secondary Analysis of the HCS Randomized Clinical Trial. JAMA Netw Open 2024; 7:e240132. [PMID: 38386322 PMCID: PMC10884876 DOI: 10.1001/jamanetworkopen.2024.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/03/2024] [Indexed: 02/23/2024] Open
Abstract
Importance Buprenorphine significantly reduces opioid-related overdose mortality. From 2002 to 2022, the Drug Addiction Treatment Act of 2000 (DATA 2000) required qualified practitioners to receive a waiver from the Drug Enforcement Agency to prescribe buprenorphine for treatment of opioid use disorder. During this period, waiver uptake among practitioners was modest; subsequent changes need to be examined. Objective To determine whether the Communities That HEAL (CTH) intervention increased the rate of practitioners with DATA 2000 waivers and buprenorphine prescribing. Design, Setting, and Participants This prespecified secondary analysis of the HEALing Communities Study, a multisite, 2-arm, parallel, community-level, cluster randomized, open, wait-list-controlled comparison clinical trial was designed to assess the effectiveness of the CTH intervention and was conducted between January 1, 2020, to December 31, 2023, in 67 communities in Kentucky, Massachusetts, New York, and Ohio, accounting for approximately 8.2 million adults. The participants in this trial were communities consisting of counties (n = 48) and municipalities (n = 19). Trial arm randomization was conducted using a covariate constrained randomization procedure stratified by state. Each state was balanced by community characteristics including urban/rural classification, fatal opioid overdose rate, and community population. Thirty-four communities were randomized to the intervention and 33 to wait-list control arms. Data analysis was conducted between March 20 and September 29, 2023, with a focus on the comparison period from July 1, 2021, to June 30, 2022. Intervention Waiver trainings and other educational trainings were offered or supported by the HEALing Communities Study research sites in each state to help build practitioner capacity. Main Outcomes and Measures The rate of practitioners with a DATA 2000 waiver (overall, and stratified by 30-, 100-, and 275-patient limits) per 100 000 adult residents aged 18 years or older during July 1, 2021, to June 30, 2022, were compared between the intervention and wait-list control communities. The rate of buprenorphine prescribing among those waivered practitioners was also compared between the intervention and wait-list control communities. Intention-to-treat and per-protocol analyses were performed. Results A total of 8 166 963 individuals aged 18 years or older were residents of the 67 communities studied. There was no evidence of an effect of the CTH intervention on the adjusted rate of practitioners with a DATA 2000 waiver (adjusted relative rate [ARR], 1.04; 95% CI, 0.94-1.14) or the adjusted rate of practitioners with a DATA 2000 waiver who actively prescribed buprenorphine (ARR, 0.97; 95% CI, 0.86-1.10). Conclusions and Relevance In this randomized clinical trial, the CTH intervention was not associated with increases in the rate of practitioners with a DATA 2000 waiver or buprenorphine prescribing among those waivered practitioners. Supporting practitioners to prescribe buprenorphine remains a critical yet challenging step in the continuum of care to treat opioid use disorder. Trial Registration ClinicalTrials.gov Identifier: NCT04111939.
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Affiliation(s)
- Thomas J. Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | | | - Erin B. Gibson
- Department of Medicine, Boston Medical Center, Boston, Massachusetts
| | - Charles E. Knott
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - Debbie M. Cheng
- Boston University School of Public Health, Boston, Massachusetts
| | - Jennifer Villani
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Jonathan M. Wai
- Department of Psychiatry, Columbia University; Division on Substance Use Disorders, New York State Psychiatric Institute, New York
| | - Derek Blevins
- Department of Psychiatry, Columbia University; Division on Substance Use Disorders, New York State Psychiatric Institute, New York
| | - James L. David
- Department of Psychiatry, Columbia University; Division on Substance Use Disorders, New York State Psychiatric Institute, New York
| | - Dawn A. Goddard-Eckrich
- Department of Psychiatry, Columbia University; Division on Substance Use Disorders, New York State Psychiatric Institute, New York
| | - Michelle R. Lofwall
- College of Medicine, University of Kentucky Center on Drug and Alcohol Research, Lexington
| | - Richard Massatti
- Ohio Department of Mental Health and Addiction Services, Columbus
| | | | | | - Laura C. Fanucchi
- College of Medicine, University of Kentucky Center on Drug and Alcohol Research, Lexington
| | | | | | - Lindsey Hammerslag
- College of Medicine, University of Kentucky Center on Drug and Alcohol Research, Lexington
| | - Devin Oller
- College of Medicine, University of Kentucky Center on Drug and Alcohol Research, Lexington
| | - Raymond R. Balise
- Department of Public Health Sciences, University of Miami, Miami, Florida
| | - Daniel J. Feaster
- Department of Public Health Sciences, University of Miami, Miami, Florida
| | - William Soares
- UMass Chan Medical School–Baystate, Springfield, Massachusetts
| | - Gary A. Zarkin
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - LaShawn Glasgow
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - Emmanuel Oga
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - John McCarthy
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - Lauren D’Costa
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - Rouba Chahine
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - Steve Gomori
- Research Triangle Institute, Research Triangle Park, North Carolina
| | - Netrali Dalvi
- Office of Prescription Monitoring and Drug Control, Massachusetts Department of Public Health, Boston
| | - Shikhar Shrestha
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | | | - Aimee Shadwick
- RecoveryOhio, Office of Ohio Governor Mike DeWine, Columbus
| | - Pamela Salsberry
- Health Behavior and Health Promotion, Ohio State University, Columbus
| | | | | | - John Winhusen
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Nabila El-Bassel
- Department of Psychiatry, Columbia University; Division on Substance Use Disorders, New York State Psychiatric Institute, New York
| | - Jeffrey H. Samet
- Department of Medicine, Boston Medical Center, Boston, Massachusetts
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Sharon L. Walsh
- College of Medicine, University of Kentucky Center on Drug and Alcohol Research, Lexington
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Freisthler B. We Have More Tools to Support At-Risk Families Than Just Child Protective Services With Mandated Reporting. JAMA Pediatr 2024; 178:96. [PMID: 37955892 DOI: 10.1001/jamapediatrics.2023.4904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
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Freisthler B, Sarabia J, Price Wolf J. Using ecological momentary assessments to understand how drinking during special occasions relates to parenting behaviors. Alcohol Clin Exp Res (Hoboken) 2023; 47:2343-2353. [PMID: 38088803 DOI: 10.1111/acer.15206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/30/2023] [Accepted: 10/04/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Drinking on special occasions (e.g., Super Bowl, Christmas) often results in more alcohol consumed. Further, police often report higher levels of crime, such as assaults and domestic violence, on days of major sporting events (e.g., Super Bowl, World Cup). Yet, drinking behaviors of parents during special occasions or large sporting events have not been assessed for their effects on parenting behaviors. Here, we assess the relationship between drinking during the Super Bowl and on Valentine's Day to determine whether they differ. METHODS Participants, recruited from social media, completed a 40-min baseline survey and 14 days of three daily Ecological Momentary Assessments (EMAs) about parenting. Two hundred fifty-five participants (with 684 EMAs) were enrolled on the Super Bowl and 184 (492 EMAs) were enrolled on Valentine's day. Measures of parenting include aggressive, punitive, and nonpunitive discipline and positive techniques. Drinking was assessed on days 7 and 14 of the EMA and corresponded to the EMA time frame during the previous week. Participants were largely White, well-educated mothers. Data were analyzed using multilevel logistic regression models. RESULTS Parents who reported drinking on the day of the Super Bowl were more likely to use aggressive discipline (OR = 2.560; 95% CI: 1.308, 5.150) and punitive parenting (OR = 2.701; 95% CI: 1.394, 5.257) during the time that drinking occurred. In contrast, parents who reported drinking on Valentine's Day were less likely to use aggressive discipline (OR = 0.197; 95% CI: 0.077, 0.502). CONCLUSIONS The differential relationship between drinking and parenting measures could be the result of differing norms or differences in who is present during the special occasions studied here. Identifying and understanding how alcohol use on special occasions contributes to parenting could help to create environments that are most conducive to positive parenting behaviors and reduce harms related to harsh or aggressive parenting.
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Affiliation(s)
| | - Joselyn Sarabia
- College of Social Work, The Ohio State University, Columbus, Ohio, USA
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Littleton T, Freisthler B. Affordable Housing and Neighborhood Child Maltreatment Reports. Child Maltreat 2023:10775595231218177. [PMID: 37994644 DOI: 10.1177/10775595231218177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Reports of child maltreatment vary by neighborhood characteristics, yet the influence of housing affordability is less understood. The current study examines the relationship between reports of suspected child maltreatment and the spatial distribution of affordable housing across 2,341 census tracts in Los Angeles County, California. Bayesian conditionally autoregressive model results indicate that neighborhoods where residents paid a greater share of their income in rent had fewer reports of suspected child maltreatment, while neighborhoods with a higher number of subsidized rental units had more reports. These findings suggest that higher cost neighborhoods provide supportive resources and amenities to families which may reduce risk of child maltreatment. Subsidized housing units are more likely to be located in high poverty, under resourced neighborhoods, thus undermining the benefits of these programs to families. These findings have implications for equitable housing policy that promotes inclusive communities as a primary prevention strategy for child maltreatment.
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Freisthler B, Hyder A, Lancaster KE, Louden EM, Rinderle AM. Response to "COVID-19 economic impact payments and opioid overdose deaths". Int J Drug Policy 2023; 121:103713. [PMID: 35523654 PMCID: PMC9065385 DOI: 10.1016/j.drugpo.2022.103713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 1947N. College Road Columbus, OH 43210, USA.
| | - Ayaz Hyder
- Division of Environmental Health Sciences, College of Public Health and Translational Data Analytics Institute, The Ohio State University, 1841 Neil Ave., Columbus, OH 43210, USA.
| | - Kathryn E Lancaster
- Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Ave., Columbus, OH 43210, USA.
| | - Elaine M Louden
- Department of Health Policy and Management, Yale School of Public Health, Yale University, 60 College St, New Haven, CT 06510, USA.
| | - Abigail Marie Rinderle
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599, USA.
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Freisthler B, Kranich C, Price Wolf J, Boyd R, Gruenewald PJ. Neighborhood market potentials for alcohol use and rates of child abuse and neglect. Alcohol Clin Exp Res 2023; 47:143-154. [PMID: 36373348 DOI: 10.1111/acer.14975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/14/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alcohol use can lead to child abuse and neglect even if the person using alcohol does not use heavily. Yet relatively few measures that reflect alcohol use are available at smaller geographic units. We assess whether the estimated level of total alcohol use per capita is related to measures of child abuse and neglect that include substantiated reports of maltreatment, total entries into foster care, and alcohol-related entries into foster care. METHODS Our sample consists of 326 Census block groups in Sacramento, California over three time points (978 space-time units). Administrative data for substantiations of child abuse and neglect and foster care entries are our outcomes. We create market potentials for alcohol use among 18- to 29-year-olds as our primary independent variable. Data are analyzed using Bayesian conditionally autoregressive spatio-temporal models. RESULTS Higher alcohol use potentials (as measured by total volume per capita of 18- to 29-year olds) are related to more children entering foster care due to drinking-related concerns by a parent or caregiver (RR = 1.032, 95% CI = [1.013, 1.051]), but not total substantiations for foster care entries. Neighborhoods with higher total volume of alcohol per 18- to 29-year-olds had more foster care entries when we used number of substantiations as the denominator (RR = 1.012, 95% CI = [1.0001, 1.023]) but were not related to foster care entries with alcohol misuse as a concern as a subset of all foster care entries. CONCLUSIONS Higher estimated volume of alcohol use per capita among young adults (aged 18 to 29) was related to more children entering foster care due to alcohol-related concerns. Reducing alcohol supply in alcohol outlets, specifically through off-premise establishments, might reduce rates for all entries into foster care or other out-of-home placement and substantiated child abuse and neglect.
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Affiliation(s)
| | - Christiana Kranich
- Ohio Colleges of Medicine Government Resource Center, The Ohio State University, Ohio, Columbus, USA
| | - Jennifer Price Wolf
- College of Social Work, San Jose State University, California, San Jose, USA
| | - Reiko Boyd
- Graduate College of Social Work, University of Houston, Texas, Houston, USA
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, CA, Berkeley, USA
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Freisthler B, Thurston H, Price Wolf J. Assessing the effects of the Sacramento Neighborhood Alcohol Prevention Project (SNAPP) on child abuse and neglect. Child Abuse Negl 2023; 135:105957. [PMID: 36442418 PMCID: PMC9839649 DOI: 10.1016/j.chiabu.2022.105957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/22/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The role of alcohol use in the etiology of abusive and neglectful parenting is significant. We examined how the Sacramento Neighborhood Alcohol Prevention Project (SNAPP) may have reduced rates of substantiated child maltreatment, entries into foster care, and entries into foster care where alcohol use was a factor. PARTICIPANTS AND SETTING The study sample is 326 Census block groups: 21 and 16 in the South and North intervention areas, respectively, and 289 in the At-Large comparison area in Sacramento, California. METHODS SNAPP used a quasi-experimental design to reduce alcohol supply and alcohol-related problems among 15-29 year olds in two economically, racially, and ethnically diverse neighborhoods. The dependent variables are substantiated child abuse and neglect; total foster care entries; and alcohol-related foster care entries. RESULTS Substantiated child abuse and neglect was inconclusive for both intervention areas. In the North, total (RR = 0.822, 95 % CI [0.721, 0.933]) and alcohol-related (RR = 0.760, 95 % CI [0.634, 0.914]) foster care entries decreased by 17.8 % and 24.0 %, respectively. Intervention effects in the South were not well-supported for foster care entries (RR = 1.118, 95 % CI [0.988, 1.258]), but increased alcohol-related foster care entries (RR = 1.264, 95 % CI [1.075, 1.484]). CONCLUSIONS Environmental intervention strategies may be effective at reducing child abuse and neglect. However, given the mixed findings from our work, we need to identify under what conditions these interventions work best and whether some components of these strategies (e.g. awareness vs. enforcement of underage sales) differentially affect child abuse and neglect.
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Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210, United States of America.
| | - Holly Thurston
- College of Social Work, The Ohio State University, 1947 College Rd. N, Columbus, OH 43210, United States of America
| | - Jennifer Price Wolf
- School of Social Work, San Jose State University, 1 Washington Square, San Jose, CA, 95112, United States of America.
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Freisthler B, Price Wolf J. Longitudinal Changes in Self-Reported Alcohol Consumption by Mothers’ During the COVID-19 Pandemic. Alcohol Alcohol 2022; 58:235-237. [PMID: 36521494 PMCID: PMC10168707 DOI: 10.1093/alcalc/agac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/30/2022] [Accepted: 11/05/2022] [Indexed: 12/23/2022] Open
Abstract
Abstract
Previous research shows that drinking by mothers was higher during the initial stages of the pandemic. Less is known about whether these drinking levels were maintained years after the first stay-at-home orders. Using three waves of data, each approximately a year apart, drinks per day remain elevated, whereas drinking frequency and continued volume have decreased during subsequent waves.
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Affiliation(s)
- Bridget Freisthler
- The Ohio State University College of Social Work, , 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210 , USA
| | - Jennifer Price Wolf
- San Jose State University School of Social Work, , 1 Washington Square, San Jose, CA 95112 , USA
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Thurston H, Freisthler B, Wolf JP. Contrasting Methods of Measurement in Spatial Analyses Examining the Alcohol Environment and Child Maltreatment. Child Maltreat 2022; 27:515-526. [PMID: 34452587 DOI: 10.1177/10775595211040756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Child physical abuse is a major public health issue in the United States. Environmental child welfare research has focused on neighborhood characteristics and the influence of alcohol and marijuana establishments. To our knowledge, child welfare studies have singularly examined the outcome in terms of victims, that is, at the level of child population, and have not considered the parent population. Thus, in this exploratory study, we use spatial scan statistics to analyze patterns of child physical abuse at the child and household level, and we use Bayesian hierarchical spatial conditional autoregressive models to determine the relative influence of alcohol availability and other environmental factors. We find that household clusters are nested in child clusters and that controlling for alcohol establishments reduces cluster size. In the Bayesian regression models, alcohol availability increased risk slightly, while neighborhood diversity (measured using Blau's Index) elevated risk considerably. Immediate implications for child welfare agencies are discussed.
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Affiliation(s)
- Holly Thurston
- College of Social Work, 2647The Ohio State University, Columbus, OH, USA
| | - Bridget Freisthler
- College of Social Work, 2647The Ohio State University, Columbus, OH, USA
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13
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Oh S, Salas-Wright CP, Vaughn MG, Freisthler B. Prescription Drug Misuse Among U.S. Mothers of Minor Children in 2015-2019: Trends, Profiles, and Behavioral Health Comorbidities. J Stud Alcohol Drugs 2022; 83:712-720. [PMID: 36136442 DOI: 10.15288/jsad.21-00343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Despite the persistent and elevated risks of prescription drug misuse (PDM) among parenting mothers in the United States, few population-based studies of this phenomenon have been conducted. To address this gap, the present study examined the latest PDM trends and patterns among parenting mothers and assessed their behavioral health comorbidities and treatment utilization. METHOD Data were derived from a nationally representative U.S. sample of parenting mothers recruited for the 2015-2019 National Survey on Drug Use and Health. After examining PDM trends since 2015, we conducted a latent class analysis to identify distinctive PDM patterns among mothers reporting past-year PDM (n = 3,042). Associations between class membership and behavioral health comorbidities/treatment receipt were tested. RESULTS We found increasing PDM trends among unmarried Hispanic mothers since 2015, whereas no notable changes were observed for other racial/ethnic groups. Of the mothers reporting past-year PDM, nearly 50% were likely to misuse prescription stimulants with alcohol/marijuana (17.9%) or multiple prescription drugs (31.7%). Specifically, the Poly-Prescription Drug Misuse group reported greater risks of illicit drug use and mental disorders than the Prescription Opioids Misuse group. CONCLUSIONS Our findings suggest that special attention is needed for PDM among unmarried Hispanic (for recent increasing trends) and White (for persistently higher rates) mothers as well as mothers misusing multiple prescription drugs. Their distinctive PDM patterns as well as heightened behavioral health comorbidities and low treatment receipt suggest the need for a screening and treatment referral system that addresses the unique treatment needs and barriers facing parenting mothers.
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Affiliation(s)
- Sehun Oh
- College of Social Work, The Ohio State University, Columbus, Ohio
| | | | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri
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14
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Freisthler B, Wernekinck U. Examining how the geographic availability of alcohol within residential neighborhoods, activity spaces, and destination nodes is related to alcohol use by parents of young children. Drug Alcohol Depend 2022; 233:109352. [PMID: 35176631 PMCID: PMC8957591 DOI: 10.1016/j.drugalcdep.2022.109352] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alcohol outlet density and drinking behaviors have been assessed based on where people live, but exposure may differ based on where people spend time. We assessed the relationship between alcohol outlet density (using three measures of geographic availability), frequency of use, and continued volume of alcohol among parents. Parents are a unique population of drinkers where the risk for harm to others can be higher as they are caring for minor children. METHODS We conducted a cross-sectional telephone and web-based survey of 1599 parents in 2015 across 30 cities in California. Participants provided information on drinking, residential addresses, and locations of daily activities. We created three measures of alcohol availability using residential neighborhoods, convex hull polygons, and destination nodes. Data were analyzed using zero-inflated negative binomial models. RESULTS Density of bars in residential neighborhoods were related to more frequent drinking (b = 0.0139, 95% CI = 0.0016, 0.0261) and higher continued volume (b = 0.0295, 95% CI = 0.0067, 0.0522). Density of bars (b = 0.0070, 95% CI = 0.0019, 0.0121) and restaurants (b = 0.0018, 95% CI = 0.0003, 0.0033) in destination nodes were related to drinking a higher continued volume of alcohol. Higher off-premise outlet density was related to a lower continued volume (b = -0.0026, 95% CI = -0.0049, -0.0002). CONCLUSIONS Outlet densities in residential neighborhood and destination nodes are related to frequency of drinking and continued volume of alcohol. Future work should seek to determine why and how residential neighborhoods and nodes are related to alcohol use behaviors and if they differ for parents compared to other adults.
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Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210, USA.
| | - Uwe Wernekinck
- College of Social Work, The Ohio State University, 1947 College Rd. N, Columbus, OH 43210, USA.
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15
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Abstract
The changing legal status of marijuana in the United States has increased access to the drug through medical marijuana dispensaries. Limited research exists that examines the effects of these dispensaries on social problems including child maltreatment. The current study examines how medical marijuana dispensaries may affect referrals for child abuse and neglect investigations. Data are analyzed from 2,342 Census tracts in Los Angeles County, California. Locations of medical marijuana dispensaries were obtained through Weedmaps.com. Using conditionally autoregressive models, local and spatially lagged dispensaries show a positive relationship to rates of referrals in the unadjusted models. However, when we adjust for alcohol outlet density and measures of social disorganization, this relationship is no longer significant. Although this study does not find a relationship between medical marijuana dispensaries and referrals for investigations of child maltreatment, it should not be considered a definitive finding of this relationship. The increasing number of states that are allowing marijuana to be used for medical and recreational purposes is resulting in more people using the drug and the effects on parenting are still unknown.
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16
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Freisthler B, Michaels N, Wolf JP. Families in Crisis: The Relationship Between Opioid Overdoses and Child Maltreatment in Neighborhood Areas. J Stud Alcohol Drugs 2022. [DOI: 10.15288/jsad.2022.83.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Nichole Michaels
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Jennifer Price Wolf
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
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17
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Freisthler B, Price Wolf J, Chadwick C, Renick K. Daily Stress and Use of Aggressive Discipline by Parents during the COVID-19 Pandemic. J Fam Violence 2022; 37:1101-1109. [PMID: 34866772 PMCID: PMC8626281 DOI: 10.1007/s10896-021-00340-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 05/07/2023]
Abstract
To assess the relationship between stress throughout the day and aggressive discipline practices by parents during COVID-19 stay at home orders. For this study, participants took baseline survey online, then provided data three times a day (10 a.m., 3 p.m., and 9 p.m.) for 14 consecutive days using Ecological Momentary Assessment procedures. Data were collected from 323 participants, covering 9,357 observations from April 13 to May 27, 2020 in Central Ohio during stay-at-home orders due to COVID-19. Use of aggressive discipline, including corporal punishment and psychological aggression, was measured using the Dimensions of Discipline Inventory. For each higher level of stress, parents had 1.3 greater odds of using aggressive discipline. Having used aggressive discipline at baseline was related to three times greater odds of using it during the study period. Higher situational stress was associated with use of aggressive parenting. When combined with less contact with mandatory reporters, this places children at risk for abuse and neglect that may go without detection and intervention for longer time-periods. First responders and medical professionals become more important in identifying and reporting suspected child maltreatment, as this may be a child's only contact with a mandated professional for six months to a year. Well child visits, routine vaccinations, and problem-focused care are important opportunities to assess parents' stress and discipline practices that may be suggestive of abuse or neglect.
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Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210 USA
| | - Jennifer Price Wolf
- School of Social Work, San Jose State University, 1 Washington Square, San Jose, CA 95112 USA
| | - Caileigh Chadwick
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210 USA
| | - Katherine Renick
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210 USA
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18
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Cooke A, Chavez L, Freisthler B. The relationships between chronic pain and changes in health with cannabis consumption patterns. Int J Drug Policy 2021; 76:102657. [PMID: 31931439 DOI: 10.1016/j.drugpo.2019.102657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 12/18/2019] [Accepted: 12/29/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Pain is the most common reason endorsed by patients seeking medical cannabis. Given the nature of chronic pain, it is particularly important to understand consumption patterns for patients who use cannabis for chronic health conditions to evaluate how frequency of use might impact overall health and functioning. This analysis examines whether levels of chronic pain were associated with cannabis consumption patterns, after controlling for patient-level differences in demographics. METHODS Our sample included 295 medical cannabis patients. Logistic regression models were fit to evaluate the association between pain (low, moderate and high) and dichotomous measures of cannabis consumption (daily vs. nondaily; ≥3 times per day vs. <3 times per day). Additionally, two ordered logit models were fit to evaluate the association between past-year health status change (better, same, or worse) and cannabis consumption. RESULTS A significantly higher proportion of respondents in the high pain category used cannabis 3 or more times per day, compared to lower pain categories. Pain level was not significantly associated with daily cannabis use. However, pain level was significantly associated with log odds of using cannabis ≥3 times per day, such that respondents with both high pain and moderate pain had significantly higher log odds of consuming cannabis ≥3 times per day compared to low pain group. CONCLUSION While the efficacy of cannabis for various medical conditions continues to be evaluated, the best available evidence suggests a possible benefit for the treatment of chronic pain. The results of this study indicate that individuals with high pain are more likely to consume cannabis multiple times a day, but this use may not be related to better health. Our results point to a need for more research on the health impacts of frequency of cannabis use among medical cannabis dispensary patients.
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Affiliation(s)
- Alexis Cooke
- Department of Psychiatry, University of California, San Francisco, 3333 California Street Suite 485, San Francisco CA 94118, United States.
| | - Laura Chavez
- Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, OH, United States
| | - Bridget Freisthler
- College of Social Work, The Ohio State University, Columbus OH, United States
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19
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Mair C, Sumetsky N, Kranich C, Freisthler B. Availability of medical cannabis dispensaries and cannabis abuse/dependence-related hospitalizations in California. Addiction 2021; 116:1908-1913. [PMID: 33565655 PMCID: PMC10680151 DOI: 10.1111/add.15420] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/18/2020] [Accepted: 01/13/2021] [Indexed: 12/15/2022]
Abstract
AIMS To estimate associations between both current- and prior-year medical cannabis dispensary densities and hospitalizations for cannabis use disorder in California, USA between 2013 and 2016. DESIGN Spatial analysis of ZIP code-level hospitalization discharge data using Bayesian Poisson hierarchical space-time models over 4 years. SETTING AND CASES California, USA from 2013 to 2016 (6832 space-time ZIP code units). MEASUREMENTS We assessed associations of annual hospitalizations for cannabis use disorder [assignment of a primary or secondary code for cannabis abuse and/or dependence using ICD-9-CM or ICD-10-CM (outcome)] with the total number of medical cannabis dispensaries per square mile in a ZIP code as well as dispensary temporal and spatial lags (primary exposures). Other exposure covariates included alcohol outlet densities, manual labor and retail sales densities and ZIP code-level economic and demographic conditions. FINDINGS One additional dispensary per square mile was associated with a median risk ratio of 1.021 (95% credible interval 1.001, 1.041). Prior-year dispensary density did not appear to be associated with hospitalizations (median risk ratio = 1.006, 95% CrI = 0.986, 1.026). Higher median household income, higher unemployment, greater off-premises alcohol outlet density and lower on-premises alcohol outlet density and poverty were all associated with decreased ZIP code-level risk of cannabis abuse/dependence hospitalizations. CONCLUSIONS In California, USA, the increasing density of medical cannabis dispensaries appears to be positively associated with same-year but not next-year hospitalizations for cannabis use disorder.
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Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
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20
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Wolf JP, Freisthler B, Chadwick C. Stress, alcohol use, and punitive parenting during the COVID-19 pandemic. Child Abuse Negl 2021; 117:105090. [PMID: 33975257 PMCID: PMC9754854 DOI: 10.1016/j.chiabu.2021.105090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/21/2021] [Accepted: 04/28/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Emerging research suggests that parents are experiencing heightened stress during the COVID-19 pandemic. Parental stress is a risk factor for harsh or punitive parenting, and this association may be exacerbated by the use of alcohol. OBJECTIVE We examine whether parental stress is associated with use of punitive parenting, as well as whether this association is modified by drinking pattern. PARTICIPANTS & SETTING We used advertisements and word-of-mouth to recruit 342 parents living in Central Ohio during the initial stay-at-home order for COVID-19. METHODS We used geographic ecological momentary assessment (gEMA) to measure parental stress and punitive parenting during three time periods (10 a.m., 3 p.m., and 9 p.m.) over a period of fourteen days using an app downloaded to their cellular telephone. Participants also completed a longer baseline survey. We used nested multilevel ordinal regression models, where at-the-moment assessments (Level 1) were nested within individuals (Level 2) to analyze data. RESULTS Higher levels of parental stress [OR = 1.149 (95 % CI = 1.123, 1.176)] and later time of day [OR = 1.255 (95 % CI = 1.146, 1.373)] were positively related to odds of punitive parenting. Drinking pattern was not significantly related to punitive parenting in models with demographic covariates. Parents who drank alcohol both monthly and weekly and had higher levels of stress had greater odds of punitive parenting than parents with high levels of stress who abstain from alcohol. CONCLUSIONS Alcohol may be an accelerant in the use of punitive parenting for parents experiencing stress. As alcohol use increases during COVID-19, children may be at higher risk for punitive parenting.
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Affiliation(s)
- Jennifer Price Wolf
- School of Social Work, San Jose State University, 1 Washington Square, San Jose, CA, 95112, United States.
| | - Bridget Freisthler
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH, 43210, United States.
| | - Caileigh Chadwick
- College of Social Work, The Ohio State University, 1947 College Road N, Columbus, OH, 43210, United States.
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21
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Freisthler B, Gruenewald PJ, Tebben E, Shockley McCarthy K, Price Wolf J. Understanding at-the-moment stress for parents during COVID-19 stay-at-home restrictions. Soc Sci Med 2021; 279:114025. [PMID: 34004571 DOI: 10.1016/j.socscimed.2021.114025] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2021] [Accepted: 05/07/2021] [Indexed: 01/22/2023]
Abstract
RATIONALE In spring 2020, many states in the United States enacted stay-at-home orders to limit the spread of COVID-19 and lessen effects on hospitals and health care workers. This required parents to act in new roles without much support. Although studies have asked parents about stress before and during the pandemic, none have examined how stress may have fluctuated throughout the day and the characteristics related to those daily changes. OBJECTIVE Our study assesses how time-varying (e.g., presence of a focal child) and day-varying (e.g., weekend vs. weekday) factors were related to parents' level of stress. METHODS We use Ecological Momentary Assessment to examine stress three times a day (10 a.m., 3 p.m., and 9 p.m.) for 14 days. We include two different dates hypothesized to be related to parents' stress levels: (1) when Ohio announced schools would go virtual for the rest of the academic year and (2) when most retail businesses were allowed to re-open. Our sample of 332 individuals, recruited via Facebook, Craigslist, and word of mouth, completed 13,360 of these brief surveys during April-May 2020. Data were analyzed using generalized ordered logit models. RESULTS Parents report lower levels of stress when completing the 9 p.m. survey, but higher levels when they were at work, during weekdays (compared to weekends) or when they were with the focal child. COVID-19 milestone dates were not related to stress levels. CONCLUSIONS Parents need some form of respite (e.g. child care, child-only activities) to reduce stress, especially during the week when parents are juggling their outside employment and their child(ren)'s schooling. Providing parents with skills and tools to identify and reduce stress, such as apps monitoring heart rate or providing deep breathing techniques, may be one way of helping parents cope with extremely stressful situations.
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Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 1947 College Road N, Columbus, OH, 43210, USA.
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Ave., Suite 601, Berkeley, CA, 94704, USA.
| | - Erin Tebben
- College of Social Work, The Ohio State University, 1947 College Road N, Columbus, OH, 43210, USA.
| | - Karla Shockley McCarthy
- College of Social Work, The Ohio State University, 1947 College Road N, Columbus, OH, 43210, USA.
| | - Jennifer Price Wolf
- School of Social Work, San Jose State University, One Washington Square, San Jose, CA, 95112, USA.
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22
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Freisthler B, Maguire-Jack K, Yoon S, Dellor E, Wolf JP. Enhancing Permanency in Children and Families (EPIC): a child welfare intervention for parental substance abuse. BMC Public Health 2021; 21:780. [PMID: 33892671 PMCID: PMC8063333 DOI: 10.1186/s12889-021-10668-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background Across Ohio, parental substance abuse has contributed to a marked increase in the number of children in foster care. Children exposed to parental substance use have a higher likelihood of physical abuse and neglect, and consequently a variety of physical, psychological and cognitive problems. The Enhancing Permanency in Children and Families (EPIC) program is a collaborative effort between the Ohio State University College of Social Work, two county offices of the Ohio Department of Job and Family Services, two juvenile courts and local behavioral health agencies. The goal of EPIC is to use three evidence-based and evidence-informed practices to reduce abusive and neglectful parenting, reduce addiction severity in parents, and improve permanency outcomes for families involved with the child welfare system due to substance abuse. Methods EPIC is a quasi-experimental study. Under the program, child welfare-involved adults who screen positive for substances are matched with a peer recovery supporter. Participants are also incentivized to participate in family treatment drug court, medications for opioid use disorders and home-based parenting supports. Participating adults (N = 250) are matched with comparison groups from counties participating in a separate intervention (Ohio START) and to those receiving treatment as usual, resulting in a final sample of 750 adults. Primary outcomes including addiction severity, child trauma symptoms, resilience, and attachment are assessed at baseline and at program completion. Additional outcomes include timely access to treatment services, length of placement in out-of-home care and recidivism into the child welfare system. Discussion This intervention formalizes cross-system collaboration between child welfare, behavioral health and juvenile courts to support families affected by addiction. The use of three evidence-based or evidence-informed strategies presents the opportunity to determine specific strategies that are most effective for reducing addiction severity. Lastly, the intervention combines several sources of funding to bolster sustainability beyond the life of the Regional Partnership Grant (RPG). Trial registration NCT04700696. Registered January 7, 2021-retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10668-1.
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Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 208 Stillman Hall, 1947 College Road, Columbus, OH, 43210, USA
| | | | - Susan Yoon
- College of Social Work, The Ohio State University, 208 Stillman Hall, 1947 College Road, Columbus, OH, 43210, USA
| | - Elinam Dellor
- College of Social Work, The Ohio State University, 208 Stillman Hall, 1947 College Road, Columbus, OH, 43210, USA.
| | - Jennifer Price Wolf
- Division of Social Work, Sacramento State University, Sacramento, California, USA.,Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California, USA
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23
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Wolf JP, Freisthler B, McCarthy KS. Parenting in poor health: Examining associations between parental health, prescription drug use, and child maltreatment. Soc Sci Med 2021; 277:113887. [PMID: 33873010 DOI: 10.1016/j.socscimed.2021.113887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/25/2021] [Accepted: 03/27/2021] [Indexed: 02/01/2023]
Abstract
RATIONALE Child maltreatment and problematic parenting are related to negative outcomes for children. Poor parental health could be a risk factor for problematic parenting through several mechanisms: 1) inadequate emotional regulation and coping; 2) impairment of parental capacity; and, 3) impairment of the parent-child relationship. OBJECTIVE This study examines relationships between self-rated parental health, prescription drug use, and a broad array of negative parenting outcomes. METHODS A sample of general population parents of children aged ten and younger was recruited from 30 mid-sized cities in California (n = 681). Weighted mixed-effects negative binomial and logistic regression models were used to examine associations between poor parental health, prescription drug use and child maltreatment (physical abuse, supervisory neglect, and physical neglect), and problematic parenting (psychological aggression and corporal punishment). RESULTS Parents in poor health used physical abuse, corporal punishment, and psychological aggression more frequently and had higher odds of supervisory neglect. Parents who were taking more prescription medications had higher odds of physical neglect. Exploratory analyses suggested that prescriptions for certain medical conditions both increased and decreased the risk of problematic parenting. CONCLUSIONS Poor health and prescription drug use are not uncommon and present largely under-recognized risk factors for a spectrum of adverse parenting outcomes. Our study provides additional evidence that parents in poor health are at heightened risk of negative parenting, and need targeted intervention supports to support family well-being.
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Affiliation(s)
- Jennifer Price Wolf
- School of Social Work, San Jose State University, One Washington Square, San Jose, CA, 95192, USA; Prevention Research Center, 2150 Shattuck Avenue, Suite 601, Berkeley, CA, 94704-1365, USA.
| | - Bridget Freisthler
- College of Social Work, Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH, 43210, USA
| | - Karla Shockley McCarthy
- College of Social Work, Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH, 43210, USA
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24
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Sprague Martinez L, Rapkin BD, Young A, Freisthler B, Glasgow L, Hunt T, Salsberry PJ, Oga EA, Bennet-Fallin A, Plouck TJ, Drainoni ML, Freeman PR, Surratt H, Gulley J, Hamilton GA, Bowman P, Roeber CA, El-Bassel N, Battaglia T. Community engagement to implement evidence-based practices in the HEALing communities study. Drug Alcohol Depend 2020; 217:108326. [PMID: 33059200 PMCID: PMC7537729 DOI: 10.1016/j.drugalcdep.2020.108326] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The implementation of evidence-based practices to reduce opioid overdose deaths within communities remains suboptimal. Community engagement can improve the uptake and sustainability of evidence-based practices. The HEALing Communities Study (HCS) aims to reduce opioid overdose deaths through the Communities That HEAL (CTH) intervention, a community-engaged, data-driven planning process that will be implemented in 67 communities across four states. METHODS An iterative process was used in the development of the community engagement component of the CTH. The resulting community engagement process uses phased planning steeped in the principles of community based participatory research. Phases include: 0) Preparation, 1) Getting Started, 2) Getting Organized, 3) Community Profiles and Data Dashboards, 4) Community Action Planning, 5) Implementation and Monitoring, and 6) Sustainability Planning. DISCUSSION The CTH protocol provides a common structure across the four states for the community-engaged intervention and allows for tailored approaches that meet the unique needs or sociocultural context of each community. Challenges inherent to community engagement work emerged early in the process are discussed. CONCLUSION HCS will show how community engagement can support the implementation of evidence-based practices for addressing the opioid crisis in highly impacted communities. Findings from this study have the potential to provide communities across the country with an evidence-based approach to address their local opioid crisis; advance community engaged research; and contribute to the implementation, sustainability, and adoption of evidence-based practices. TRIAL REGISTRATION ClinicalTrials.gov (NCT04111939).
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Affiliation(s)
- Linda Sprague Martinez
- Macro Department, School of Social Work, Boston University, 264 Baystate Road, Boston, MA 02215, United States.
| | - Bruce D. Rapkin
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten, Room 3A2E, Bronx, NY 10461, United States
| | - April Young
- Department of Epidemiology, University of Kentucky College of Public Health, 111 Washington Avenue Office 211C, Lexington, KY 40536, United States
| | - Bridget Freisthler
- Ohio State University College of Social Work, 1947 College Rd N, Columbus, OH 43210, United States
| | - LaShawn Glasgow
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States
| | - Tim Hunt
- Columbia University, School of Social Work, Center for Healing of Opioid and Other Substance Use Disorders (CHOSEN), 1255 Amsterdam, Avenue, Rm 806, New York, NY 10027, United States
| | - Pamela J. Salsberry
- Ohio State University College of Public Health, 250 Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Emmanuel A. Oga
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States
| | - Amanda Bennet-Fallin
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Tracy J. Plouck
- College of Health Sciences and Professions, Ohio University, 1 Ohio University Drive, Athens, OH 45701, United States
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, School of Medicine, & Department of Health Law Policy, School of Public Health, Boston University, 801 Massachusetts Avenue 2ndFloor, Boston, MA 02118, United States
| | - Patricia R. Freeman
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 789 S Limestone St, Lexington, KY 40536, United States
| | - Hilary Surratt
- Department of Behavioral Science, College of Medicine, University of Kentucky, 125 Medical Behavioral Science Building, Lexington, KY 40536-0298, United States
| | - Jennifer Gulley
- Clark County Health Department, 400 Professional Ave, Winchester, KY 40391, United States
| | - Greer A. Hamilton
- School Work, Boston University, 264 Baystate Road, Boston, MA 02215, United States
| | - Paul Bowman
- South End Community Health Center, 1601 Washington St, Boston, MA 02118, United States
| | - Carter A. Roeber
- National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857, United States
| | - Nabila El-Bassel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027-5927, United States
| | - Tracy Battaglia
- Women's Health Unit Boston Medical Center, Schools of Medicine & Public Health, Boston University, 801 Massachusetts Avenue 2ndFloor, Boston, MA 02118, United States
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Walsh SL, El-Bassel N, Jackson RD, Samet JH, Aggarwal M, Aldridge AP, Baker T, Barbosa C, Barocas JA, Battaglia TA, Beers D, Bernson D, Bowers-Sword R, Bridden C, Brown JL, Bush HM, Bush JL, Button A, Campbell AN, Cerda M, Cheng DM, Chhatwal J, Clarke T, Conway KP, Crable EL, Czajkowski A, David JL, Drainoni ML, Fanucchi LC, Feaster DJ, Fernandez S, Freedman D, Freisthler B, Gilbert L, Glasgow LM, Goddard-Eckrich D, Gutnick D, Harlow K, Helme DW, Huang T, Huerta TR, Hunt T, Hyder A, Kerner R, Keyes K, Knott CE, Knudsen HK, Konstan M, Larochelle MR, Craig Lefebvre R, Levin F, Lewis N, Linas BP, Lofwall MR, Lounsbury D, Lyons MS, Mann S, Marks KR, McAlearney A, McCollister KE, McCrimmon T, Miles J, Miller CC, Nash D, Nunes E, Oga EA, Oser CB, Plouck T, Rapkin B, Freeman PR, Rodriguez S, Root E, Rosen-Metsch L, Sabounchi N, Saitz R, Salsberry P, Savitsky C, Schackman BR, Seiber EE, Slater MD, Slavova S, Speer D, Martinez LS, Stambaugh LF, Staton M, Stein MD, Stevens-Watkins DJ, Surratt HL, Talbert JC, Thompson KL, Toussant K, Vandergrift NA, Villani J, Walker DM, Walley AY, Walters ST, Westgate PM, Winhusen T, Wu E, Young AM, Young G, Zarkin GA, Chandler RK. The HEALing (Helping to End Addiction Long-term SM) Communities Study: Protocol for a cluster randomized trial at the community level to reduce opioid overdose deaths through implementation of an integrated set of evidence-based practices. Drug Alcohol Depend 2020; 217:108335. [PMID: 33248391 PMCID: PMC7568493 DOI: 10.1016/j.drugalcdep.2020.108335] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 09/17/2020] [Accepted: 09/17/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Opioid overdose deaths remain high in the U.S. Despite having effective interventions to prevent overdose deaths, there are numerous barriers that impede their adoption. The primary aim of the HEALing Communities Study (HCS) is to determine the impact of an intervention consisting of community-engaged, data-driven selection, and implementation of an integrated set of evidence-based practices (EBPs) on reducing opioid overdose deaths. METHODS The HCS is a four year multi-site, parallel-group, cluster randomized wait-list controlled trial. Communities (n = 67) in Kentucky, Massachusetts, New York and Ohio are randomized to active intervention (Wave 1), which starts the intervention in Year 1 or the wait-list control (Wave 2), which starts the intervention in Year 3. The HCS will test a conceptually driven framework to assist communities in selecting and adopting EBPs with three components: 1) a community engagement strategy with local coalitions to guide and implement the intervention; 2) a compendium of EBPs coupled with technical assistance; and 3) a series of communication campaigns to increase awareness and demand for EBPs and reduce stigma. An implementation science framework guides the intervention and allows for examination of the multilevel contexts that promote or impede adoption and expansion of EBPs. The primary outcome, number of opioid overdose deaths, will be compared between Wave 1 and Wave 2 communities during Year 2 of the intervention for Wave 1. Numerous secondary outcomes will be examined. DISCUSSION The HCS is the largest community-based implementation study in the field of addiction with an ambitious goal of significantly reducing fatal opioid overdoses.
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Abstract
This study used mixed methods to examine parent-reported harm to children (lack of supervision or physical harm) due to alcohol use by themselves or someone else as well as parent beliefs about alcohol, parenting, and harms to children. We conducted a cross-sectional general population survey of 1,599 parents who were primary caregivers to a child aged 10 or younger and follow-up interviews with 23 parents who responded "yes" to one of the questions about alcohol use causing harm their child. Survey data were analyzed using multilevel logistic models. Compared to abstainers, parents who drank at least once a year were less likely to report that someone else's drinking caused a lack of supervision or physical harm to their child. Higher continued volumes of drinking were related to fewer reports of not watching a child closely enough. Social companionship support (having people to go out with) was related to greater odds that a parent's drinking would cause physical harm to his or her child(ren). In the qualitative analysis, four relevant themes emerged: perceived effects of alcohol use, tangible support and child supervision, immediate and distal harm, and turning points in drinking behaviors.
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Affiliation(s)
| | | | | | - Yiwen Cao
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
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Freisthler B, Sumetsky N, Kranich C, Chadwick C, Mair C. Opioid Misuse and the Availability of Medical Marijuana Through Dispensaries. J Stud Alcohol Drugs 2020; 81:489-496. [PMID: 32800086 PMCID: PMC7437552 DOI: 10.15288/jsad.2020.81.489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 04/01/2020] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE In this study we assess whether changes in ZIP code-level density of medical marijuana facilities are related to changes in rates of opioid poisonings and opioid use disorder hospitalizations in California. METHOD A panel study using California hospital discharge data was conducted to assess the relationship between density of medical marijuana dispensaries and opioid poisonings and use disorder. There were 8,536 space-time units at the ZIP code level. Outcome measures included ZIP code counts of opioid poisonings and opioid use disorder; independent variables were local- and adjacent-area medical marijuana dispensaries and demographic and economic characteristics. RESULTS Independent of effects for covariates, densities of medical marijuana dispensaries were positively related to opioid use disorder (RR = 1.05, CI [1.03, 1.06]) and opioid poisonings (RR = 1.04, CI [1.02, 1.05]) in local areas, but negatively related to opioid misuse in spatially adjacent areas (RR = 0.91, CI [0.88, 0.94] for opioid use disorder, RR = 0.89, CI [0.86, 0.93] for opioid poisonings). CONCLUSIONS Although state-level studies suggest that more liberal marijuana policies may result in fewer opioid overdose deaths, our results within one state suggest that local availability of medical marijuana may not reduce those deaths. The relationship appears to be more complex, possibly based on socioeconomic conditions within and adjacent to areas with higher densities of medical marijuana dispensaries.
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Affiliation(s)
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | | | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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Thurston H, Freisthler B. The spatio-temporal distribution of naloxone administration events in rural Ohio 2010-16. Drug Alcohol Depend 2020; 209:107950. [PMID: 32146358 PMCID: PMC7231523 DOI: 10.1016/j.drugalcdep.2020.107950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/22/2020] [Accepted: 02/26/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION In 2017, Ohio had the second highest rate of drug overdose deaths in the United States. Current opioid related epidemiologic literature has begun to uncover the environmental level influences on the opioid epidemic and how the end results may ultimately manifest over space and time. This work is still nascent however, with most clustering research conducted at a spatial unit such as county level, which (1) can obscure differences between urban and rural communities, (2) does not consider dynamics that cross county lines, and (3) is difficult to interpret directly into strategic and localized intervention efforts. We address this gap by describing, at the Census block level, the spatial-temporal clustering of opioid related events in rural Ohio. METHODS We use the outcome of the administration of naloxone emergency medical service (EMS) calls in rural Ohio Census blocks during 2010-16 in a Poisson model of spatial scan statistics. RESULTS We found that naloxone event clustering in rural Ohio in the recent decade was widely dispersed over time and space, with clusters that average 17 times the risk of having an event compared to areas outside the cluster. Many of the larger spatial clusters crossed administrative boundaries (i.e., county lines) suggesting that opioid misuse may be less responsive to county level policies than to other factors. DISCUSSION Timely identification of localized overdose event clustering can guide affected communities toward rapid interventions aimed at minimizing the morbidity and mortality resulting from contagious opioid misuse.
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Affiliation(s)
- Holly Thurston
- College of Social Work, The Ohio State University, 1947 College Rd. N, Columbus, OH 43210, United States; Division of Social Work, California State University, Sacramento, 6000 J Street, Sacramento, CA 95819-6090, United States.
| | - Bridget Freisthler
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210, United States.
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Freisthler B, Kepple NJ, Wolf JP, Carson L. Activity Spaces: Assessing Differences in Alcohol Exposures and Alcohol Use for Parents. GeoJournal 2019; 2019:10.1007/s10708-019-10059-5. [PMID: 33132483 PMCID: PMC7597847 DOI: 10.1007/s10708-019-10059-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Parental alcohol use and alcohol outlet densities in residential areas are related to risk for child maltreatment. However, some parents spend significant time outside of their residential neighborhood. Thus, we may not be accurately assessing how alcohol environments are related to risks for problematic parenting. Here, we examine how residential environments and activity spaces are related to outlet density and whether drinking events in our sample of parents differ by location (e.g., routine vs. rare locations) and whether their children are present. We conducted semi-structured interviews with 60 parents living in four cities in the San Francisco Bay area who provided information on where they spent time, where they drank, and whether children were present. We constructed measures of activity spaces (e.g., convex hull polygons) and activity patterns (e.g., shortest network distance) and calculated outlet density in each. Density of alcohol outlets for residential Census tract was not related to density of the activity space and activity pattern measures. Alcohol use occurred more frequently (regardless of whether their children were present) inside activity spaces operationalized as convex hull polygons or two standard deviational ellipses. Measures that capture larger activity space areas (e.g., convex hull polygons, two standard deviational ellipses) may better model where people spend time, regardless of whether the location is routine or rare. By continuing to use activity spaces to explore relationships between outlet densities, drinking behaviors, and problems, we can start to ascertain those mechanisms by which outlets may affect local problems.
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Affiliation(s)
- Bridget Freisthler
- College of Social Work, The Ohio State University, 340C Stillman Hall, 1947 College Rd. N, Columbus, OH 43210
| | - Nancy J Kepple
- University of Kansas, School of Social Welfare, 1545 Lilac Lane, 113 Twente, Lawrence, KS 66047
| | - Jennifer Price Wolf
- Division of Social Work, California State University, Sacramento, Mariposa Hall 5035, 6000 J Street, Sacramento, CA 95819-6090
| | - Leslie Carson
- College of Social Work, The Ohio State University, 1947 College Rd. N, Columbus, OH 43210
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Marco M, Gracia E, López-Quílez A, Freisthler B. Child maltreatment and alcohol outlets in Spain: Does the country drinking culture matters? Child Abuse Negl 2019; 91:23-30. [PMID: 30818249 DOI: 10.1016/j.chiabu.2019.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 02/10/2019] [Accepted: 02/19/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Alcohol outlet density has been linked to rates of substantiated maltreatment both cross-sectionally and over time. Most of these studies have been conducted in Anglo-Saxon countries, especially in the U.S., but other countries, where alcohol outlets and alcohol consumption may have different social meanings, are clearly underrepresented in the literature. OBJECTIVE The aim of this study was to analyze whether alcohol outlet density is associated with neighborhood-level child maltreatment risk in a South-European city. PARTICIPANTS AND SETTING A longitudinal study was conducted in the city of Valencia (Spain). As spatial units, we used 552 census block groups. Family units with child maltreatment protection measures from 2004 to 2015 were geocoded (n = 1799). METHODS A Bayesian spatio-temporal autoregression model was conducted to model the outcome variable. RESULTS Results indicated that, once controlled for other neighborhood-level characteristics, the influence of off-premise density and restaurant/cafe density were not relevant, while bar density showed a negative relationship with child maltreatment risk. Spatially lagged alcohol outlet variables were also not relevant in the model. CONCLUSIONS Our results suggest the importance of taking into account the cultural influences on the relationship between alcohol outlets and child maltreatment risk. Future cross-cultural research is needed for better understanding this relationship.
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Affiliation(s)
- Miriam Marco
- Department of Social Psychology, University of Valencia, Avda. Blasco Ibáñez, 21, Valencia, 46010, Spain.
| | - Enrique Gracia
- Department of Social Psychology, University of Valencia, Avda. Blasco Ibáñez, 21, Valencia, 46010, Spain.
| | - Antonio López-Quílez
- Department of Statistics and Operations Research, University of Valencia, Dr. Moliner, 50, Burjassot, Valencia, 46100, Spain.
| | - Bridget Freisthler
- College of Social Work, The Ohio State University, Stillman Hall, 1947 College Rd., Columbus, OH, 42310, USA.
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Abstract
Very little is known about how type of substance use is comparatively related to a range of parenting behaviors. We conduct a preliminary examination to ascertain effects of substance type on physical abuse compared with other child discipline tactics with data from a telephone survey in 2009 of 3,023 parents in 50 cities in California. Kruskal-Wallis tests and hierarchical generalized linear models are conducted to determine the relationship between substance type and frequency of nonviolent discipline, corporal punishment, and child physical abuse. Type of drug used is differentially related to use of discipline strategies in multivariate models. Nonviolent discipline and corporal punishment show a dose-response relationship when a parent who reported using more substances also reported using both types of discipline more frequently. We suggest that addiction professionals should consider partnering with a specialist in child development or child welfare to conduct in-depth assessments of parenting strategies among the highest-risk groups, such as those with past-year alcohol use or a history of polysubstance use or methamphetamine use.
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Affiliation(s)
- Bridget Freisthler
- Professor and Associate Dean of Research, College of Social Work, The Ohio State University, Columbus, Ohio, USA
| | - Nancy Jo Kepple
- Assistant Professor, School of Social Welfare, University of Kansas, Lawrence, KS, USA
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Abstract
BACKGROUND As medical marijuana legislation becomes more common, concerns arise about the overconcentration of dispensaries, raising questions about the number of medicinal marijuana dispensaries (MMD) needed to serve medicinal users. OBJECTIVES This paper applies niche-marketing theory-which suggests dispensaries market to specific types of people-to examine if MMDs might be targeting recreational users. Observed differences between dispensary populations and between dispensary clients and local residents may indicate that dispensaries are drawing in patients based on factors other than medical need. METHODS Data were collected via exit surveys with patients at four dispensaries in Long Beach, CA. A total of 132 patients were surveyed regarding demographic data, purchase information, medical condition, and nearest cross street for their home address. Census tract information was collected for every dispensary. RESULTS Chi-squared tests show significant associations between dispensary visited and race (χ2 = 31.219, p < 0.001) and significant associations between medical condition and dispensary visited (χ2 = 22.123, p < 0.05). Lastly, we found that all four of the dispensaries had patients who were different from community residents in some characteristics. CONCLUSIONS There were significant differences relating to race, medical condition, and distance traveled across dispensaries. Results suggest dispensary users do not necessarily reside in the same area in which dispensaries are located and do not necessarily reflect the local population. Taken together these results provide some support for market segmentation.
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Affiliation(s)
- Alexis Cooke
- a Department of Community Health Sciences, Fielding School of Public Health , University of California , Los Angeles , California , USA
| | | | - Elycia Mulholland
- c Department of Social Welfare , Luskin School of Public Affairs, University of California , Los Angeles , California , USA
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Berg CJ, Henriksen L, Cavazos-Rehg PA, Haardoerfer R, Freisthler B. The emerging marijuana retail environment: Key lessons learned from tobacco and alcohol retail research. Addict Behav 2018; 81:26-31. [PMID: 29421347 PMCID: PMC5845833 DOI: 10.1016/j.addbeh.2018.01.040] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 01/09/2023]
Abstract
The emerging retail market for recreational marijuana use warrants research and surveillance as such markets are established in more US states. This research can be informed by the existing literature regarding tobacco and alcohol, which highlights the impact of spatial access to tobacco and alcohol retailers and exposure to tobacco and alcohol marketing on smoking and drinking among youth and young adults. Prior research indicates that tobacco and alcohol retailers, as well as medical marijuana dispensaries, are disproportionately located in neighborhoods characterized by socioeconomic disadvantage and by higher proportions of racial/ethnic minorities and young adults. Moreover, retail marketing or point-of-sale practices may differentially target subpopulations and differ by neighborhood demography and local policy. This literature and the methods employed for studying the tobacco and alcohol market could inform research on the retail environment for marijuana, as current gaps exist. In particular, much of the existing literature involves cross-sectional research designs; longitudinal studies are needed. Moreover, standardized measures are needed for systematic monitoring of industry marketing practices and to conduct research examining neighborhood differences in exposure to retail marketing for marijuana and its contribution to use modality and frequency, alone and in combination with nicotine and alcohol. The use of standardized measures for tobacco and alcohol marketing have been critical to develop an evidence base from cross-sectional and longitudinal studies that document the impact of retail marketing on substance use by adolescents and adults. Similar research is needed to establish an evidence base to inform federal, state, and local regulations of marijuana.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, 1070 Arastradero Rd, suite 353, Palo Alto, CA 94304, United States
| | - Patricia A Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, United States
| | - Regine Haardoerfer
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Bridget Freisthler
- College of Social Work, Ohio State University, 1947 College Road, Columbus, OH 43210, United States
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Berg CJ, Henriksen L, Cavazos-Rehg P, Schauer GL, Freisthler B. Point-of-sale marketing and context of marijuana retailers: Assessing reliability and generalizability of the marijuana retail surveillance tool. Prev Med Rep 2018; 11:37-41. [PMID: 29984136 PMCID: PMC6030680 DOI: 10.1016/j.pmedr.2018.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/06/2018] [Accepted: 05/11/2018] [Indexed: 11/20/2022] Open
Abstract
As recreational marijuana expands, standardized surveillance measures examining the retail environment are critical for informing policy and enforcement. We conducted a reliability and generalizability study using a previously developed tool involving assessment of a sample of 25 randomly selected Seattle recreational marijuana retailers (20 recreational; 5 recreational/medical) in 2017. The tool assessed: 1) contextual/neighborhood features (i.e., facilities nearby); 2) compliance/security (e.g., age-of-sale signage, age verification); and 3) marketing (i.e., promotions, product availability, price). We found that retailers were commonly within two blocks of restaurants (n = 23), grocery stores (n = 17), liquor stores (n = 13), and bars/clubs (n = 11). Additionally, two were within two blocks of schools, and four were within two blocks of parks. Almost all (n = 23) had exterior signage indicating the minimum age requirement, and 23 verified age. Two retailers had exterior ads for marijuana, and 24 had interior ads. Overall, there were 76 interior ads (M = 3.04; SD = 1.84), most commonly for edibles (n = 28). At least one price promotion/discount was recorded in 17 retailers, most commonly in the form of loyalty membership programs (n = 10) or daily/weekly deals (n = 10). One retailer displayed potential health harms/warnings, while three posted some health claim. Products available across product categories were similar; we also noted instances of selling retailer-branded apparel/ paraphernalia (which is prohibited). Lowest price/unit across product categories demonstrated low variability across retailers. This study documented high inter-rater reliability of the surveillance tool (Kappas = 0.73 to 1.00). In conclusion, this tool can be used in future research and practice aimed at examining retailers marketing practices and regulatory compliance.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States
| | - Lisa Henriksen
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, 3300 Hillview Ave, suite 120, Palo Alto, CA 94304, United States
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, United States
| | - Gillian L Schauer
- Department of Health Services, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, United States
| | - Bridget Freisthler
- College of Social Work, Ohio State University, 1947 College Road, Columbus, OH 43210, United States
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Abstract
The current study assesses how characteristics of medical marijuana use are related to general health status and past year change in health. An analytic sample of 312 patients were recruited from 16 medical marijuana dispensaries across Los Angeles, California. Patients completed a short intercept survey and a longer patient survey. Surveys asked information about health, marijuana use behaviors, preferred ways to use marijuana, marijuana recommendation, and sociodemographic information. Data were analyzed using hierarchical linear modeling of patients nested within dispensaries. For general health status, patients who smoke marijuana, have more medical conditions for which they received their medical marijuana recommendation, and use marijuana more times per day report lower levels of general health. The number of days using marijuana per month was related to worse health in the past year. Medical marijuana use does not appear to improve overall health status according to the results presented here, but is limited by the cross-sectional nature of the study. As the legalization of medical marijuana use continues to grow across the United States, identifying how marijuana is related to health will allow physicians to better determine who may benefit from its use.
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Affiliation(s)
- Bridget Freisthler
- Ohio State University, College of Social Work, 1947 College Road, Columbus, Ohio 43210,
| | - Alexis Cooke
- University of California, Los Angeles, Fielding School of Public Health, 650 Charles E. Young Dr. South, Los Angeles, CA 90095,
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Berg CJ, Henriksen L, Cavazos-Rehg P, Schauer GL, Freisthler B. The development and pilot testing of the marijuana retail surveillance tool (MRST): assessing marketing and point-of-sale practices among recreational marijuana retailers. Health Educ Res 2017; 32:465-472. [PMID: 29237032 PMCID: PMC5914449 DOI: 10.1093/her/cyx071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 11/17/2017] [Indexed: 06/07/2023]
Abstract
As recreational marijuana expands, it is critical to develop standardized surveillance measures to study the retail environment. To this end, our research team developed and piloted a tool assessing recreational marijuana retailers in a convenience sample of 20 Denver retailers in 2016. The tool assesses: (i) compliance and security (e.g. age-of-sale signage, ID checks, security cameras); (ii) marketing (i.e. promotions, product availability and price) and (iii) contextual and neighborhood features (i.e. retailer type, facilities nearby). Most shops (90.0%) indicated the minimum age requirement, all verified age. All shops posted interior ads (M = 2.6/retailer, SD = 3.4), primarily to promote edibles and other non-smoked products. Price promotions were common in shops (73.7%), 57.9% used social media promotions and 31.6% had take-away materials (e.g. menus, party promotions). Nearly half of the shops (42.1%) advertised health claims. All shops offered bud, joints, honey oil, tinctures, kief, beverages, edibles and topicals; fewer sold clones and seeds. Six shops (31.6%) sold shop-branded apparel and/or paraphernalia. Prices for bud varied within and between stores ($20-$45/'eighth', ∼3.5 g). Twelve were recreational only, and eight were both recreational and medicinal. Liquor stores were commonly proximal. Reliability assessments with larger, representative samples are needed to create a standardized marijuana retail surveillance tool.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, USA
| | - Lisa Henriksen
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, 3300 Hillview Ave, suite 120, Palo Alto, CA 94304, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., St. Louis, MO 63110, USA
| | - Gillian L Schauer
- Department of Health Services, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Bridget Freisthler
- College of Social Work, Ohio State University, 1947 College Road, Columbus, OH 43210, USA
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Kepple NJ, Freisthler B. Place over traits? Purchasing edibles from medical marijuana dispensaries in Los Angeles, CA. Addict Behav 2017; 73:1-3. [PMID: 28412327 DOI: 10.1016/j.addbeh.2017.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 04/05/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To examine discrete purchasing behaviors of marijuana-infused edibles from medical marijuana dispensaries with the aim to identify potential venue- and individual-level targets for prevention. METHODS Two-stage, venue-based sampling approach was used to randomly select patrons exiting 16 medical marijuana dispensaries in Los Angeles, California during Spring 2013. Hierarchical generalized linear modeling was used to examine the likelihood of purchasing edibles among 524 patrons reporting a discrete purchase regressed on characteristics of the sampled dispensaries and their patrons. RESULTS At a venue level, patrons were more likely to purchase edibles from dispensaries located within Census tracts with higher median incomes or in close proximity to a higher number of dispensaries. At an individual level, patrons who identified as Black or Hispanic were associated with a lower likelihood of purchasing edibles when compared to patrons who identified as other non-White, non-Hispanic race/ethnicity. CONCLUSIONS Place-based policies focused on regulating edible sales through dispensaries may be fruitful in influencing access to edibles. Additionally, social marketing campaigns may benefit from targeting both locations where edible purchases are more likely and populations who are more likely to purchase edibles.
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Affiliation(s)
- Nancy Jo Kepple
- University of Kansas, School of Social Welfare, 1545 Lilac Lane, Lawrence, KS 66045, United States.
| | - Bridget Freisthler
- The Ohio State University, College of Social Work, 1947 College Road, Columbus, OH 43210, United States.
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Abstract
Although drug use is considered a risk factor for child maltreatment, very little work has examined how the drug environment may affect physical abuse and neglect by parents. Utilizing information from a telephone survey with 2,597 respondents from 43 cities with valid police data on narcotics incidents, we analyzed the relationship between drug use, drug availability, and child maltreatment using multilevel models. City-level rates of drug abuse and dependence were related to more frequent physical abuse. Parents who use drugs in areas with greater availability of drugs reported more physical abuse and physical neglect. Emotional support was protective of all types of maltreatment. While most child welfare interventions focus on reducing parental drug use in order to reduce child abuse, these findings suggest environmental prevention or neighborhood strengthening approaches designed to reduce the supply of illicit drugs may also reduce child abuse through multiple mechanisms.
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Affiliation(s)
| | | | - Wendy Wiegmann
- 3 School of Social Welfare, University of California, Berkeley, CA, USA
| | - Nancy J Kepple
- 4 School of Social Welfare, University of Kansas, Lawrence, KS, USA
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Thomas C, Freisthler B. Erratum to: Evaluating the Change in Medical Marijuana Dispensary Locations in Los Angeles Following the Passage of Local Legislation. J Prim Prev 2017; 38:343. [DOI: 10.1007/s10935-017-0479-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Thurston H, Freisthler B, Bell J, Tancredi D, Romano PS, Miyamoto S, Joseph JG. Environmental and individual attributes associated with child maltreatment resulting in hospitalization or death. Child Abuse Negl 2017; 67:119-136. [PMID: 28254689 DOI: 10.1016/j.chiabu.2017.02.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 02/10/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
Abstract
Maltreatment continues to be a leading cause of death for young children. Researchers are beginning to uncover which neighborhood attributes may be associated with maltreatment outcomes. However, few studies have been able to explore these influences while controlling for individual family attributes, and none have been able to parse out the most severe outcomes-injuries resulting in hospitalization or death. This study utilizes a retrospective, case-control design on a dataset containing both individual and environmental level attributes of children who have been hospitalized or died due to maltreatment to explore the relative influence of attributes inside and outside the household walls. Binary conditional logistic regression was used to model the outcome as a function of the individual and environmental level predictors. Separate analyses also separated the outcome by manner of maltreatment: abuse or neglect. Finally, a sub-analysis included protective predictors representing access to supportive resources. Findings indicate that neighborhood attributes were similar for both cases and controls, except in the neglect only model, wherein impoverishment was associated with higher odds of serious maltreatment. Dense housing increased risk in all models except the neglect only model. In a sub-analysis, distance to Family Resource Centers was inversely related to serious maltreatment. In all models, variables representing more extreme intervention and/or removal of the victim and/or perpetrator from the home (foster care or criminal court involvement) were negatively associated with the risk of becoming a case. Medi-Cal insurance eligibility of a child was also negatively associated with becoming a case. Government interventions may be playing a critical role in child protection. More research is needed to ascertain how these interventions assert their influence.
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Affiliation(s)
- Holly Thurston
- University of California, Davis, Betty Irene Moore School of Nursing, 4610 X Street, Sacramento, CA, 95817, United States.
| | - Bridget Freisthler
- Ohio State University, College of Social Work, 1947 College Road, Columbus, OH 43210, United States.
| | - Janice Bell
- University of California, Davis, Betty Irene Moore School of Nursing, 4610 X Street, Sacramento, CA, 95817, United States.
| | - Daniel Tancredi
- Department of Pediatrics, UC Davis Medical Center, 2516 Stockton Blvd., Sacramento, CA, 95817, United States.
| | - Patrick S Romano
- Department of Internal Medicine, UC Davis Medical Center, 4150 V Street, Sacramento, CA, 95817, United States.
| | - Sheridan Miyamoto
- Penn State University, College of Nursing, 201 Nursing Sciences Building, University Park, PA, 16802, United States.
| | - Jill G Joseph
- University of California, Davis, Betty Irene Moore School of Nursing, 4610 X Street, Sacramento, CA, 95817, United States.
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Thomas C, Freisthler B. Evaluating the Change in Medical Marijuana Dispensary Locations in Los Angeles Following the Passage of Local Legislation. J Prim Prev 2017; 38:265-277. [DOI: 10.1007/s10935-017-0473-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wolf JP, Freisthler B, Kepple NJ, Chávez R. The places parents go: understanding the breadth, scope, and experiences of activity spaces for parents. GeoJournal 2017; 82:355-368. [PMID: 28392621 PMCID: PMC5381933 DOI: 10.1007/s10708-015-9690-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Neighborhood environments are related to parenting behaviors, which in turn have a life-long effect on children's health and well-being. Activity spaces, which measure individual routine patterns of movement, may be helpful in assessing how physical and social environments shape parenting. In this study we use qualitative data and GIS mapping from 4 California cities to examine parental activity spaces. Parents described a number of factors that shape their activity spaces including caregiving status, the age of their children, and income. Parental activity spaces also varied between times (weekends vs. weekdays) and places (adult-only vs. child-specific places). Knowing how to best capture and study parental activity spaces could identify mechanisms by which environmental factors influence parenting behaviors and child health.
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Affiliation(s)
- Jennifer Price Wolf
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612
| | - Bridget Freisthler
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612
- UCLA Luskin School of Public Affairs, 337 Charles E. Young Drive East, Los Angeles, CA, 90095
| | - Nancy Jo Kepple
- UCLA Luskin School of Public Affairs, 337 Charles E. Young Drive East, Los Angeles, CA, 90095
| | - Raúl Chávez
- University of California, Berkeley School of Social Welfare, 120 Haviland Hall, Berkeley, CA 94720
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Thurston H, Freisthler B, Bell J, Tancredi D, Romano PS, Miyamoto S, Joseph JG. The temporal-spatial distribution of seriously maltreated children. Spat Spatiotemporal Epidemiol 2017; 20:1-8. [PMID: 28137674 DOI: 10.1016/j.sste.2016.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/11/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
Abstract
This descriptive study utilized Bernoulli and Poisson spatial scan statistical models in SatScan v.9.4 to examine the distribution in space and time of residence of maltreatment cases-operationalized as families with serious maltreatment (resulting in death or hospitalization) of children under 6 years-for the presence of clusters ("hot spots"). In the Poisson model, a population dataset of serious maltreatment cases were non-randomly dispersed in four major areas, with these "hot spots" moving over time and space. Most cases were outside these clusters. In the Bernoulli model, the geographic distribution of a case-control dataset of families with serious maltreatment who were previously investigated by child welfare did not differ compared to controls previously investigated by child welfare with no serious maltreatment. Findings suggest that child fatality prevention efforts such as Back to Sleep and Never Shake a Baby campaigns should continue to be universal efforts, targeted to all parents.
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Affiliation(s)
- Holly Thurston
- Betty Irene Moore School of Nursing, UC Davis, 4610 X Street, Sacramento, CA 95817, USA.
| | - Bridget Freisthler
- Ohio State University, College of Social Work, 1947 College Road, Columbus, OH 43210, USA.
| | - Janice Bell
- Betty Irene Moore School of Nursing, UC Davis, 4610 X Street, Sacramento, CA 95817, USA.
| | - Daniel Tancredi
- Department of Pediatrics, UC Davis Medical Center, 2516 Stockton Blvd, Sacramento, CA 95817, USA.
| | - Patrick S Romano
- Department of Internal Medicine, UC Davis Medical Center, 4150 V Street, Sacramento, CA 95817, USA.
| | - Sheridan Miyamoto
- Penn State College of Nursing, 201 Nursing Sciences Building, University Park, PA 16802, USA.
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, UC Davis, 4610 X Street, Sacramento, CA 95817, USA.
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Freisthler B, Wolf JP. Testing a Social Mechanism: Does Alcohol Outlet Density Moderate the Relationship Between Levels of Alcohol Use and Child Physical Abuse? Violence Vict 2016; 31:1080-1099. [PMID: 27642071 PMCID: PMC5354982 DOI: 10.1891/0886-6708.vv-d-14-00183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Parental alcohol use and alcohol outlet density are both associated with child abuse. Guided by alcohol availability theory, this article examines whether alcohol outlet density moderates the relationship between parental alcohol use and child physical abuse. METHODS A general population telephone survey of 3,023 parents or legal guardians 18 years or older was conducted across 50 California cities, whereas densities of alcohol outlets were measured for by zip code. Data were analyzed via overdispersed multilevel Poisson models. RESULTS Ex-drinkers, light drinkers, and heavy drinkers use physical abuse more often than lifetime abstainers. Moderate drinking was not related to child physical abuse. Proportion of bars was negatively related to frequency of physical abuse. Moderating relationships between alcohol outlet density and drinking categories were found for all drinking patterns. CONCLUSION Different types of alcohol outlets may be differentially related to drinking patterns, indicating that the interaction of drinking patterns and the drinking environment may place children at greater risk for being physically abused.
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Wolf JP, Freisthler B. Understanding the Roles of Context, Frequency, and Quantity of Alcohol Consumption in Child Physical Abuse: Risks for Mothers and Fathers. J Fam Violence 2016; 31:539-548. [PMID: 28479669 PMCID: PMC5418584 DOI: 10.1007/s10896-015-9795-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Alcohol use is related to child physical abuse, although little is known about gender-specific risks factors. This study examines the relationships between alcohol outlets, context-specific drinking, dose-response drinking and child physical abuse for mothers and fathers. METHOD Telephone interviews were conducted with 1,973 female and 1,050 male respondents in 50 California cities. Weighted negative binomial models were used to calculate the frequency of physical abuse in the past year. RESULTS Drinking more often at restaurants was related to higher frequency of physical abuse for fathers, while mothers who drank more frequently at bars and parties used physical abuse more often. There were no significant dose-response drinking relationships for fathers. Drinking higher amounts at bars, parties, and restaurants was associated with less frequent physical abuse for mothers. DISCUSSION Our findings suggest that a focus on drinking contexts may reveal heightened risk for many mothers who do not consume large amounts of alcohol.
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Affiliation(s)
- Jennifer Price Wolf
- California State University, Sacramento Division of Social Work, 4010 Mariposa Hall, Sacramento, CA 95819
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612-3749
| | - Bridget Freisthler
- Prevention Research Center, 180 Grand Avenue, Suite 1200, Oakland, CA, 94612-3749
- UCLA Luskin School of Public Affairs, 337 Charles E. Young Drive East, Los Angeles, CA, 90095
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Freisthler B, Ponicki WR, Gaidus A, Gruenewald PJ. A micro-temporal geospatial analysis of medical marijuana dispensaries and crime in Long Beach, California. Addiction 2016; 111:1027-35. [PMID: 26748438 PMCID: PMC4861677 DOI: 10.1111/add.13301] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 11/12/2015] [Accepted: 12/31/2015] [Indexed: 11/28/2022]
Abstract
AIMS To determine whether the density of marijuana dispensaries in California, USA, in 2012-13 was related to violent and property crimes, both locally and in adjacent areas, during a time in which local law enforcement conducted operations to reduce the number of storefront medical marijuana dispensaries. DESIGN Data on locations of crimes and medical marijuana dispensaries as well as other covariates were collected for a sample of 333 Census block groups. SETTING Long Beach, California, USA from January 2012 to December 2013. OBSERVATIONS A total of 7992 space-time observations (from 333 Census block groups over 24 time-points). MEASUREMENTS Outcome measures focused on block-group counts of violent and property crimes. Predictors were numbers of local and adjacent-area medical marijuana dispensaries. Covariates included markers of alcohol availability as well as area demographic and economic characteristics. FINDINGS After adjustment for covariates, density of medical marijuana dispensaries was unrelated to property and violent crimes in local areas but related positively to crime in spatially adjacent areas [incident rate ratio (IRR) = 1.0248, CI (1.0097, 1.0402) for violent crime, IRR = 1.0169, CI (1.0071, 1.0268) for property crime]. CONCLUSIONS Using law enforcement to reduce medical marijuana dispensaries in California appears to have reduced crime in residential areas near to, but not in, these locations.
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Affiliation(s)
- Bridget Freisthler
- Luskin School of Public Affairs University of California, Los Angeles 3250 Public Affairs Building, Box 951656 Los Angeles, CA 90095
| | - William R. Ponicki
- Prevention Research Center Pacific Institute for Research and Evaluation 180 Grand Avenue, Suite 1200 Oakland, CA 94612-3749
| | - Andrew Gaidus
- Prevention Research Center Pacific Institute for Research and Evaluation 180 Grand Avenue, Suite 1200 Oakland, CA 94612-3749
| | - Paul J. Gruenewald
- Prevention Research Center Pacific Institute for Research and Evaluation 180 Grand Avenue, Suite 1200 Oakland, CA 94612-3749
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Abstract
Venue-based sampling is the identification of, and outreach to, locations visited by the population of interest for the purpose of collecting data. The method is frequently used to reach specific populations, commonly referred to as "hidden populations." Medical marijuana users represent a hidden population of persons who use marijuana for medicinal purposes. We examine whether venue-based procedures introduce selection or non-respondent bias into the study. The venue based sampling procedures employed for the UCLA Medical Marijuana Study used a two-stage, venue-based sampling approach. First, analyses were conducted to assess potential bias within dispensaries that agreed to participate in the surveys. Secondly, analyses were conducted to examine differences among patrons who responded to surveys. Overall, selection bias was generally absent among study results. Results also illuminated the minimal respondent bias observed among the survey respondents. Results suggest that the use of dispensaries to access and survey medical marijuana users is a viable option to gather patient information that adequately represents the greater population of medical marijuana users in Los Angeles. Thus, recommendations and conclusions based on findings from venue-based studies of medical marijuana users at dispensary sites serve to impartially inform meaningful research.
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Affiliation(s)
- Crystal Thomas
- a Doctoral Student, UCLA Luskin School of Public Affairs , Department of Social Welfare , Los Angeles , CA , USA
| | - Bridget Freisthler
- b Professor, UCLA Luskin School of Public Affairs , Department of Social Welfare , Los Angeles , CA , USA
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Kepple NJ, Mulholland E, Freisthler B, Schaper E. Correlates of Amount Spent on Marijuana Buds During a Discrete Purchase at Medical Marijuana Dispensaries: Results from a Pilot Study. J Psychoactive Drugs 2016; 48:50-5. [PMID: 26757234 DOI: 10.1080/02791072.2015.1116719] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Marijuana purchasing behaviors vary by the purchaser's individual characteristics; however, little is known about patients' purchasing behaviors when buying from medical marijuana dispensaries (MMDs). Our objective was to explore whether patient characteristics were associated with amount spent during one financial transaction at medical marijuana dispensaries. We conducted a pilot study of four purposively sampled MMD locations in Long Beach, California, in 2012. A total of 132 medical marijuana patients (33 patients per dispensary) participated in an exit survey about their demographic characteristics, conditions for their medical marijuana recommendation, amount spent at the dispensary, and cross-streets of where they lived. The sample reported amounts spent on discrete purchases of marijuana buds averaging $40.82 (ranging from $10 to $255). Multivariate regression analyses indicated average amount spent differed significantly by patient age and condition. An increase in 10 years of age was associated with a 10% higher amount spent. Receiving a recommendation for anxiety and/or sleeping problems or other nonspecified conditions was related to higher discrete purchase amounts than chronic pain. This pilot suggests that variations in patient purchasing behaviors from MMDs exist. These purchase behaviors can provide insight into variations in how patients use dispensaries, consume products, and allocate personal resources.
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Affiliation(s)
- Nancy Jo Kepple
- a Assistant Professor, School of Social Welfare , University of Kansas , Lawrence , KS , USA
| | - Elycia Mulholland
- b Research Assistant, Department of Social Welfare, Luskin School of Public Affairs , University of California Los Angeles , Los Angeles , CA , USA
| | - Bridget Freisthler
- c Professor, Department of Social Welfare, Luskin School of Public Affairs , University of California Los Angeles , Los Angeles , CA , USA.,d Faculty Affiliate, California Center for Population Research , University of California Los Angeles , Los Angeles , CA , USA
| | - Elizabeth Schaper
- e Research Assistant, California Center for Population Research , University of California Los Angeles , Los Angeles , CA , USA
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Tam CC, Freisthler B, Curry SR, Abrams LS. Where Are the Beds? Housing Locations for Transition Age Youth Exiting Public Systems. Fam Soc 2016; 97:111-119. [PMID: 28490852 PMCID: PMC5421640 DOI: 10.1606/1044-3894.2016.97.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Transition age youth (TAY) from the child welfare and juvenile justice systems experience high rates of homelessness, but little is known about the neighborhoods to which they return after they exit these systems. This exploratory study investigates whether housing options are located in areas where TAY exit public systems and if the characteristics of areas surrounding these facilities support their transition to adulthood. Results show that housing is not related to areas where TAY exit public systems. Further, supportive housing and shelter density is related to low-income areas. Implications for practice and policy on housing locations for TAY are discussed.
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Affiliation(s)
- Christina C Tam
- Department of Social Welfare, University of California, Los Angeles, , (424) 258-4564, f: (310) 206-7564
| | - Bridget Freisthler
- Department of Social Welfare, University of California, Los Angeles, , (310) 206-1602, f: (310) 206-7564
| | - Susanna R Curry
- Department of Social Welfare, University of California, Los Angeles, , (424) 258-0954, f: (310) 206-7564
| | - Laura S Abrams
- Department of Social Welfare, University of California, Los Angeles, , (310) 206-0693, f: (310) 206-7564
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Abstract
Access to social services is important for the safety of children and ultimately for reunification of families involved in the child welfare system. The process of linking families to services however, varies by caseworker and can be cumbersome and time-consuming. The DCFS Needs Portal is an internet-based intervention to improve the timing and quality of social service referrals in Los Angeles County We used a case study approach including in-depth interviews, direct observations and user feedback obtained from the Needs Portal to 1) determine perceived benefits and barriers to adopting the Needs Portal and 2) report how the flow of information between users and developers was used to adapt to user needs. Our analyses revealed four major barriers: 1) caseworker apprehension regarding new technology, 2) variation in communication styles by user type, 3) lack of technological infrastructure and 4) competing workplace demands. Information sharing between developers and users has the potential to better meet the needs of users and ultimately maximize utilization of new technology. Although internet-based interventions are designed to inexpensively and effectively coordinate services, emerging interventions may require in-person assistance and modifications in order to succeed.
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Affiliation(s)
- Elinam Dellor
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | | | - Jennifer Price Wolf
- Division of Social Work, California State University, Sacramento; Prevention Research Center
| | - Susanna R. Curry
- Luskin School of Public Affairs, University of California, Los Angeles
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