1
|
Conner LR, Ruppel M, Oser CB. A scoping review: Forced/coerced sterilization as a socio-cultural risk factor for sexually transmitted HIV for older Black women. J Health Psychol 2024:13591053241240922. [PMID: 38654481 DOI: 10.1177/13591053241240922] [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] [Indexed: 04/26/2024] Open
Abstract
Understanding socio-cultural factors that influence older (age 50 and up) Black women's risk for sexually transmitted HIV has often been absent from policies and programs. This scoping review asked: What does academic literature reveal about forced/coerced sterilization as a risk factor for older Black women who are disproportionately affected by sexually transmitted HIV? Using the Arksey and O'Malley scoping review methodology, the authors identified academic and gray literature published between 2000 and 2023. Of the 407 sources identified and screened, three articles met the criteria for inclusion. One study focused on birth control conspiracy beliefs, another focused on racial differences in Norplant use, and the third focused on the intergenerational transmission of mistrust of medical care that influences HIV prevention among Black Americans. The study findings suggest that because the link has not been made between socio-cultural factors that impact older Black women's reproductive health practices, further investigation is warranted.
Collapse
|
2
|
Davis A, Knudsen HK, Walker DM, Chassler D, Lunze K, Westgate PM, Oga E, Rodriguez S, Tan S, Holloway J, Walsh SL, Oser CB, Lefebvre RC, Fanucchi LC, Glasgow L, McAlearney AS, Surratt HL, Konstan MW, Huang TTK, LeBaron P, Nakayima J, Stein MD, Rudorf M, Nouvong M, Kinnard EN, El-Bassel N, Tilley J, Macoubray A, Savitzky C, Farmer A, Beers D, Salsberry P, Huerta TR. Effects of the Communities that Heal (CTH) intervention on perceived opioid-related community stigma in the HEALing Communities Study: results of a multi-site, community-level, cluster-randomized trial. Lancet Reg Health Am 2024; 32:100710. [PMID: 38510790 PMCID: PMC10950860 DOI: 10.1016/j.lana.2024.100710] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/11/2024] [Accepted: 02/20/2024] [Indexed: 03/22/2024]
Abstract
Background Community stigma against people with opioid use disorder (OUD) and intervention stigma (e.g., toward naloxone) exacerbate the opioid overdose crisis. We examined the effects of the Communities that HEAL (CTH) intervention on perceived opioid-related community stigma by stakeholders in the HEALing Communities Study (HCS). Methods We collected three surveys from community coalition members in 66 communities across four states participating in HCS. Communities were randomized into Intervention (Wave 1) or Wait-list Control (Wave 2) arms. We conducted multilevel linear mixed models to compare changes in primary outcomes of community stigma toward people treated for OUD, naloxone, and medication for opioid use disorder (MOUD) by arm from time 1 (before the start of the intervention) to time 3 (end of the intervention period in the Intervention arm). Findings Intervention stakeholders reported a larger decrease in perceived community stigma toward people treated for OUD (adjusted mean change (AMC) -3.20 [95% C.I. -4.43, -1.98]) and toward MOUD (AMC -0.33 [95% C.I. -0.56, -0.09]) than stakeholders in Wait-list Control communities (AMC -0.18 [95% C.I. -1.38, 1.02], p = 0.0007 and AMC 0.11 [95% C.I. -0.09, 0.31], p = 0.0066). The relationship between intervention status and change in stigma toward MOUD was moderated by rural-urban status (urban AMC -0.59 [95% CI, -0.87, -0.32], rural AMC not sig.) and state. The difference in stigma toward naloxone between Intervention and Wait-list Control stakeholders was not statistically significant (p = 0.18). Interpretation The CTH intervention decreased stakeholder perceptions of community stigma toward people treated for OUD and stigma toward MOUD. Implementing the CTH intervention in other communities could decrease OUD stigma across diverse settings nationally. Funding US National Institute on Drug Abuse.
Collapse
Affiliation(s)
- Alissa Davis
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Hannah K. Knudsen
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Daniel M. Walker
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA
| | - Deborah Chassler
- Boston University School of Social Work, 264-270 Bay State Road, Boston, MA, 02215, USA
| | - Karsten Lunze
- Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Department of Medicine, 801 Massachusetts Ave., Boston, MA, 02118, USA
| | - Philip M. Westgate
- Department of Biostatistics, College of Public Health, University of Kentucky, 760 Press Avenue, Lexington, KY, 40536, USA
| | - Emmanuel Oga
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Sandra Rodriguez
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Sylvia Tan
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - JaNae Holloway
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Sharon L. Walsh
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Carrie B. Oser
- Department of Sociology, Center on Drug and Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USA
| | - R. Craig Lefebvre
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Laura C. Fanucchi
- Department of Medicine, Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Ave, Lexington, KY, 40508, USA
| | - LaShawn Glasgow
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Ann Scheck McAlearney
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA
| | - Hilary L. Surratt
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Michael W. Konstan
- Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Terry T.-K. Huang
- Center for Systems and Community Design and NYU-CUNY Prevention Research Center, Graduate School of Public Health & Health Policy, City University of New York, 55 W. 125 Street, Room 803, New York, NY, 10027, USA
| | - Patricia LeBaron
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Julie Nakayima
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Michael D. Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - Maria Rudorf
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Monica Nouvong
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Elizabeth N. Kinnard
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Nabila El-Bassel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Jess Tilley
- New England Drug Users Union, 36 Bedford Terrace, Suite 2, Northampton, MA, 01060, USA
| | - Aaron Macoubray
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709, USA
| | - Caroline Savitzky
- Boston Medical Center, Section of Infectious Diseases, 801 Massachusetts Ave., Boston, MA, 02118, USA
| | - Amy Farmer
- The Ohio State University College of Medicine, HEALing Communities Research, 530 W. Spring St., Suite 275, Columbus, OH, 43215, USA
| | - Donna Beers
- Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Pamela Salsberry
- The Ohio State University College of Public Health, 1841 Neil Ave., Columbus, OH, 43210, USA
| | - Timothy R. Huerta
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 4000, Columbus, OH, 43202, USA
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd., Suite 5000, Columbus, OH, 43202, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, 1585 Neil Ave, Columbus, OH, 43210, USA
| |
Collapse
|
3
|
Peddireddy SR, Livingston MD, Young AM, Freeman PR, Ibragimov U, Komro KA, Lofwall MR, Oser CB, Staton M, Cooper HLF. Willingness to utilize a mobile treatment unit in five counties at the epicenter of the US rural opioid epidemic. J Subst Use Addict Treat 2024; 159:209262. [PMID: 38103835 PMCID: PMC10947911 DOI: 10.1016/j.josat.2023.209262] [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: 05/23/2023] [Revised: 09/26/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION US federal policies are evolving to expand the provision of mobile treatment units (MTUs) offering medications for opioid use disorder (MOUD). Mobile MOUD services are critical for rural areas with poor geographic access to fixed-site treatment providers. This study explored willingness to utilize an MTU among a sample of people who use opioids in rural Eastern Kentucky counties at the epicenter of the US opioid epidemic. METHODS The study analyzed Cross-sectional survey data from the Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE) study covering five rural counties in the state. Logistic regression models investigated the association between willingness to utilize an MTU providing buprenorphine and naltrexone and potential correlates of willingness, identified using the Behavioral Model for Vulnerable Populations. RESULTS The analytic sample comprised 174 people who used opioids within the past six months. Willingness to utilize an MTU was high; 76.5 % of participants endorsed being willing. Those who had recently received MOUD treatment, compared to those who had not received any form of treatment or recovery support services, had six-fold higher odds of willingness to use an MTU. However, odds of being willing to utilize an MTU were 73 % lower among those who were under community supervision (e.g., parole, probation) and 81 % lower among participants who experienced an overdose within the past six months. CONCLUSIONS There was high acceptability of MTUs offering buprenorphine and naltrexone within this sample, highlighting the potential for MTUs to alleviate opioid-related harms in underserved rural areas. However, the finding that people who were recently under community supervision or had overdosed were significantly less willing to seek mobile MOUD treatment suggest barriers (e.g., stigma) to mobile MOUD at individual and systemic levels, which may prevent improving opioid-related outcomes in these rural communities given their high rates of criminal-legal involvement and overdose.
Collapse
Affiliation(s)
- Snigdha R Peddireddy
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA.
| | - Melvin D Livingston
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
| | - April M Young
- Department of Epidemiology and Environmental Health, University of Kentucky College of Public Health, Lexington, KY, USA
| | - Patricia R Freeman
- Department of Pharmacy Practice & Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Umedjon Ibragimov
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
| | - Kelli A Komro
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
| | - Michelle R Lofwall
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Carrie B Oser
- Department of Sociology, University of Kentucky College of Arts & Sciences, Lexington, KY, USA
| | - Michele Staton
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Hannah L F Cooper
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, USA
| |
Collapse
|
4
|
Oser CB, Rockett M, Otero S, Batty E, Booty M, Gressick R, Staton M, Knudsen HK. Rural and urban clinician views on COVID-19's impact on substance use treatment for individuals on community supervision in Kentucky. Health Justice 2024; 12:12. [PMID: 38530619 PMCID: PMC10964696 DOI: 10.1186/s40352-024-00266-9] [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: 09/12/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND The COVID-19 pandemic produced system-level changes within the criminal legal system and community-based substance use disorder (SUD) treatment system with impacts on recovery efforts. This study examines rural and urban clinicians' perspectives of COVID-19 on SUD treatment delivery for people on community supervision. METHODS Virtual qualitative interviews were conducted between April and October 2020 with 25 community supervision clinicians employed by Kentucky's Department of Corrections (DOC), who conduct assessments and facilitate community-based treatment linkages for individuals on probation or parole. Transcripts were analyzed in NVivo using directed content analysis methods. RESULTS Clinicians were predominantly white (92%) and female (88%) with an average of over 9 years working in the SUD treatment field and 4.6 years in their current job. Four COVID-19 themes were identified by both rural and urban clinicians including: (1) telehealth increases the modes of communication, but (2) also creates paperwork and technological challenges, (3) telehealth requires more effort for inter/intra-agency collaboration, and (4) it limits client information (e.g., no urine drug screens). Two additional rural-specific themes emerged related to COVID-19: (5) increasing telehealth options removes SUD treatment transportation barriers and (6) requires flexibility with programmatic requirements for rural clients. CONCLUSIONS Findings indicate the need for community-based SUD treatment providers approved or contracted by DOC to support and train clients to access technology and improve information-sharing with community supervision officers. A positive lesson learned from COVID-19 transitions was a reduction in costly travel for rural clients, allowing for greater engagement and treatment adherence. Telehealth should continue to be included within the SUD continuum of care, especially to promote equitable services for individuals from rural areas.
Collapse
Affiliation(s)
- Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USA.
| | - Maria Rockett
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1515 Patterson Office Tower, Lexington, KY, 40508, USA
| | - Sebastian Otero
- College of Medicine, University of Kentucky, 1515 Patterson Office Tower, Lexington, KY, 40506, USA
| | - Evan Batty
- Department of Sociology, Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Marisa Booty
- Department of Sociology, Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Rachel Gressick
- College of Public Health, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| | - Michele Staton
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 117 Medical Behavioral Science Building, Lexington, KY, 40508, USA
| | - Hannah K Knudsen
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY, 40508, USA
| |
Collapse
|
5
|
Rockett ML, Knudsen HK, Oser CB. The influence of familial networks and stigma on prison-based medication initiation for individuals with opioid use disorder: Clinicians' perceptions. J Subst Use Addict Treat 2024; 162:209353. [PMID: 38521351 DOI: 10.1016/j.josat.2024.209353] [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] [Received: 11/30/2023] [Revised: 02/03/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION Individuals with criminal legal system (CLS) involvement experience opioid use disorder (OUD) at elevated rates when compared to their non-justice involved counterparts. Medications for opioid use disorder (MOUD) are efficacious but underutilized within this population. Interpersonal relationships and stigma play salient roles in the outcomes of OUD treatment. This study examines prison-based treatment staff perspectives on how familial networks and stigma interact to impact one's decision of whether to initiate MOUD while in prison in Kentucky. METHODS A coding team analyzed qualitative interviews with prison-based clinicians (n = 23) and administrators (n = 9) collected from the Geographic variation in Addiction Treatment Experiences (GATE) study using NVivo software. The study analyzed excerpts associated with the primary codes of "stigma" and "social networks" and the secondary code of "family" in order to assess the relationship between familial stigma and MOUD initiation from treatment staff viewpoints. RESULTS Arising themes suggest that clients' families' lack of MOUD knowledge plays a crucial role in perpetuating related stigma, that this stigma often materializes as a belief that MOUD is a continuation of illicit substance use and that stigma levels vary across MOUD forms (e.g., more stigma towards agonists than antagonists). CONCLUSIONS These findings carry implications for better understanding how intervention stigma within one's familial network impacts prison-based medication initiation decisions. Resulting themes suggest support for continued expansion of efforts by Kentucky Department of Corrections to involve participant families in education and treatment initiatives to reduce intervention stigma and increase treatment utilization.
Collapse
Affiliation(s)
- Maria L Rockett
- Department of Sociology, University of Kentucky, United States.
| | - Hannah K Knudsen
- Department of Behavioral Science, University of Kentucky, United States
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, United States
| |
Collapse
|
6
|
Oyler DR, Knudsen HK, Oser CB, Walsh SL, Roberts M, Nigam SR, Westgate PM, Freeman PR. Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study. Drug Alcohol Depend Rep 2024; 10:100207. [PMID: 38283913 PMCID: PMC10821613 DOI: 10.1016/j.dadr.2023.100207] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/09/2023] [Accepted: 11/20/2023] [Indexed: 01/30/2024]
Abstract
Background Opioid overdoses differentially affect demographic groups. Strategies to reduce overdose deaths, specifically overdose education and naloxone distribution (OEND), are not consistently delivered equitably. Methods The HEALing Communities StudySM (HCS) is a cluster-randomized trial designed to implement evidence-based practices, including OEND, to reduce overdose deaths across communities. Individuals receiving OEND in eight Kentucky counties between January 2020 and June 2022 provided demographics and overdose history. Recipient characteristics were compared to opioid overdose decedent characteristics to evaluate whether OEND was equitably delivered to the target population. Recipient characteristics were also analyzed based on whether OEND was delivered in criminal justice, behavioral health, or health care facilities. Results A total of 26,273 demographic records were analyzed from 137 partner agencies. Most agencies were in behavioral health (85.6 %) or criminal justice sectors (10.4 %). About half of OEND recipients were male (50.6 %), which was significantly lower than the 70.3 % of overdose decedents who were male, (p<0.001). OEND recipients tended to be younger than overdose decedents, but there were not significant differences in race/ethnicity between OEND recipients and overdose decedents. Over 40 % of OEND recipients had overdosed, and 68.9 % had witnessed a prior overdose. There were notable differences across facility types, as males and Black individuals accounted for fewer OEND recipients in addiction treatment facilities compared to jails. Conclusion Although OEND recipients' demographics resembled those of decedents, specific attention should be paid to ensuring equitable OEND access. Variation in OEND uptake by facility type may reflect biases and barriers to care.
Collapse
Affiliation(s)
- Douglas R. Oyler
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| | - Hannah K. Knudsen
- Department of Behavioral Science and Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Carrie B. Oser
- Department of Sociology and Center on Drug and Alcohol Research, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA
| | - Sharon L. Walsh
- Department of Behavioral Science and Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Monica Roberts
- Substance Use Priority Research Area, University of Kentucky, Lexington, KY, USA
| | - Shawn R. Nigam
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Philip M. Westgate
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Patricia R. Freeman
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
7
|
Walker DM, Lefebvre RC, Davis A, Shiu-Yee K, Chen S, Jackson RD, Helme DW, Oga EA, Oser CB, Stotz C, Balvanz P, Asman K, Holloway J, Lewis N, Knudsen HK. Differences in perceptions of community stigma towards opioid use disorder between community substance use coalition members and the general public. J Subst Use Addict Treat 2024; 158:209276. [PMID: 38142801 PMCID: PMC10947872 DOI: 10.1016/j.josat.2023.209276] [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: 04/20/2023] [Revised: 11/01/2023] [Accepted: 12/15/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION To examine differences in perceptions about community stigma towards individuals with opioid use disorder (OUD) between community members involved in the opioid response (i.e., coalition members) and the general public, and how community geography may moderate this relationship. METHODS This study administered identical cross-sectional surveys about perceived community opioid-related stigma to two distinct populations in 66 communities participating in the HEALing Communities Study prior to the intervention period (i.e., coalition members, November 2019-January 2020; residents, March-April 2020). Linear-mixed models compared survey responses of populations, including the moderating effect of community rural/urban location. RESULTS A total of 826 coalition members and 1131 residents completed the surveys. The study found no differences between the coalition members and residents for general perceived community opioid-related stigma. In both urban and rural communities, coalition members reported greater perceived community stigma than residents reported towards medication for opioid use disorder (MOUD), naloxone, and drug treatment as an alternative to incarceration. CONCLUSION Our findings suggest similar perceived community opioid-related stigma between coalition members and residents, yet differences emerge related to evidence-based practices (i.e., MOUD, naloxone, and drug treatment as an alternative to incarceration) to reduce opioid overdose deaths. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04111939.
Collapse
Affiliation(s)
- Daniel M Walker
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4000, Columbus, OH 43202, USA; CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4000, Columbus, OH 43202, USA.
| | - R Craig Lefebvre
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 22709, USA
| | - Alissa Davis
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA
| | - Karen Shiu-Yee
- CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4000, Columbus, OH 43202, USA
| | - Sadie Chen
- CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 700 Ackerman Rd, Suite 4000, Columbus, OH 43202, USA
| | - Rebecca D Jackson
- Center for Clinical and Translational Science and the Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, The Ohio State University, 376 W. 10th Ave, Suite 205, Columbus, OH 43210, USA
| | - Donald W Helme
- Department of Communication, College of Communication and Information, University of Kentucky, 263 Blazer Dining, Lexington, KY 40506, USA
| | - Emmanuel A Oga
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 22709, USA
| | - Carrie B Oser
- Department of Sociology, Center for Health Equity Transformation, Center on Drug & Alcohol Research, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40508, USA
| | - Caroline Stotz
- Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA
| | - Peter Balvanz
- Boston Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA
| | - Kat Asman
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 22709, USA
| | - JaNae Holloway
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 22709, USA
| | - Nicky Lewis
- Department of Communication, College of Communication and Information, University of Kentucky, 263 Blazer Dining, Lexington, KY 40506, USA
| | - Hannah K Knudsen
- Department of Sociology, Center for Health Equity Transformation, Center on Drug & Alcohol Research, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40508, USA; Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY 40508, USA
| |
Collapse
|
8
|
McGladrey M, Kelsch J, Lofwall MR, Fanucchi LC, Walsh SL, Oser CB. Get It in Writing: How to Make Medications for Opioid Use Disorder Available During Incarceration. J Correct Health Care 2024; 30:3-6. [PMID: 38150232 PMCID: PMC11071097 DOI: 10.1089/jchc.23.08.0065] [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] [Indexed: 12/28/2023]
Abstract
In a case example from the Kentucky HEALing Communities Study, extensive resources were deployed to address structural barriers and facilitate the provision of medication for opioid use disorder (OUD) in an urban county jail. However, implementation was unsuccessful, and this case example emphasizes the importance of including evidence-based medication for OUD (MOUD) treatment in the scope of work of jails' contracted medical providers. The privatization of correctional health care services allows local governments with opioid abatement funds to incorporate requirements into medical provider contracts to screen all people entering jails for OUD and to offer MOUD at intake, throughout incarceration, and upon release to everyone for whom it is clinically indicated. We provide sample contractual language that can be added to requests for medical provider proposals to help drive the private correctional health care market toward integrating MOUD treatment into their standard of care. This approach also could expedite efforts to scale up broad MOUD access across U.S. jails through sharing of workflows and best practices among the small group of national correctional health care companies contracted with jails in states with broad mandates, such as Massachusetts. Clinical Trial Registration: NCT04111939.
Collapse
Affiliation(s)
- Margaret McGladrey
- Center for Innovation in Population Health, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Jordan Kelsch
- Substance Use Priority Research Area, University of Kentucky, Lexington, Kentucky, USA
| | - Michelle R. Lofwall
- Center on Drug and Alcohol Research, Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Laura C. Fanucchi
- Department of Internal Medicine, University of Kentucky, Lexington, Kentucky, USA
| | - Sharon L. Walsh
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA
| | - Carrie B. Oser
- Center on Drug and Alcohol Research, Center for Health Equity Transformation, Department of Sociology, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
9
|
Davis A, Stringer KL, Drainoni ML, Oser CB, Knudsen HK, Aldrich A, Surratt HL, Walker DM, Gilbert L, Downey DL, Gardner SD, Tan S, Lines LM, Vandergrift N, Mack N, Holloway J, Lunze K, McAlearney AS, Huerta TR, Goddard-Eckrich DA, El-Bassel N. Community-level determinants of stakeholder perceptions of community stigma toward people with opioid use disorders, harm reduction services and treatment in the HEALing Communities Study. Int J Drug Policy 2023; 122:104241. [PMID: 37890391 PMCID: PMC10841835 DOI: 10.1016/j.drugpo.2023.104241] [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: 07/17/2023] [Revised: 09/16/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Community stigma toward people with opioid use disorder (OUD) can impede access to harm reduction services and treatment with medications for opioid use disorder (MOUD). Such community OUD stigma is partially rooted in community-level social and economic conditions, yet there remains a paucity of large-scale quantitative data examining community-level factors associated with OUD stigma. We examined whether rurality, social inequity, and racialized segregation across communities from four states in the HEALing Communities Study (HCS) were associated with 1) greater perceived community stigma toward people treated for OUD, 2) greater perceived intervention stigma toward MOUD, and 3) greater perceived intervention stigma toward naloxone by community stakeholders in the HCS. METHODS From November 2019-January 2020, a cross-sectional survey about community OUD stigma was administered to 801 members of opioid overdose prevention coalitions across 66 communities in four states prior to the start of HCS intervention activities. Bivariate analyses assessed pairwise associations between community rural/urban status and each of the three stigma variables, using linear mixed effect modeling to account for response clustering within communities, state, and respondent sociodemographic characteristics. We conducted similar bivariate analyses to assess pairwise associations between racialized segregation and social inequity. RESULTS On average, the perceived community OUD stigma scale score of stakeholders from rural communities was 4% higher (β=1.57, SE=0.7, p≤0.05), stigma toward MOUD was 6% higher (β=0.28, SE=0.1, p≤0.05), and stigma toward naloxone was 10% higher (β=0.46, SE=0.1, p≤0.01) than among stakeholders from urban communities. No significant differences in the three stigma variables were found among communities based on racialized segregation or social inequity. CONCLUSION Perceived community stigma toward people treated for OUD, MOUD, and naloxone was higher among stakeholders in rural communities than in urban communities. Findings suggest that interventions and policies to reduce community-level stigma, particularly in rural areas, are warranted.
Collapse
Affiliation(s)
- Alissa Davis
- Columbia University School of Social Work, New York, NY, United States.
| | - Kristi Lynn Stringer
- Department of Health and Human Performance, Community and Public Health, Middle Tennessee State University, Murfreesboro, TN, United States
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedesian School of Medicine/Boston Medical Center, Boston, MA, United States; Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, United States
| | - Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Hannah K Knudsen
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, Lexington, KY, United States
| | - Alison Aldrich
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Hilary L Surratt
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, Lexington, KY, United States
| | - Daniel M Walker
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Louisa Gilbert
- Columbia University School of Social Work, New York, NY, United States
| | - Dget L Downey
- Columbia University School of Social Work, New York, NY, United States
| | - Sam D Gardner
- Columbia University School of Social Work, New York, NY, United States
| | - Sylvia Tan
- RTI International, Research Triangle Park, NC, United States
| | - Lisa M Lines
- RTI International, Research Triangle Park, NC, United States
| | | | - Nicole Mack
- RTI International, Research Triangle Park, NC, United States
| | - JaNae Holloway
- RTI International, Research Triangle Park, NC, United States
| | - Karsten Lunze
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedesian School of Medicine/Boston Medical Center, Boston, MA, United States
| | - Ann Scheck McAlearney
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Timothy R Huerta
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | | | - Nabila El-Bassel
- Columbia University School of Social Work, New York, NY, United States
| |
Collapse
|
10
|
Knudsen HK, Freeman PR, Oyler DR, Oser CB, Walsh SL. Scaling up overdose education and naloxone distribution in Kentucky: adoption and reach achieved through a "hub with many spokes" model. Addict Sci Clin Pract 2023; 18:72. [PMID: 38031180 PMCID: PMC10688494 DOI: 10.1186/s13722-023-00426-6] [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: 05/15/2023] [Accepted: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Scaling up overdose education and naloxone distribution (OEND), an evidence-based practice for reducing opioid overdose mortality, in communities remains a challenge. Novel models and intentional implementation strategies are needed. Drawing upon the EPIS model's phases of Exploration, Preparation, Implementation, and Sustainment (Aarons et al. in Adm Policy Ment Health 38:4-23, 2011), this paper describes the development of the University of Kentucky's unique centralized "Naloxone Hub with Many Spokes" approach to implementing OEND as part of the HEALing Communities Study (HCS-KY). METHODS To scale up OEND in eight Kentucky counties, implementation strategies were utilized at two levels: a centralized university-based naloxone dispensing unit ("Naloxone Hub") and adopting organizations ("Many Spokes"). Implementation strategies varied across the EPIS phases, but heavily emphasized implementation facilitation. The Naloxone Hub provided technical assistance, overdose education resources, and no-cost naloxone to partner organizations. Implementation outcomes across the EPIS phases were measured using data from internal study management trackers and naloxone distribution data submitted by partner organizations. RESULTS Of 209 organizations identified as potential partners, 84.7% (n = 177) engaged in the Exploration/Preparation phase by participating in an initial meeting with an Implementation Facilitator about the HCS-KY OEND program. Adoption of the HCS-KY OEND program, defined as receipt of at least one shipment of naloxone, was achieved with 69.4% (n = 145) of all organizations contacted. During the Implementation phase, partner organizations distributed 40,822 units of naloxone, with partner organizations distributing a mean of 281.5 units of naloxone (SD = 806.2). The mean number of units distributed per county was 5102.8 (SD = 3653.3; range = 1057 - 11,053) and the mean county level distribution rate was 8396.5 units per 100,000 residents (SD = 8103.1; range = 1709.5-25,296.3). Of the partner organizations that adopted the HCS-KY OEND program, 87.6% (n = 127) attended a sustainability meeting with an Implementation Facilitator and agreed to transition to the state-funded naloxone program. CONCLUSIONS These data demonstrate the feasibility of this "Hub with Many Spokes" model for scaling up OEND in communities highly affected by the opioid epidemic. Trial registration ClinicalTrials.gov, NCT04111939. Registered 30 September 2019, https://clinicaltrials.gov/ct2/show/NCT04111939 .
Collapse
Affiliation(s)
- Hannah K Knudsen
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA.
| | - Patricia R Freeman
- Department of Pharmacy Practice and Science and Center for the Advancement of Pharmacy Practice, College of Pharmacy, University of Kentucky, Lexington, KY, 40536, USA
| | - Douglas R Oyler
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, 40536, USA
| | - Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, and Center for Health Equity Transformation, University of Kentucky, Lexington, KY, 40536, USA
| | - Sharon L Walsh
- Department of Behavioral Science and Center on Drug & Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA
| |
Collapse
|
11
|
Jones AA, Duncan MS, Perez-Brumer A, Connell CM, Burrows WB, Oser CB. Impacts of intergenerational substance use and trauma among black women involved in the criminal justice system: A longitudinal analysis. J Subst Use Addict Treat 2023; 153:208952. [PMID: 37654010 PMCID: PMC10474323 DOI: 10.1016/j.josat.2023.208952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/16/2022] [Revised: 12/01/2022] [Accepted: 01/04/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Intergenerational substance use and trauma disproportionately impact racialized women. Yet, how these factors impact outcomes in women involved in the criminal justice system is understudied. METHODS Using data from 443 participants in the Black Women in a Study of Epidemics, we assessed the impact of intergenerational substance use and trauma on participant drug use and open Child Protective Services (CPS) cases over 18 months. In repeated-measures logistic regression, intergenerational substance and trauma were independent variables, while participants' drug use at each follow-up and any open CPS case (s) served as separate dependent variables. Models were adjusted for criminal justice involvement, age, marital status, education, childhood guardian, number of children, and prior year homelessness. RESULTS On average, participants were aged 35 years, 64 % had never married, and 44 % were raised by both parents. Two-thirds of women (67 %) reported intergenerational substance use (≥1 parent and/or grandparent with alcohol/drug problems), while only 13 % reported intergenerational trauma. Each increase in the number of parents/grandparents with drug/alcohol problems was associated with 30 % increased odds of participants' drug use (aOR 1.30, 95 % CI: 1.07,1.57) and 40 % increased odds of having an open CPS case (aOR 1.40, 95 % CI: 1.11, 1.78). The association of intergenerational trauma and CPS cases was attenuated with sociodemographic/contextualizing factors. CONCLUSIONS Intergenerational substance use and trauma are associated with negative outcomes. Our findings highlight the need for substance use treatment to address the pervasive generational effects of substance use and trauma faced by racialized women in the criminal justice system.
Collapse
Affiliation(s)
- Abenaa A Jones
- Department of Human Development and Family Studies, Pennsylvania State University, United States of America; Consortium for Substance Use and Addiction, The Pennsylvania State University, United States of America.
| | - Meredith S Duncan
- Department of Biostatistics, University of Kentucky, United States of America.
| | | | - Christian M Connell
- Department of Human Development and Family Studies, Pennsylvania State University, United States of America.
| | - William B Burrows
- Department of Biostatistics, University of Kentucky, United States of America.
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, United States of America; Center on Drug & Alcohol Research, Center for Health Equity Transformation.
| |
Collapse
|
12
|
Choi S, Bunting A, Nadel T, Neighbors CJ, Oser CB. Organizational access points and substance use disorder treatment utilization among Black women: a longitudinal cohort study. Health Justice 2023; 11:31. [PMID: 37603194 PMCID: PMC10440874 DOI: 10.1186/s40352-023-00236-7] [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: 11/22/2022] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
INTRODUCTION Health and social service organizations, including the emergency department (ED) and public assistance programs, constitute a social safety net that may serve as an "access point" for substance use treatment utilization. Racialization of substance use disorder (SUD) and gender disparities in access to treatment contribute to differences in health and social service utilization, including substance use treatment for Black women. We therefore explored the role of various access points in facilitating the use of substance use treatment among Black women with substance use and involvement in the criminal justice system. METHODS We used data from the Black Women in the Study of Epidemics (B-WISE) project (2008-2011), which recruited Black women who use drugs from community, probation, and prison recruitment settings in Kentucky. B-WISE is a three-wave panel survey collected on a six-month interval. We estimated dynamic panel models to understand whether time-varying use of services influenced women's substance use treatment utilization over 18-months, adjusting for time-invariant characteristics. We stratified the analysis based on where women were recruited (i.e., community, prison, and probation). RESULTS The sample included 310 persons and 930 person-waves. For the community and prison samples, the use of an ED in the 6 months prior decreased women's likelihood of subsequent substance use treatment use (Coef: -0.21 (95% CI: -0.40, -0.01); -0.33 (95% CI: -0.60, -0.06), respectively). For the probation sample, receiving support from public assistance (i.e., food stamps, housing, cash assistance) increased the likelihood of subsequent substance use treatment use (0.27 (95% CI: 0.08, 0.46)). CONCLUSION Interactions with health and social service organizations predicted Black women's use of substance use treatment services and varied based on their involvement in the criminal justice system. Public assistance venues for Black women on probation may be a point of intervention to increase their access to and use of substance use treatment.
Collapse
Affiliation(s)
- Sugy Choi
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Amanda Bunting
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Talia Nadel
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Charles J Neighbors
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
13
|
Janulis P, Phillips G, Melville J, Hogan B, Banner K, Mustanski B, Oser CB, Tillson M, Schneider J, Birkett M. Network canvas: an open-source tool for capturing social and contact network data. Int J Epidemiol 2023; 52:1286-1291. [PMID: 36944105 PMCID: PMC10396415 DOI: 10.1093/ije/dyad036] [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: 09/07/2022] [Accepted: 03/08/2023] [Indexed: 03/23/2023] Open
Abstract
MOTIVATION Social influence and contact networks are extremely important for understanding health behaviour and the spread of disease. Yet, most traditional software tools are not optimized to capture these data, making measurement of personal networks challenging. Our team developed Network Canvas to provide an end-to-end workflow with intuitive interfaces to enable researchers to design and conduct network interviews. IMPLEMENTATION Network Canvas consists of three applications (Architect, Interviewer and Server). All applications are written in JavaScript and run on Windows, macOS and Linux; Interviewer also runs on Android and iOS. GENERAL FEATURES Network Canvas substantially reduces the complexity and technical knowledge required to collect network data via three point-and-click applications. The tool has wide applicability for measuring contact and social influence networks in epidemiology. AVAILABILITY Network Canvas is open source and freely available [networkcanvas.com] under the GNU General Public License 3.
Collapse
Affiliation(s)
- Patrick Janulis
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Gregory Phillips
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Joshua Melville
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Bernie Hogan
- Oxford Internet Institute, University of Oxford, Oxford, UK
| | - Kate Banner
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | - Martha Tillson
- Department of Sociology, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - John Schneider
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Michelle Birkett
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| |
Collapse
|
14
|
Malone N, Dogan-Dixon JN, Thorpe S, Thrasher SS, Wheeler P, Stevens-Watkins D, Oser CB. Cultural Predictors of Self-Esteem Among Black Women With Criminal Justice Involvement and Herpes Simplex Virus. Health Promot Pract 2023:15248399231171951. [PMID: 37264999 DOI: 10.1177/15248399231171951] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Black women have disproportionately alarming HSV-2 infection rates yet receive little attention in sexual health literature. Using a strengths-based resilience framework, this study sought to determine culturally relevant protective predictors of self-esteem for Black women who are justice-involved and have HSV-2. The authors conducted secondary data analysis on data from the "Black Women in the Study of Epidemics (B-WISE) Project," a longitudinal prospective study investigating health disparities and health services utilization among Black women with justice involvement. At baseline, N = 151 Black women with HSV-2 who were incarcerated or on probation completed survey measures assessing self-esteem, ethnic identity affirmation and belonging, perceived social support, and John Henryism Active Coping. Hierarchical linear regression analyses revealed ethnic identity affirmation and belonging and John Henryism Active Coping were significant predictors of self-esteem at 6-month follow-up. Implications are provided for current health professionals.
Collapse
|
15
|
Pérez-Figueroa RE, Oser CB, Malinowska K. Access to naloxone in underserved communities. BMJ 2023; 381:894. [PMID: 37185348 DOI: 10.1136/bmj.p894] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
| | - Carrie B Oser
- University of Kentucky College of Arts and Sciences, Lexington, KY, USA
| | | |
Collapse
|
16
|
Booty M, Harp K, Batty E, Knudsen HK, Staton M, Oser CB. Barriers and facilitators to the use of medication for opioid use disorder within the criminal justice system: Perspectives from clinicians. J Subst Use Addict Treat 2023; 149:209051. [PMID: 37084815 DOI: 10.1016/j.josat.2023.209051] [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] [Received: 09/09/2022] [Revised: 01/09/2023] [Accepted: 04/15/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION This article examines social service clinicians' (SSCs) perspectives of factors within the criminal justice system that impact justice-involved individuals' use of medications for opioid use disorder (MOUD). Opioid use disorder (OUD) rates are high among justice-involved individuals, and overdose risk is heightened upon release from incarceration. This study is innovative, as it specifically focuses on criminal justice contexts that influence the MOUD continuum of care from the perspective of clinicians working within the criminal justice system. Understanding criminal justice-related facilitators and barriers to MOUD treatment will guide tailored policy intervention to increase MOUD use and promote recovery and remission among justice-involved individuals. METHODS The study completed qualitative interviews with 25 SSCs who are employed by a state department of corrections to provide assessment and referrals to substance use treatment to individuals on community supervision. The study used NVivo software to code the major themes found within each transcribed interview; two research assistants participated in consensus coding to ensure consistency in coding across transcripts. This study focused on the secondary codes that fell under the "Criminal Justice System" primary code, as well as codes that indicated barriers and facilitators to MOUD treatment. RESULTS SSCs cited sentencing time credits as structural facilitators of MOUD treatment; clients sought more information about extended-release naltrexone since time off of their sentence was available if initiated. Support for extended-release naltrexone by officers and judges was often mentioned as an attitudinal facilitator of initiation. Poor intra-agency collaboration among department of corrections agents was an institutional barrier to MOUD. Also, probation and parole officers' stigma surrounding other types of MOUD, specifically buprenorphine and methadone, was an attitudinal barrier to MOUD within the criminal justice system. CONCLUSIONS Future research should examine the effect that time credits have on extended-release naltrexone initiation, considering the wide consensus among SSCs that their clients were motivated to initiate this type of MOUD because of the resulting time off their sentences. Stigma among probation and parole officers and lack of communication within the criminal justice system need to be addressed so that more individuals with OUD may be exposed to life-saving treatments.
Collapse
Affiliation(s)
- Marisa Booty
- University of Kentucky College of Arts & Sciences, Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506, United States of America.
| | - Kathi Harp
- University of Kentucky College of Public Health, Department of Health Management & Policy, 111 Washington Ave, Lexington, KY 40536, United States of America
| | - Evan Batty
- University of Kentucky College of Arts & Sciences, Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America
| | - Hannah K Knudsen
- University of Kentucky College of Medicine, Department of Behavioral Science, 109 Medical Behavioral Science Building, Lexington, KY 40536, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America
| | - Michele Staton
- University of Kentucky College of Medicine, Department of Behavioral Science, 109 Medical Behavioral Science Building, Lexington, KY 40536, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America
| | - Carrie B Oser
- University of Kentucky College of Arts & Sciences, Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506, United States of America; University of Kentucky Center on Drug & Alcohol Research, 845 Angliana Ave, Lexington, KY 40508, United States of America; University of Kentucky Center for Health Equity Transformation, Suite 460 Healthy Kentucky Research Building, 760 Press Avenue, Lexington, KY 40536, United States of America
| |
Collapse
|
17
|
Oser CB, Batty E, Booty M, Eddens K, Knudsen HK, Perry B, Rockett M, Staton M. Social ecological factors and medication treatment for opioid use disorder among justice-involved rural and urban persons: the Geographic variation in Addiction Treatment Experiences (GATE) longitudinal cohort study protocol. BMJ Open 2023; 13:e066068. [PMID: 36940952 PMCID: PMC10030549 DOI: 10.1136/bmjopen-2022-066068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
INTRODUCTION Three medications are Food and Drug Administration approved for the treatment of opioid use disorder (OUD); however, these medications are underused within prisons, which elevates the risk of relapse and overdose when persons with opioid use disorder (POUD) are released. Research is scant regarding the multilevel factors associated with POUDs' willingness to initiate medication treatment for opioid use disorder (MOUD) while in prison and their continued engagement in treatment after release. Furthermore, rural and urban populations have not been compared. The Geographic variation in Addiction Treatment Experiences (GATE) study seeks to identify multilevel factors (ie, individual, personal network, and structural factors) influencing prison-based extended-release injectable naltrexone (XR-NTX) and buprenorphine initiation and will examine predictors of postrelease MOUD use and adverse outcomes (ie, relapse, overdose, recidivism) among both rural and urban POUDs. METHODS AND ANALYSIS This mixed methods study employs a social ecological framework. A prospective observational longitudinal cohort study is being conducted with 450 POUDs using survey and social network data collected in prison, immediately postrelease, 6 months postrelease and 12 months postrelease to identify multilevel rural-urban variation in key outcomes. In-depth qualitative interviews are being conducted with POUDs, prison-based treatment staff and social service clinicians. To maximise rigour and reproducibility, we employ a concurrent triangulation strategy, whereby qualitative and quantitative data contribute equally to the analysis and are used for cross-validation when examining scientific aims. ETHICS AND DISSEMINATION The GATE study was reviewed and approved by the University of Kentucky's Institutional Review Board prior to implementation. Findings will be disseminated through presentations at scientific and professional association conferences, peer-reviewed journal publications and a summary aggregate report submitted to the Kentucky Department of Corrections.
Collapse
Affiliation(s)
- Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, Kentucky, USA
| | - Evan Batty
- Department of Sociology, Center on Drug & Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Marisa Booty
- Department of Sociology, Center on Drug & Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Kate Eddens
- Department of Epidemiology & Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana, USA
| | - Hannah K Knudsen
- Department of Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Brea Perry
- Department of Sociology, Irsay Family Research Institute, Indiana University, Bloomington, Indiana, USA
| | - Maria Rockett
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, Kentucky, USA
| | - Michele Staton
- Department of Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
18
|
Batty EJ, Ibragimov U, Fadanelli M, Gross S, Cooper K, Klein E, Ballard AM, Young AM, Lockard AS, Oser CB, Cooper HLF. A qualitative analysis of rural syringe service program fidelity in Appalachian Kentucky: Staff and participant perspectives. J Rural Health 2023; 39:328-337. [PMID: 36117151 PMCID: PMC10484119 DOI: 10.1111/jrh.12715] [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] [Indexed: 11/29/2022]
Abstract
PURPOSE As drug-related epidemics have expanded from cities to rural areas, syringe service programs (SSPs) and other harm reduction programs have been slow to follow. The recent implementation of SSPs in rural areas demands attention to program fidelity based on core components of SSP success. METHODS Semistructured interviews conducted with clients and staff at 5 SSPs in 5 counties within 2 Central Appalachian health districts. Interviews covered fidelity of SSP implementation to 6 core components: (1) meet needs for harm reduction supplies; (2) education and counseling for sexual, injection, and overdose risks; (3) cooperation between SSPs and local law enforcement; (4) provide other health and social services; (5) ensure low threshold access to services; and (6) promote dignity, the impact of poor fidelity on vulnerability to drug-related harms, and the risk environment's influence on program fidelity. We applied thematic methods to analyze the data. FINDINGS Rural SSPs were mostly faithful to the 6 core components. Deviations from core components can be attributed to certain characteristics of the local rural risk environment outlined in the risk environment model, including geographic remoteness, lack of resources and underdeveloped infrastructure, and stigma against people who inject drugs (PWID) CONCLUSIONS: As drug-related epidemics continue to expand outside cities, scaling up SSPs to serve rural PWID is essential. Future research should explore whether the risk environment features identified also influence SSP fidelity in other rural areas and develop and test strategies to strengthen core components in these vulnerable areas.
Collapse
Affiliation(s)
- E J Batty
- Department of Sociology, University of Kentucky, Lexington, Kentucky, USA
| | - U Ibragimov
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - M Fadanelli
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - S Gross
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - K Cooper
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - E Klein
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - A M Ballard
- Department of Environmental Health, Emory University, Atlanta, Georgia, USA
| | - A M Young
- Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA
| | - A S Lockard
- Kentucky River District Health Department, Hazard, Kentucky, USA
| | - C B Oser
- Department of Sociology, University of Kentucky, Lexington, Kentucky, USA
| | - H L F Cooper
- Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
19
|
Fallin-Bennett A, Tillson M, Webster JM, Oser CB, Becan JE, Knight K, Byard J, Staton M. Scales for participant Alliance with Recovery Coach (SPARC): initial development and pilot test. Addict Res Theory 2023; 32:20-26. [PMID: 38385062 PMCID: PMC10881207 DOI: 10.1080/16066359.2023.2182881] [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: 10/06/2022] [Accepted: 02/16/2023] [Indexed: 02/23/2024]
Abstract
Recovery coaches are individuals with lived experience with recovery from substance use disorder who typically engender a greater sense of trust than found with other types of healthcare providers. However, there currently are no validated tools that measure the connection between recovery coaches and their participants. The purpose of this study was to describe the initial development of the Scales for Participant Alliance with Recovery Coach (SPARC) to measure recovery coach connection or alliance, including initial psychometric analyses. Measurement development began with five scales of the Client Evaluation of Self Treatment (treatment participation, treatment satisfaction, rapport, peer support, and social support). Adapted items were pre-tested with focus groups (n = 8) to ensure they were meaningful and accurately reflected the domains (Study 1). After modifications, the SPARC has six scales (engagement, satisfaction, rapport, motivation and encouragement, role model and community linkage). The survey was piloted with 100 individuals (Study 2) age 18 or over who had met with a recovery coach within the last six months. Most study participants were male (60%) and white (87%) with less than two years in recovery. After removing two low performing items, the items for five of the domains had acceptable internal consistency. The items for the engagement domain had a slightly lower reliability. Findings suggest that items cover relevant recovery coach roles, are internally consistent within domains, and can be easily administered to individuals engaging in recovery coaching services. Additional research is needed with a larger, more heterogenous sample to further refine items.
Collapse
Affiliation(s)
- Amanda Fallin-Bennett
- University of Kentucky College of Nursing, Lexington, KY, USA
- Voices of Hope, Lexington Inc., Lexington, KY, USA
| | - Martha Tillson
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - J. Matthew Webster
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Carrie B. Oser
- Department of Sociology, Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | | | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Jeremy Byard
- Louisville Recovery Community Connection, Louisville, KY, USA
| | - Michele Staton
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
20
|
Uhrig Castonguay BJ, LeMasters K, Corsi C, Batty EJ, Krajewski TJ, Travis M, Waleed C, Oser CB, Nowotny KM, Brinkley-Rubinstein L. Retention strategies among those on community supervision in the South: Lessons learned during the COVID-19 pandemic. PLoS One 2023; 18:e0283621. [PMID: 37018225 PMCID: PMC10075476 DOI: 10.1371/journal.pone.0283621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/13/2023] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Cohort studies must implement effective retention strategies to produce internally valid and generalizable results. Ensuring all study participants are retained, particularly those involved in the criminal legal system, ensures study findings and future interventions will be relevant to this group, who are often lost to follow-up: critical to achieving health equity. Our objective was to characterize retention strategies and describe overall retention among an 18-month longitudinal cohort study of persons on community supervision prior to and during the COVID-19 pandemic. METHODS We implemented various retention strategy best-practices (e.g., multiple forms of locator information, training study staff on rapport building, study-branded items). During the COVID-19 pandemic, we developed and describe new retention strategies. We calculated overall retention and analyzed differences between those retained and lost to follow-up by demographic characteristics. RESULTS Prior to the start of the COVID-19 pandemic, 227 participants enrolled across three sites (N = 46 North Carolina; N = 99 Kentucky; N = 82 Florida). Of these, 180 completed the final 18-month visit, 15 were lost to follow-up, and 32 were ineligible. This resulted in an overall retention of 92.3% (180/195). While most participant characteristics did not differ by retention status, a greater proportion of those experiencing unstable housing were lost to follow-up. CONCLUSION Our findings highlight that when retention strategies are flexible, particularly during a pandemic, high retention is still achievable. In addition to retention best-practices (e.g., frequent requests for updated locator information) we suggest other studies consider retention strategies beyond the study participant (e.g., paying participant contacts) and incentivize on-time study visit completion (e.g., providing a bonus when completed the study visit on time).
Collapse
Affiliation(s)
- Breana J Uhrig Castonguay
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- School of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Katherine LeMasters
- School of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Chris Corsi
- School of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Evan J Batty
- Department of Sociology, University of Kentucky, Lexington, Kentucky, United States of America
| | - Taylor J Krajewski
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Center for AIDS Research, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Madelene Travis
- School of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Craig Waleed
- Disability Rights of North Carolina, Raleigh, North Carolina, United States of America
| | - Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, Kentucky, United States of America
| | - Kathryn M Nowotny
- Department of Sociology and Criminology, University of Miami, Miami, Florida, United States of America
| | - Lauren Brinkley-Rubinstein
- School of Social Medicine, Center for Health Equity Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| |
Collapse
|
21
|
Perry BL, Odabaş M, Yang KC, Lee B, Kaminski P, Aronson B, Ahn YY, Oser CB, Freeman PR, Talbert JC. New means, new measures: assessing prescription drug-seeking indicators over 10 years of the opioid epidemic. Addiction 2022; 117:195-204. [PMID: 34227707 PMCID: PMC8664959 DOI: 10.1111/add.15635] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 06/26/2020] [Revised: 10/02/2020] [Accepted: 06/23/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Prescription drug-seeking (PDS) from multiple prescribers is a primary means of obtaining prescription opioids; however, PDS behavior has probably evolved in response to policy shifts, and there is little agreement about how to operationalize it. We systematically compared the performance of traditional and novel PDS indicators. DESIGN Longitudinal study using a de-identified commercial claims database. SETTING United States, 2009-18. PARTICIPANTS A total of 318 million provider visits from 21.5 million opioid-prescribed patients. MEASUREMENTS We applied binary classification and generalized linear models to compare predictive accuracy and average marginal effect size predicting future opioid use disorder (OUD), overdose and high morphine milligram equivalents (MME). We compared traditional indicators of PDS to a network centrality measure, PageRank, that reflects the prominence of patients in a co-prescribing network. Analyses used the same data and adjusted for patient demographics, region, SES, diagnoses and health services. FINDINGS The predictive accuracy of a widely used traditional measure (N + unique doctors and N + unique pharmacies in 90 days) on OUD, overdose and MME decreased between 2009 and 2018, and performed no better than chance (50% accuracy) after 2015. Binarized PageRank measures however exhibited higher predictive accuracy than the traditional binary measures throughout 2009-2018. Continuous indicators of PDS performed better than binary thresholds, with days of Rx performing best overall with 77-93% predictive accuracy. For example, days of Rx had the highest average marginal effects on overdose and OUD: a 1 standard deviation increase in days of Rx was associated with a 6-8% [confidence intervals (CIs) = 0.058-0.061 and 0.078-0.082] increase in the probability of overdose and a 4-5% (CIs = 0.038-0.043 and 0.047-0.053) increase in the probability of OUD. PageRank performed nearly as well or better than traditional indicators of PDS, with predictive performance increasing after 2016. CONCLUSIONS In the United States, network-based measures appear to have increasing promise for identifying prescription opioid drug-seeking behavior, while indicators based on quantity of providers or pharmacies appear to have decreasing utility.
Collapse
Affiliation(s)
- Brea L. Perry
- Network Science Institute, Indiana University, 1001 45/46 Bypass, Bloomington, IN, United States of America,Department of Sociology, Indiana University, Bloomington, IN, United States of America
| | - Meltem Odabaş
- Department of Sociology, Indiana University, Bloomington, IN, United States of America
| | - Kai-Cheng Yang
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
| | - Byungkyu Lee
- Department of Sociology, Indiana University, Bloomington, IN, United States of America
| | - Patrick Kaminski
- Department of Sociology, Indiana University, Bloomington, IN, United States of America,School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
| | - Brian Aronson
- Department of Sociology, Indiana University, Bloomington, IN, United States of America
| | - Yong-Yeol Ahn
- Network Science Institute, Indiana University, 1001 45/46 Bypass, Bloomington, IN, United States of America,School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, Lexington, KY, United States of America
| | - Patricia R. Freeman
- Department of Pharmacy Practice and Science, University of Kentucky, Lexington, KY, United States of America
| | - Jeffrey C. Talbert
- Department of Pharmacy Practice and Science, University of Kentucky, Lexington, KY, United States of America
| |
Collapse
|
22
|
Abstract
PURPOSE The purpose of this study was to conduct a psychometric evaluation of a new 35-item survey developed in the United States to measure rural identity. METHODS Factor structure, reliability, convergent validity, and incremental validity of the Rural Identity Scale (RIS) were examined using two datasets. Study 1 examined RIS psychometric properties using survey data collected from substance use treatment counselors in a southeastern state (n = 145), while Study 2 used data collected from women incarcerated in rural jails (n = 400). FINDINGS A one-factor structure containing 15 items was identified in the RIS, with acceptable internal reliability (α = .72-.83). In Study 1, participants from rural counties had significantly higher RIS scores than their urban counterparts. In both studies, convergent validity was evaluated and the RIS scores were significantly associated with other measures relevant to identity and rurality at the bivariate level. Incremental validity was supported in multivariable models as the RIS scores were significantly and uniquely associated with primary rural place variables in each sample. CONCLUSIONS This study is an initial step toward a reliable, valid scale measuring rural identity. RIS may be especially beneficial to health research as a methodological tool that can contextualize health behaviors among rural populations and highlight potential interventions to promote health equity.
Collapse
Affiliation(s)
- Carrie B. Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, Kentucky
| | - Justin Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan J. Batty
- Department of Sociology, University of Kentucky, Lexington, Kentucky
| | - Erin Pullen
- Indiana University Network Science Institute, Bloomington, Indiana
| | - Michele Staton
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, Lexington, Kentucky
| |
Collapse
|
23
|
Abstract
BACKGROUND Obtaining accurate drug use data is important in the field of substance use research. Urinalysis, considered gold standard, can be costly or infeasible, whereas self-report is quick and easy, but susceptible to imperfect recall or misrepresentation. It is important to determine the concordance between self-report and urinalysis, and better understand the contexts and participant characteristics that influence self-report accuracy. The current study aims to assess this concordance for marijuana and cocaine in a sample of Black American women, some with criminal justice exposure, and to investigate predictors of non-concordance. METHODS In this longitudinal study, a sample of Black American women were recruited from community, prison, and probation settings. Self-report drug use and urine drug screens were obtained at 6-, 12-, and 18-month follow-ups, allowing for the calculation of concordance. Generalized linear mixed models were used to assess participant characteristics that predicted non-concordance (both false positives and false negatives). RESULTS In general, there was agreement between self-report and urinalysis results for both marijuana and cocaine. Baseline drug use status was the most consistent predictor of non-concordance. Individuals recruited while on probation were more likely to have false negative results and less likely to have false positive results. Additionally, concordance rates for marijuana increased over the follow-up period. CONCLUSIONS Self-reported marijuana and cocaine use are accurate measures of actual drug consumption in a sample of Black American women with a variety of criminal justice interactions.
Collapse
Affiliation(s)
- Christopher J McLouth
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, Lexington, KY, USA
| | - Danelle Stevens-Watkins
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
24
|
Knudsen HK, Drainoni ML, Gilbert L, Huerta TR, Oser CB, Aldrich AM, Campbell AN, Crable EL, Garner BR, Glasgow LM, Goddard-Eckrich D, Marks KR, McAlearney AS, Oga EA, Scalise AL, Walker DM. Corrigendum to "Model and approach for assessing implementation context and fidelity in the HEALing Communities Study" [Drug Alcohol Depend. 217 (2020) 108330]. Drug Alcohol Depend 2021; 224:108742. [PMID: 33984669 PMCID: PMC8445314 DOI: 10.1016/j.drugalcdep.2021.108742] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hannah K. Knudsen
- Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA,Corresponding author at: University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases and Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University School of Medicine, USA; Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2014, Boston, MA, 02118, USA.
| | - Louisa Gilbert
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
| | - Timothy R. Huerta
- College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 530, Columbus, OH, 43210, USA
| | - Carrie B. Oser
- Department of Sociology and Center on Drug and Alcohol Research, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USA
| | - Alison M. Aldrich
- CATALYST, the Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 530, Columbus, OH, 43210, USA
| | - Aimee N.C. Campbell
- Columbia University Irving Medical Center, Department of Psychiatry and New York State Psychiatric Institute, 1051 Riverside Drive, Box 120, New York, NY, 10032, USA
| | - Erika L. Crable
- Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University School of Medicine, Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2030, Boston, MA, 02118, USA
| | - Bryan R. Garner
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA
| | - LaShawn M. Glasgow
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA
| | - Dawn Goddard-Eckrich
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
| | - Katherine R. Marks
- Department of Behavioral Science, University of Kentucky, 1100 Veterans Drive, Medical Behavioral Science Building Room 108, Lexington, KY, 40536, USA
| | - Ann Scheck McAlearney
- Department of Family and Community Medicine and CATALYST, The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 530, Columbus, OH, 43210, USA.
| | - Emmanuel A. Oga
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA
| | - Ariel L. Scalise
- Department of Infectious Disease, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Daniel M. Walker
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 520, Columbus, OH, 43210, USA
| |
Collapse
|
25
|
Bunting AM, Oser CB, Staton M, Knudsen HK. Pre-incarceration polysubstance use involving opioids: A unique risk factor of postrelease return to substance use. J Subst Abuse Treat 2021; 127:108354. [PMID: 34134861 DOI: 10.1016/j.jsat.2021.108354] [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] [Received: 09/03/2020] [Revised: 12/07/2020] [Accepted: 03/02/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Justice-involved populations are at increased risk of overdose following release from prison and jail. This risk is exacerbated by polysubstance use, including the use of opioids with other substances. This study explored pre-incarceration polysubstance use involving opioids as a unique risk factor for postrelease return to substance use. METHODS The study examined data from a cohort of 501 justice-involved persons who were enrolled in a therapeutic community treatment program while incarcerated. Latent profile validation identified profiles of polysubstance use involving opioids prior to incarceration. Multivariate logistic regression examined return to substance use, defined as self-reported relapse, and a time series model examined time in the community until a relapse event occurred. RESULTS A latent profile validation found six unique polysubstance opioid patterns prior to incarceration. Two of these profiles, primarily alcohol and primarily buprenorphine, were at increased and accelerated risk for relapse postrelease relative to a less polysubstance use profile. Both profiles at increased risk had pre-incarceration co-use of marijuana (≈45% of month) and nonmedical use of opioids (≈40% of month) but were unique in their respective near daily use of alcohol and nonmedical buprenorphine. CONCLUSIONS Among persons who use opioids returning to the community, return to substance use occurs along a continuum of risk. Providers' consideration of polysubstance use patterns during treatment may assist in mitigating adverse outcomes for patients postrelease.
Collapse
Affiliation(s)
- Amanda M Bunting
- Department of Sociology, University of Kentucky, Lexington, KY 40508, United States.
| | - Carrie B Oser
- Department of Sociology, University of Kentucky, Lexington, KY 40508, United States; Center on Drug and Alcohol and Research, University of Kentucky, Lexington, KY 40508, United States
| | - Michele Staton
- Center on Drug and Alcohol and Research, University of Kentucky, Lexington, KY 40508, United States; Department of Behavioral Science, University of Kentucky, Lexington, KY 40508, United States
| | - Hannah K Knudsen
- Center on Drug and Alcohol and Research, University of Kentucky, Lexington, KY 40508, United States; Department of Behavioral Science, University of Kentucky, Lexington, KY 40508, United States
| |
Collapse
|
26
|
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.
Collapse
|
27
|
Knudsen HK, Drainoni ML, Gilbert L, Huerta TR, Oser CB, Aldrich AM, Campbell AN, Crable EL, Garner BR, Glasgow LM, Goddard-Eckrich D, Marks KR, McAlearney AS, Oga EA, Scalise AL, Walker DM. Model and approach for assessing implementation context and fidelity in the HEALing Communities Study. Drug Alcohol Depend 2020; 217:108330. [PMID: 33086156 PMCID: PMC7531282 DOI: 10.1016/j.drugalcdep.2020.108330] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 08/13/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND In response to the U.S. opioid epidemic, the HEALing (Helping to End Addiction Long-termSM) Communities Study (HCS) is a multisite, wait-listed, community-level cluster-randomized trial that aims to test the novel Communities That HEAL (CTH) intervention, in 67 communities. CTH will expand an integrated set of evidence-based practices (EBPs) across health care, behavioral health, justice, and other community-based settings to reduce opioid overdose deaths. We present the rationale for and adaptation of the RE-AIM/PRISM framework and methodological approach used to capture the CTH implementation context and to evaluate implementation fidelity. METHODS HCS measures key domains of the internal and external CTH implementation context with repeated annual surveys and qualitative interviews with community coalition members and key stakeholders. Core constructs of fidelity include dosage, adherence, quality, and program differentiation-the adaptation of the CTH intervention to fit each community's needs. Fidelity measures include a monthly CTH checklist, collation of artifacts produced during CTH activities, coalition and workgroup attendance, and coalition meeting minutes. Training and technical assistance delivered by the research sites to the communities are tracked monthly. DISCUSSION To help attenuate the nation's opioid epidemic, the adoption of EBPs must be increased in communities. The HCS represents one of the largest and most complex implementation research experiments yet conducted. Our systematic examination of implementation context and fidelity will significantly advance understanding of how to best evaluate community-level implementation of EBPs and assess relations among implementation context, fidelity, and intervention impact.
Collapse
Affiliation(s)
- Hannah K. Knudsen
- Department of Behavioral Science and Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA,Corresponding author at: University of Kentucky, 845 Angliana Avenue, Room 204, Lexington, KY, 40508, USA
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases and Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University School of Medicine, Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2014, Boston, MA, 02118, USA.
| | - Louisa Gilbert
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
| | - Timothy R. Huerta
- College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 530, Columbus, OH, 43210, USA
| | - Carrie B. Oser
- Department of Sociology and Center on Drug and Alcohol Research, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY, 40506, USA
| | - Alison M. Aldrich
- CATALYST, the Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 530, Columbus, OH, 43210, USA
| | - Aimee N.C. Campbell
- Columbia University Irving Medical Center, Department of Psychiatry and New York State Psychiatric Institute, 1051 Riverside Drive, Box 120, New York, NY, 10032, USA
| | - Erika L. Crable
- Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University School of Medicine, Department of Health Law, Policy and Management, Boston University School of Public Health, 801 Massachusetts Avenue, Room 2030, Boston, MA, 02118, USA
| | - Bryan R. Garner
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA
| | - LaShawn M. Glasgow
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA
| | - Dawn Goddard-Eckrich
- Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA.
| | - Katherine R. Marks
- Department of Behavioral Science, University of Kentucky, 1100 Veterans Drive, Medical Behavioral Science Building Room 108, Lexington, KY, 40536, USA
| | - Ann Scheck McAlearney
- Department of Family and Community Medicine and CATALYST, the Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 530, Columbus, OH, 43210, USA.
| | - Emmanuel A. Oga
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC, 27709-2194, USA
| | - Ariel L. Scalise
- Department of Infectious Disease, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA, 02118, USA
| | - Daniel M. Walker
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, 460 Medical Center Drive, Suite 520, Columbus, OH, 43210, USA
| |
Collapse
|
28
|
Staton M, Dickson MF, Tillson M, Leukefeld C, Webster JM, Knudsen HK, Oser CB. A preliminary examination of substance use risk among metropolitan and non-metropolitan girls involved in the juvenile justice system. J Child Adolesc Subst Abuse 2020; 29:46-57. [PMID: 33762805 DOI: 10.1080/1067828x.2020.1827471] [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] [Indexed: 10/23/2022]
Abstract
Research is limited on geographic differences in substance use risk factors among juvenile justice-involved girls. This secondary data analysis from one state juvenile justice system, collected as part of the NIH/NIDA funded JJTRIALS cooperative agreement, assessed criminogenic needs at intake for 160 girls from metropolitan and non-metropolitan counties. Although girls from different geographic areas did not differ significantly on key variables of interest, including substance use risk and related criminality variables, findings suggest that substance use risk is related to criminal history, substance-related offenses, and relationship problems among justice-involved girls. Implications include gender-specific juvenile justice programming and research.
Collapse
Affiliation(s)
- Michele Staton
- Center on Drug and Alcohol Research, University of Kentucky.,Department of Behavioral Science, University of Kentucky
| | - Megan F Dickson
- Center on Drug and Alcohol Research, University of Kentucky.,Department of Behavioral Science, University of Kentucky
| | - Martha Tillson
- Center on Drug and Alcohol Research, University of Kentucky.,Department of Sociology, University of Kentucky
| | - Carl Leukefeld
- Center on Drug and Alcohol Research, University of Kentucky.,Department of Behavioral Science, University of Kentucky
| | - J Matthew Webster
- Center on Drug and Alcohol Research, University of Kentucky.,Department of Behavioral Science, University of Kentucky
| | - Hannah K Knudsen
- Center on Drug and Alcohol Research, University of Kentucky.,Department of Behavioral Science, University of Kentucky
| | - Carrie B Oser
- Center on Drug and Alcohol Research, University of Kentucky.,Department of Sociology, University of Kentucky
| |
Collapse
|
29
|
Perry BL, Yang KC, Kaminski P, Odabas M, Park J, Martel M, Oser CB, Freeman PR, Ahn YY, Talbert J. Co-prescription network reveals social dynamics of opioid doctor shopping. PLoS One 2019; 14:e0223849. [PMID: 31652266 PMCID: PMC6814254 DOI: 10.1371/journal.pone.0223849] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 09/30/2019] [Indexed: 01/04/2023] Open
Abstract
This paper examines network prominence in a co-prescription network as an indicator of opioid doctor shopping (i.e., fraudulent solicitation of opioids from multiple prescribers). Using longitudinal data from a large commercially insured population, we construct a network where a tie between patients is weighted by the number of shared opioid prescribers. Given prior research suggesting that doctor shopping may be a social process, we hypothesize that active doctor shoppers will occupy central structural positions in this network. We show that network prominence, operationalized using PageRank, is associated with more opioid prescriptions, higher predicted risk for dangerous morphine dosage, opioid overdose, and opioid use disorder, controlling for number of prescribers and other variables. Moreover, as a patient's prominence increases over time, so does their risk for these outcomes, compared to their own average level of risk. Results highlight the importance of co-prescription networks in characterizing high-risk social dynamics.
Collapse
Affiliation(s)
- Brea L. Perry
- Network Science Institute, Indiana University, 1001 45/46 Bypass, Bloomington, IN, United States of America
- Department of Sociology, Indiana University, Bloomington, IN, United States of America
| | - Kai Cheng Yang
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
| | - Patrick Kaminski
- Department of Sociology, Indiana University, Bloomington, IN, United States of America
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
| | - Meltem Odabas
- Department of Sociology, Indiana University, Bloomington, IN, United States of America
| | - Jaehyuk Park
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
| | - Michelle Martel
- Department of Psychology, University of Kentucky, Lexington, KY, United States of America
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, Lexington, KY, United States of America
| | - Patricia R. Freeman
- Department of Pharmacy Practice and Science, University of Kentucky, Lexington, KY, United States of America
| | - Yong-Yeol Ahn
- Network Science Institute, Indiana University, 1001 45/46 Bypass, Bloomington, IN, United States of America
- School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
| | - Jeffery Talbert
- Department of Pharmacy Practice and Science, University of Kentucky, Lexington, KY, United States of America
| |
Collapse
|
30
|
Gardner SK, Elkington KS, Knight DK, Huang S, DiClemente RJ, Spaulding AC, Oser CB, Robertson AA, Baird-Thomas C. Juvenile justice staff endorsement of HIV/STI prevention, testing, and treatment linkage. Health Justice 2019; 7:15. [PMID: 31485779 PMCID: PMC6724232 DOI: 10.1186/s40352-019-0096-7] [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] [Received: 07/02/2019] [Accepted: 08/22/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND While involvement in the legal system offers an opportunity to educate, screen, and treat high-risk youth, research shows that staff attitudes toward these practices can serve as barriers to implementation. The current study investigates the degree to which JJ staff endorse HIV prevention, testing, and treatment linkage practices with youth under community supervision and examines differences between individuals who supervise youth (e.g., juvenile probation officer) and those working in non-supervisory roles (e.g., case manager, assessment specialist). METHODS Juvenile justice staff consenting to participation in JJ-TRIALS completed an initial staff survey (N = 501). Survey items measured perceived importance of HIV/STI prevention (4 items); perceived importance of HIV/STI testing (7 items); and perceived importance of HIV/STI treatment linkage (8 items). RESULTS Confirmatory Factor Analysis (CFA) was computed (SAS CALIS procedure) for each of the three domains. Findings suggest that while staff recognize that youth are at risk for HIV/STIs and require provision of HIV/STI prevention and treatment linkage, attitudes concerning the importance of procuring or providing testing services for youth is substantially lower. Furthermore, analytic models comparing staff with and without supervision responsibilities (computed using SAS PROC MIXED) indicated that attitudes differed by site and staff responsible for supervision rated HIV treatment linkage practices as less important compared to non-supervising staff. CONCLUSIONS Establishing partnerships with health agencies equipped with resources and skillsets to provide HIV/STI testing and related services may be an effective model to promote greater awareness and use of best practices among JJ staff and more effectively address the unmet needs of this high-risk population of youth.
Collapse
Affiliation(s)
- Sheena K. Gardner
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Katherine S. Elkington
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Danica K. Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX 76109 USA
| | - Sofia Huang
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Ralph J. DiClemente
- College of Global Public Health, New York University, 715 #719, Broadway, New York, NY 10003 USA
| | - Anne C. Spaulding
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506 USA
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Connie Baird-Thomas
- Social Science Research Center, Mississippi State University, 153 Mississippi Parkway, Canton, MS 39046 USA
| |
Collapse
|
31
|
Oser CB, Harp K, Pullen E, Bunting AM, Stevens-Watkins D, Staton M. African-American Women's Tobacco and Marijuana Use: The Effects of Social Context and Substance Use Perceptions. Subst Use Misuse 2019; 54:873-884. [PMID: 30849266 PMCID: PMC6476643 DOI: 10.1080/10826084.2018.1528464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite the status of tobacco and marijuana as two of the most commonly used substances in the U.S., both have detrimental health and social consequences for disfranchized African-Americans. Substance use may be shaped by social contextual influences from families and peers in African-American communities, and little research has examined perceptions of wrongfulness, harms, and dangers associated with daily tobacco and marijuana use among African-American women. OBJECTIVES This study explores the effects of African-American women's social context and substance use perceptions (wrongfulness/harmfulness/dangerousness) on daily tobacco and marijuana use. METHODS Survey data was collected in-person from 521 African-American women. Multivariate logistic models identified the significant correlates of women's daily use of tobacco and marijuana in the past six months. RESULTS 52.59% of participants reported daily tobacco use and 10.56% used marijuana daily. Multivariate models indicated that women were more likely to be daily tobacco users if they had a family member with a substance use problem or perceived tobacco use to be wrong, harmful, or more dangerous than marijuana. In the models with marijuana as the dependent variable, women who lived with a person who used drugs were more likely to use marijuana daily. Perceiving marijuana use as wrong or harmful to one's health was protective against daily marijuana use. CONCLUSIONS Findings stress the need for prevention and intervention efforts for African-American women that highlight social context influences and promote greater awareness of the health risks associated with daily tobacco and marijuana use.
Collapse
Affiliation(s)
- Carrie B. Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506,
| | - Kathi Harp
- Department of Health Management & Policy, 111 Washington Ave., College of Public Health Building, University of Kentucky, Lexington, KY 40536
| | - Erin Pullen
- Indiana University Network Science Institute, 1001 E. State Road, Bloomington, IN 47408
| | - Amanda M. Bunting
- Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506,
| | - Danelle Stevens-Watkins
- Department of Educational, School, & Counseling Psychology, Center on Drug & Alcohol Research, University of Kentucky, 235 Dickey Hall, Lexington, KY 40506,
| | - Michele Staton
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, 141 Medical Behavioral Science Building, Lexington, KY 40536,
| |
Collapse
|
32
|
Strickland JC, Staton M, Leukefeld CG, Oser CB, Webster JM. Hepatitis C antibody reactivity among high-risk rural women: opportunities for services and treatment in the criminal justice system. Int J Prison Health 2019; 14:89-100. [PMID: 29869584 DOI: 10.1108/ijph-03-2017-0012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/06/2023]
Abstract
Purpose The purpose of this paper is to examine the drug use and criminal justice factors related to hepatitis C virus (HCV) antibody reactivity among rural women in the USA recruited from local jails. Design/methodology/approach Analyses included 277 women with a history of injection drug use from three rural jails in Kentucky. Participants completed health and drug use questionnaires and received antibody testing for HCV. Findings The majority of women tested reactive to the HCV antibody (69 percent). Reactivity was associated with risk factors, such as unsterile needle use. Criminal justice variables, including an increased likelihood of prison incarceration, an earlier age of first arrest, and a longer incarceration history, were associated with HCV reactive tests. Participants also endorsed several barriers to seeking healthcare before entering jail that were more prevalent in women testing HCV reactive regardless of HCV status awareness before entering jail. Originality/value Injection and high-risk sharing practices as well as criminal justice factors were significantly associated with HCV reactivity. Future research and practice could focus on opportunities for linkages to HCV treatment during incarceration as well as during community re-entry to help overcome real or perceived treatment barriers. The current study highlights the importance of the criminal justice system as a non-traditional, real-world setting to examine drug use and related health consequences such as HCV by describing the association of high-risk drug use and criminal justice consequences with HCV among rural women recruited from local jails.
Collapse
Affiliation(s)
- Justin C Strickland
- Department of Psychology, College of Arts and Sciences, University of Kentucky , Lexington, Kentucky, USA
| | - Michele Staton
- Department of Behavioral Science, College of Medicine, University of Kentucky , Lexington, Kentucky, USA.,Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA
| | - Carl G Leukefeld
- Department of Behavioral Science, College of Medicine, University of Kentucky , Lexington, Kentucky, USA.,Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA
| | - Carrie B Oser
- Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA.,Department of Sociology, College of Arts and Sciences, University of Kentucky , Lexington, Kentucky, USA
| | - J Matthew Webster
- Department of Behavioral Science, College of Medicine, University of Kentucky , Lexington, Kentucky, USA.,Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA
| |
Collapse
|
33
|
Surratt HL, Staton M, Leukefeld CG, Oser CB, Webster JM. Patterns of buprenorphine use and risk for re-arrest among highly vulnerable opioid-involved women released from jails in rural Appalachia. J Addict Dis 2018; 37:1-4. [PMID: 30574844 DOI: 10.1080/10550887.2018.1531738] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 10/27/2022]
Abstract
Aims: Opioid use is common among correctional populations, yet few inmates receive treatment during incarceration or post-release, particularly in rural areas. This article examines associations of buprenorphine use, licit and illicit, health services use, and risk for re-arrest within 3 months of jail release among rural opioid-involved women. Methods: Women were randomly selected from three rural Appalachian jails. Those with moderate to severe opioid-involvement on the NM-ASSIST, and data on patterns of buprenorphine use (N = 188), were included in this analysis. Logistic regression analyses examined predictors of re-arrest within 3 months of release. Results: Median age was 32, all were White. At follow-up, 39 (22.7%) had been rearrested; 9 (5.2%) reported receiving MAT, all with buprenorphine. Significant risk factors for re-arrest included: number of days high, injection use, number of illicit buprenorphine days, and withdrawal symptoms in the follow-up period. The sole protective factor was having a regular source of healthcare at follow-up. Conclusions: Rural opioid-involved women released from jail are highly vulnerable to re-arrest, and lack access to supportive care systems for substance treatment. Innovations to integrate MAT into reentry to improve access is recommended.
Collapse
|
34
|
Bunting AM, Oser CB, Staton M, Eddens KS, Knudsen H. Clinician identified barriers to treatment for individuals in Appalachia with opioid use disorder following release from prison: a social ecological approach. Addict Sci Clin Pract 2018; 13:23. [PMID: 30509314 PMCID: PMC6278109 DOI: 10.1186/s13722-018-0124-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 11/21/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia. METHODS A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals with OUD in Appalachian Kentucky following release from prison. Semi-structured qualitative interviews with 15 social service clinicians (SSCs) employed by the Department of Corrections were conducted to identify barriers at the individual, interpersonal, organizational/institutional level, community, and systems levels. Two independent coders conducted line-by-line coding to identify key themes. RESULTS Treatment barriers were identified across the social ecological spectrum. At the individual-level, SSCs highlighted high-risk drug use and a lack of motivation. At the interpersonal level, homogenous social networks (i.e., homophilious drug-using networks) and networks with limited treatment knowledge inhibited treatment. SSC's high case load and probation/parole officer's limited understanding of treatment were organizational/institutional barriers. Easy access to opioids, few treatment resources, and a lack of community support for treatment were barriers at the community level. SSC's noted system-level barriers such as lack of transportation options, cost, and uncertainty about the implementation of the Affordable Care Act. CONCLUSIONS More rural infrastructure resources as well as additional education for family networks, corrections staff, and the community at large in Appalachia are needed to address barriers to OUD treatment. Future research should examine barriers from the perspective of other key stakeholders (e.g., clients, families of clients) and test interventions to increase access to OUD treatment.
Collapse
Affiliation(s)
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, Lexington, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, USA
| | - Michele Staton
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, USA
- Department of Behavioral Science, University of Kentucky, Lexington, USA
| | - Katherine S. Eddens
- Indiana University Network Science Institute, Indiana University, Bloomington, USA
| | - Hannah Knudsen
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, USA
- Department of Behavioral Science, University of Kentucky, Lexington, USA
| |
Collapse
|
35
|
Harp KLH, Oser CB. A longitudinal analysis of the impact of child custody loss on drug use and crime among a sample of African American mothers. Child Abuse Negl 2018; 77:1-12. [PMID: 29287167 PMCID: PMC5857224 DOI: 10.1016/j.chiabu.2017.12.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 05/31/2017] [Revised: 12/06/2017] [Accepted: 12/18/2017] [Indexed: 05/22/2023]
Abstract
UNLABELLED This study examines the influence of child custody loss on drug use and crime among a sample of African American mothers. Two types of custody loss are examined: informal custody loss (child living apart from mother but courts not involved), and official loss (child removed from mother's care by authorities). METHODS Using data from 339 African American women, longitudinal random coefficient models analyzed the effects of each type of custody loss on subsequent drug use and crime. RESULTS indicated that both informal and official custody loss predicted increased drug use, and informal loss predicted increased criminal involvement. Findings demonstrate that child custody loss has negative health implications for African American mothers, potentially reducing their likelihood of regaining or retaining custody of their children. CONCLUSIONS This study highlights the need to integrate drug treatment and other types of assistance into family case plans to improve reunification rates and outcomes among mothers, children, and families. Additionally, the finding that informal loss predicts increased drug use suggests that community-based efforts within the mother's social network could be implemented to intervene before child welfare system involvement becomes necessary.
Collapse
Affiliation(s)
- Kathi L H Harp
- University of Kentucky College of Public Health, Department of Health Management and Policy, 111 Washington Avenue, College of Public Health Building, Lexington, KY 40536, United States.
| | - Carrie B Oser
- University of Kentucky, Department of Sociology, Center on Drug and Alcohol Research, Patterson Office Tower, Lexington, KY 40506, United States.
| |
Collapse
|
36
|
Link TC, Oser CB. The Role of Stressful Life Events and Cultural Factors on Criminal Thinking among African American Women Involved in the Criminal Justice System. Crim Justice Behav 2018; 45:8-30. [PMID: 31097844 PMCID: PMC6516471 DOI: 10.1177/0093854817736083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
African American women are positioned at the intersection of multiple disadvantaged statuses and disproportionately impacted by criminal justice policies, as evinced by their increased likelihood of incarceration. Yet, they continue to be overlooked in mainstream criminological research. Using data from 418 African American women in the B-WISE (Black Women in a Study of Epidemics) project, the current study investigates the relationship between several prominent stressors occurring in five social contexts and criminal thinking as a coping strategy. Findings indicate that criminal thinking may be one maladaptive coping mechanism to manage stressors, such as gendered racism, financial stress, and network loss, that occur across these multiple social contexts for African American women in prison and on probation. Spirituality, on the other hand, seems to operate as a buffer. Implications for practice include promoting programs that strengthen a sense of collective identity in the community, as well as hiring more African American women who could provide additional culturally-competent behavioral health services in criminal justice professions.
Collapse
Affiliation(s)
- Tanja C Link
- Kennesaw State University, Department of Sociology & Criminal Justice, 402 Bartow Ave NW, Kennesaw, GA 30144 USA, ,
| | - Carrie B Oser
- University of Kentucky, Department of Sociology, Center on Drug and Alcohol Research, 1531 Patterson Office Tower, Lexington, KY 40506 USA, ,
| |
Collapse
|
37
|
Dickson MF, Staton M, Tillson M, Leukefeld C, Webster JM, Oser CB. The Affordable Care Act and Changes in Insurance Coverage and Source of Health Care among High-risk Rural, Substance-using, Female Offenders Transitioning to the Community. J Health Care Poor Underserved 2018; 29:843-863. [PMID: 30122668 PMCID: PMC6130194 DOI: 10.1353/hpu.2018.0064] [Citation(s) in RCA: 4] [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] [Indexed: 11/11/2022]
Abstract
PURPOSE This study examines health care coverage and health care among rural, drug-involved female offenders under the Affordable Care Act (ACA) compared with pre-ACA and whether being insured is associated with having a usual source of care. METHODS This study involved random selection, screening, and face-to-face interviews with drug-using women in three rural Appalachian jails. Analyses focused on participants who had completed a three-month follow-up interview after release from jail (N=371). RESULTS Analyses indicated that women released after ACA implementation were more likely than those released pre-implementation to be insured. A multivariate logistic regression model showed that being insured was significantly related to having a usual health care source during community re-entry. CONCLUSIONS Results demonstrate the benefits of the ACA, signaling important implications for public health in rural communities and the criminal justice system, including targeting underserved groups during incarceration and providing information about and resources for health care enrollment.
Collapse
Affiliation(s)
| | - Michele Staton
- Center on Drug and Alcohol Research, University of Kentucky
- Department of Behavioral Science, University of Kentucky
| | - Martha Tillson
- Center on Drug and Alcohol Research, University of Kentucky
- College of Social Work, University of Kentucky
| | - Carl Leukefeld
- Center on Drug and Alcohol Research, University of Kentucky
- Department of Behavioral Science, University of Kentucky
| | - J. Matthew Webster
- Center on Drug and Alcohol Research, University of Kentucky
- Department of Behavioral Science, University of Kentucky
| | - Carrie B. Oser
- Center on Drug and Alcohol Research, University of Kentucky
- Department of Sociology, University of Kentucky
| |
Collapse
|
38
|
Staton M, Strickland JC, Tillson M, Leukefeld C, Webster JM, Oser CB. Partner Relationships and Injection Sharing Practices among Rural Appalachian Women. Womens Health Issues 2017; 27:652-659. [PMID: 28882550 DOI: 10.1016/j.whi.2017.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/19/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND The role of relationships in initiating and maintaining women's risk behaviors has been established. However, understanding factors that may underlie partner relationships and women's risky drug use, particularly in rural contexts, is limited. This study is the first to examine the association between injecting partners and women's risky injection practices as a function of relationship power perception. METHODS Female participants were recruited from three rural jails in the Appalachian region. Women were selected randomly, provided informed consent, and screened for study eligibility criteria. This cross-sectional analysis focuses on women who inject drugs during the year before entering jail (n = 199). MAIN FINDINGS Approximately three-quarters (76%) reported having a recent main male sexual partner with a history of injection drug use. Although having a risky partner independently increased the likelihood of women reporting shared injection practices, perceptions of relationship power significantly moderated the effect on shared needle (adjusted odds ratio, 0.02; 95% CI, 0.003-0.23; p = .001) and shared works (adjusted odds ratio, 0.17; 95% CI, 0.03-0.95; p = .04) use. CONCLUSIONS This interaction indicated that, for women who inject drugs with a recent injecting male partner, greater perception of relationship power was associated with a decreased likelihood of shared injection practices. Implications for clinical assessment and intervention are discussed.
Collapse
Affiliation(s)
- Michele Staton
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky.
| | - Justin C Strickland
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky
| | - Martha Tillson
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky
| | - Carl Leukefeld
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - J Matthew Webster
- Department of Behavioral Science, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Carrie B Oser
- Department of Sociology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky
| |
Collapse
|
39
|
Oser CB, Pullen E, Stevens-Watkins D, Perry BL, Havens JR, Staton-Tindall M, Leukefeld CG. African American women and sexually transmitted infections: The contextual influence of unbalanced sex ratios and individual risk behaviors. J Drug Issues 2016; 47:543-561. [PMID: 28983125 DOI: 10.1177/0022042616678610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/15/2022]
Abstract
This study uses data from 564 African American women to examine the correlates of lifetime prevalence of a sexually transmitted infection (STI). Specifically, we test the effects of perceptions about the availability of African American males, five partner characteristics, and drug history. At the bivariate-level, women with an STI diagnosis were significantly more likely to have dated a man who was married, older, had sex with another man, involved in concurrent partnerships, and had been incarcerated. About half of the participants stated it was difficult to find an eligible African American male and attributed the limited pool of same-race partners to drug trafficking, a lack of monogamy, and high rates of incarceration. Multivariate analyses revealed having dated a man who had concurrent sexual partnerships or had been incarcerated, as well as drug use during sex were positively associated with ever having an STI. Individual and contextual implications are addressed.
Collapse
Affiliation(s)
- Carrie B Oser
- Department of Sociology, Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Erin Pullen
- Indiana University Network Science Institute, Bloomington, Indiana, USA
| | - Danelle Stevens-Watkins
- Department of Educational, Counseling, and School Psychology, Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Brea L Perry
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Jennifer R Havens
- Department of Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Michele Staton-Tindall
- College of Social Work, Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| | - Carl G Leukefeld
- Department of Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
40
|
Harp KLH, Oser CB. Factors associated with two types of child custody loss among a sample of African American mothers: A novel approach. Soc Sci Res 2016; 60:283-296. [PMID: 27712685 PMCID: PMC5119635 DOI: 10.1016/j.ssresearch.2016.06.007] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 04/11/2016] [Accepted: 06/06/2016] [Indexed: 05/30/2023]
Abstract
African American families are overrepresented in the Child Welfare System; however, extant research on this phenomenon has (1) focused mostly on Caucasian or mixed-race samples and (2) has not examined informal custody arrangements alongside official child custody loss. This research addresses these gaps in the literature by examining factors associated with both official and informal child custody loss among a sample of African American mothers. Multinomial regression results show that having ever been incarcerated following a conviction increases the odds of experiencing both types of custody loss relative to no loss. Additionally, mother's experiences of childhood victimization increase the likelihood of informal custody loss relative to no loss, while being older, past year homelessness, number of minor children, being lesbian or bisexual, crack/cocaine use, and more family social support increase the odds of official loss versus no loss. Finally, increases in social support from friends decrease the odds of official loss. Implications are discussed.
Collapse
Affiliation(s)
- Kathi L H Harp
- University of Kentucky, College of Public Health, Department of Health Management & Policy, USA.
| | - Carrie B Oser
- University of Kentucky, Department of Sociology, Center on Drug and Alcohol Research, USA
| |
Collapse
|
41
|
Dickson MF, Staton-Tindall M, Smith KE, Leukefeld C, Webster JM, Oser CB. A Facebook Follow-Up Strategy for Rural Drug-Using Women. J Rural Health 2016; 33:250-256. [PMID: 27467119 DOI: 10.1111/jrh.12198] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 06/21/2016] [Accepted: 06/24/2016] [Indexed: 11/27/2022]
Abstract
PURPOSE Facebook (FB) use has grown exponentially over the past decade, including in rural areas. Despite its popularity, FB has been underutilized as a research follow-up approach to maintain contact with research participants and may have advantages in less densely populated areas and among more hard-to-reach, at-risk groups. The overall goal of this study was to examine FB as a supplemental follow-up approach to other follow-up strategies with rural drug-using women. METHODS Face-to-face interviews were conducted with randomly selected women who completed baseline interviews in 3 rural jails in 1 state. Analyses focus on participants who were released from jail and were eligible for 3-month follow-up (n = 284). Bivariate analyses were used to examine differences between FB users and nonusers, and multivariate logistic regression models examined predictors of 3-month follow-up participation and being located for follow-up using FB. FINDINGS About two-thirds (64.4%) of participants were regular FB users. Bivariate analyses indicated that FB users were younger, more educated, and more likely to have used alcohol in the 30 days before incarceration but less likely to have a chronic health problem. Regression analyses indicated that rural FB users had more than 5 times the odds of being located for the 3-month follow-up interview, even after controlling for other variables. There were no significant predictors of being followed up using FB. CONCLUSIONS Findings suggest that FB is widely used and well accepted among rural drug-using women. Among hard-to-reach populations, including those in rural, geographically isolated regions, FB serves as a method to improve participant follow-up.
Collapse
Affiliation(s)
- Megan F Dickson
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky
| | - Michele Staton-Tindall
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky.,College of Social Work, University of Kentucky, Lexington, Kentucky
| | - Kirsten E Smith
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky
| | - Carl Leukefeld
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky.,Department of Behavioral Science, University of Kentucky, Lexington, Kentucky
| | - J Matthew Webster
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky.,Department of Behavioral Science, University of Kentucky, Lexington, Kentucky
| | - Carrie B Oser
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky.,Department of Sociology, University of Kentucky, Lexington, Kentucky
| |
Collapse
|
42
|
Vinson ES, Oser CB. Risk and Protective Factors for Suicidal Ideation in African American Women With a History of Sexual Violence as a Minor. Violence Against Women 2016; 22:1770-1787. [PMID: 26933090 DOI: 10.1177/1077801216632614] [Citation(s) in RCA: 2] [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] [Indexed: 11/17/2022]
Abstract
Compared with other ethnic groups, African Americans have the highest rate of childhood victimization. The literature is sparse with regard to suicidal ideation among African American women with a history of sexual violence as a minor. Using survey data, this study utilized logistic regression to investigate the roles of a risk factor, criminal justice involvement, and protective factors, ethnic identity, and spiritual well-being, in experiencing suicidal ideation. Findings suggest that criminal justice involvement and the interaction of ethnic identity and spiritual well-being are important factors in understanding which African American women may be at a greater risk of experiencing suicidal ideation.
Collapse
Affiliation(s)
- Ebony S Vinson
- 1 Virginia Commonwealth University, Richmond, VA, USA.,2 University of Kentucky, Lexington, KY, USA
| | - Carrie B Oser
- 1 Virginia Commonwealth University, Richmond, VA, USA.,2 University of Kentucky, Lexington, KY, USA
| |
Collapse
|
43
|
Otis MD, Oser CB, Staton-Tindall M. Violent Victimization and Substance Dependency: Comparing Rural Incarcerated Heterosexual and Sexual Minority Women. J Soc Work Pract Addict 2016; 16:176-201. [PMID: 27660590 PMCID: PMC5027961 DOI: 10.1080/1533256x.2016.1143372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 11/30/2015] [Indexed: 05/30/2023]
Abstract
This exploratory study examines the relationship between sexual identity and violent victimization experiences as predictors of differences in illicit substance and alcohol use and substance use problems among a sample of incarcerated women in rural Appalachia (N = 400). Results indicated that, compared to heterosexual women, sexual minority women were more likely to have a lifetime history of weapon, physical, and sexual assault, and were younger at the time of their first violent victimization. Sexual minority women were younger than heterosexual women at the age of onset for intravenous drug use and at the time they first got drunk, and were more likely to report having overdosed. Multivariate analysis found violent victimization to be the strongest predictor of a history of overdose and substance use problems.
Collapse
Affiliation(s)
- Melanie D Otis
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | - Carrie B Oser
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | | |
Collapse
|
44
|
Oser CB, Bunting AM, Pullen E, Stevens-Watkins D. African American Female Offender's Use of Alternative and Traditional Health Services After Re-Entry: Examining the Behavioral Model for Vulnerable Populations. J Health Care Poor Underserved 2016; 27:120-48. [PMID: 27133515 PMCID: PMC4855295 DOI: 10.1353/hpu.2016.0052] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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] [Indexed: 12/16/2022]
Abstract
This is the first known study to use the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict African American women's use of three types of health services (alternative, hospitalization, and ambulatory) in the 18 months after release from prison. In the multivariate models, the most robust predictors of all three types of service utilization were in the vulnerable theoretical domains. Alternative health services were predicted by ethnic community membership, higher religiosity, and HIV/HCV. Hospitalizations were predicted by the lack of barriers to health care and disability. Ambulatory office visits were predicted by more experiences of gendered racism, a greater number of physical health problems, and HIV/HCV. Findings highlight the importance of cultural factors and HIV/HCV in obtaining both alternative and formal health care during community re-entry. Clinicians and policymakers should consider the salient role that the vulnerable domain plays in offender's accessing health services.
Collapse
Affiliation(s)
- Carrie B. Oser
- 1531 Patterson Office Tower, Department of Sociology, Center on Drug & Alcohol Research, University of Kentucky, Lexington, Kentucky, 40506. Phone: 859-257-6890. Fax: 859-323-0272
| | - Amanda M. Bunting
- 1505 Patterson Office Tower, Department of Sociology, University of Kentucky, Lexington, Kentucky, 40506. Phone: 859-257-6896. Fax: 859-323-0272
| | - Erin Pullen
- Indiana University Network Science Institute, Bloomington, Indiana, 47405. Phone: 231-878-8494. Fax: 812-855-0781
| | - Danelle Stevens-Watkins
- 245 Dickey Hall, Department of Educational, Counseling, and School Psychology, University of Kentucky, Lexington, Kentucky, 40506. Phone: 859-257-7889. Fax: 859-257-5662
| |
Collapse
|
45
|
Luke DJ, Oser CB. Ebony and Ivory? Interracial dating intentions and behaviors of disadvantaged African American women in Kentucky. Soc Sci Res 2015; 53:338-350. [PMID: 26188458 PMCID: PMC4509521 DOI: 10.1016/j.ssresearch.2015.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 04/01/2014] [Revised: 04/25/2015] [Accepted: 06/24/2015] [Indexed: 06/04/2023]
Abstract
Using data from 595 predominantly disadvantaged African American women in Kentucky, this study examines perceptions about racial/ethnic partner availability, cultural mistrust, and racism as correlates of interracial dating intentions and behaviors with both white and Hispanic men. Participants reported levels of dating intentions and behaviors were significantly higher with whites than Hispanics. The multivariate models indicate less cultural mistrust and believing it is easier to find a man of that racial/ethnic category were associated with higher interracial dating intentions. Women were more likely to have dated a white man if they believed it was easier to find a white man and had interracial dating intentions; however, interracial dating intentions was the only significant correlate of having dated a Hispanic man. Findings suggest a shrinking social distance between racial groups, broadening the MMPI for African American women; yet, the low levels of interracial relationships are likely driven by preferences of men.
Collapse
Affiliation(s)
- David J Luke
- University of Kentucky, Department of Sociology, 1515 Patterson Office Tower, Lexington, KY 40506, USA.
| | - Carrie B Oser
- University of Kentucky, Department of Sociology, Center on Drug and Alcohol Research, 1531 Patterson Office Tower, Lexington, KY 40506, USA.
| |
Collapse
|
46
|
Staton-Tindall M, Webster JM, Oser CB, Havens JR, Leukefeld CG. Drug use, hepatitis C, and service availability: perspectives of incarcerated rural women. Soc Work Public Health 2015; 30:385-96. [PMID: 25950907 PMCID: PMC4425245 DOI: 10.1080/19371918.2015.1021024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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
This study examined drug use, hepatitis C, and service availability and use among a high-risk sample of rural women serving time in jails. Data was collected from female offenders (N = 22) who participated in four focus groups in three rural jail facilities located in Appalachia. Findings indicated that drug misuse is prevalent in this impoverished area of the country, and that the primary route of administration of drug use is injection. Findings also indicate that injection drug use is also commonly associated with contracting hepatitis C (HCV), which is also perceived to be prevalent in the area. Despite knowledge associated with HCV risks, women in this sample were seemingly apathetic about the increasing spread of HCV in the area and unconcerned about the long-term consequences of the course of the infection. Implications for future research and practice are discussed.
Collapse
Affiliation(s)
| | - J. Matthew Webster
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, Lexington, KY, USA
| | - Jennifer R. Havens
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Carl G. Leukefeld
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
47
|
Stevens-Watkins D, Perry B, Pullen E, Jewell J, Oser CB. Examining the associations of racism, sexism, and stressful life events on psychological distress among African-American women. Cultur Divers Ethnic Minor Psychol 2014; 20:561-569. [PMID: 25313434 PMCID: PMC4197405 DOI: 10.1037/a0036700] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
African-American women may be susceptible to stressful events and adverse health outcomes as a result of their distinct social location at the intersection of gender and race. Here, racism and sexism are examined concurrently using survey data from 204 African-American women residing in a southeastern U.S. urban city. Associations among racism, sexism, and stressful events across social roles and contexts (i.e., social network loss, motherhood and childbirth, employment and finances, personal illness and injury, and victimization) are investigated. Then, the relationships among these stressors on psychological distress are compared, and a moderation model is explored. Findings suggest that racism and sexism are a significant source of stress in the lives of African-American women and are correlated with one another and with other stressful events. Implications for future research and clinical considerations are discussed.
Collapse
Affiliation(s)
| | - Brea Perry
- Department of Sociology, University of Kentucky
| | - Erin Pullen
- Department of Sociology, University of Kentucky
| | | | | |
Collapse
|
48
|
Oser CB, Harp KLH. Treatment outcomes for prescription drug misusers: the negative effect of geographic discordance. J Subst Abuse Treat 2014; 48:77-84. [PMID: 25200740 DOI: 10.1016/j.jsat.2014.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 08/04/2014] [Accepted: 08/06/2014] [Indexed: 11/29/2022]
Abstract
This is the first known study to examine geographic discordance (traveling from one's home residence to a county with a different socio-cultural context to receive substance abuse treatment) as a predictor of clinical and social functioning treatment outcomes (i.e., relapse, self-help attendance, anxiety, and incarceration) among a sample of prescription drug misusers. Treatment entry and 12-month follow-up client-level survey data were collected from 187 clients who misused prescription drugs, and center-level survey data were collected from the supervisors at treatment centers attended by the clients. Multivariate models reveal that geographic discordance significantly increased the odds that prescription drug misusers would report relapse to prescription opioid misuse, anxiety, and any incarceration at follow-up. Moreover, geographically discordant clients were significantly less likely to have attended a self-help group, net of the effect of other individual- and center-level factors. Implications for clinical practice and substance abuse treatment policy are provided.
Collapse
Affiliation(s)
- Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, University of Kentucky, Lexington, KY 40506, USA.
| | - Kathi L H Harp
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, Lexington, KY 40506, USA
| |
Collapse
|
49
|
Stevens-Watkins D, Sharma S, Knighton JS, Oser CB, Leukefeld CG. Examining Cultural Correlates of Active Coping Among African American Female Trauma Survivors. Psychol Trauma 2014; 6:328-336. [PMID: 25180071 PMCID: PMC4149226 DOI: 10.1037/a0034116] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
African American women are at a greater risk for exposure to multiple traumatic events and are less likely to seek mental health services than White women. Many women report avoidant and passive coping strategies placing them at an increased risk for lower psychological adjustment. Thus, the purpose of the current study is to examine the role of culturally relevant factors such as spirituality, self-esteem, and social support as significant correlates of John Henryism Active Coping among African American female trauma survivors. The study utilized secondary data from the B-WISE project (Black Women in a Study of Epidemics) with a sample of 161 community-based African American women with a self-reported history of trauma. Results indicate that participants with higher self-esteem and existential well-being were more likely to cope actively with daily life stressors. However, socio-demographics were not significant correlates of John Henryism Active Coping at the multivariate level. Implications for clinical practice are discussed along with the Strong Black Woman (SBW) ideology, which may explain over-reporting of positive attributes such as self-esteem and existential well-being. Limitations of the study and directions of future research are also discussed.
Collapse
|
50
|
Perkins EB, Oser CB. Job frustration in substance abuse counselors working with offenders in prisons versus community settings. Int J Offender Ther Comp Criminol 2014; 58:718-734. [PMID: 23525175 PMCID: PMC3994171 DOI: 10.1177/0306624x13479347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 06/02/2023]
Abstract
Substance abuse counselors who work with offenders are facing increasing caseloads, which puts them at higher risk of job frustration. The purpose of this study was to explore differences between substance abuse counselors employed in prison versus community settings in terms of level of organizational support and job frustration. This study also investigated whether organizational support was associated with job frustration after controlling for counselor characteristics and workplace setting. This was accomplished utilizing data that were collected from 267 counselors as part of the Criminal Justice Drug Abuse Treatment Studies research cooperative. Results indicated that counselors employed in community settings, as compared with those employed in prisons, are more likely to report higher levels of perceived organizational support. In addition, ordinal logistic regression results reveal that counselors who are non-White and have greater levels of organizational support have less job frustration, after controlling for counselor characteristics and workplace setting. The researches to practice implications are discussed.
Collapse
Affiliation(s)
- Elizabeth B. Perkins
- Morehead State University, Department of Sociology, Social Work, & Criminology/Criminal Justice
| | - Carrie B. Oser
- University of Kentucky, Department of Sociology, Center on Drug & Alcohol Research
| |
Collapse
|