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Warnock CA, Ondrusek AR, Edelman EJ, Kershaw T, Muilenburg JL. Perspectives regarding cannabis use: Results from a qualitative study of individuals engaged in substance use treatment in Georgia and Connecticut. Drug Alcohol Depend Rep 2024; 11:100228. [PMID: 38585142 PMCID: PMC10997993 DOI: 10.1016/j.dadr.2024.100228] [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: 01/13/2024] [Revised: 03/08/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
Objective Cannabis use is increasingly pervasive throughout the U.S. People in treatment for substance use disorders (SUD) may be especially at-risk of harm due to this changing context of cannabis in the U.S. This study's objective was to qualitatively describe experiences and beliefs around cannabis among people who had entered treatment for any SUD in the past 12-months. Methods From May to November of 2022, we conducted 27 semi-structured interviews (n=16 in Georgia, n=11 in Connecticut) with individuals in treatment for SUD in Georgia and Connecticut. Interviews were recorded, transcribed, and thematically analyzed using an emergent approach. Results All participants had used cannabis in the past. Four themes emerged from the interviews. Participants: (1) perceived cannabis as an important contributor to non-cannabis substance use initiation in adolescence; (2) viewed cannabis as a substance with the potential to improve health with fewer side effects than prescription medications; (3) expressed conflicting opinions regarding cannabis as a trigger or tool to manage cravings for other non-cannabis substances currently; and 4) described concerns related to negative legal, social service, and treatment-related consequences as well as negative peer perception relating to the use of cannabis. Conclusion Although participants described cannabis's important role as an initiatory drug in adolescence and young adulthood, many felt that cannabis was a medicinal substance for a range of health challenges. These findings suggest SUD treatment clinicians should address medicinal beliefs related to cannabis among their clients and emphasizes the need for research on cannabis use and SUD treatment outcomes.
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Affiliation(s)
- Charles A. Warnock
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Ashlin R. Ondrusek
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - E. Jennifer Edelman
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, USA
| | - Trace Kershaw
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Jessica L. Muilenburg
- Department of Health Promotion and Behavior, University of Georgia College of Public Health, Athens, GA, USA
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Viera A, Tengatenga C, McBurney E, Lauckner J, Tran E, Muilenburg JL, Kershaw TS, Lauckner C. "The Phone is my Lifeline": Use of Mobile Phone Technology to Support Recovery among Individuals in Treatment for Substance Use Disorders. Subst Use Misuse 2023; 58:1360-1366. [PMID: 37331982 DOI: 10.1080/10826084.2023.2223265] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background: People experiencing substance use disorders (SUD) face myriad challenges in maintaining changes in substance use after treatment. Mobile phones can play a role in supporting the recovery process. To date, research has not explored how individuals use mobile phones to seek social support as they enter SUD recovery. Objectives: We sought to understand how individuals in SUD treatment use mobile technology in support of their recovery. Methods: We conducted semi-structured interviews with thirty individuals in treatment for any SUD in northeastern Georgia and southcentral Connecticut. Interviews explored participants' attitudes toward mobile technology and how they used mobile technology while using substances, in treatment, and in recovery. Qualitative data were coded and analyzed using thematic analysis. Results: We identified three major themes related to how participants: (1) adapted their use of mobile technology as they entered recovery, (2) relied on mobile technology for social support while in recovery, while (3) some found aspects of mobile technology triggering. Many individuals in SUD treatment reported using mobile phones to buy or sell drugs; as such, they took measures to adapt their use of mobile technology as they changed substance use behaviors. As they entered recovery, individuals relied on mobile phones for affiliational, emotional, informational, and instrumental support, though some did share they found some aspects of mobile phones triggering. Conclusion: These findings highlight the importance of treatment providers engaging in conversations around mobile phone use to help individuals avoid triggers and connect with social supports. These findings uncover new opportunities for recovery support interventions utilizing mobile phones as a delivery mechanism.
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Affiliation(s)
- A Viera
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - C Tengatenga
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - E McBurney
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - J Lauckner
- Substance Use Research Priority Area, University of Kentucky, Lexington, Kentucky, USA
| | - E Tran
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - J L Muilenburg
- Department of Health Promotion and Behavior, University of Georgia College of Public Health, Athens, Georgia, USA
| | - T S Kershaw
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - C Lauckner
- Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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Schipani-McLaughlin AM, Salazar LF, Muilenburg JL, Lauckner C, Swartzendruber A, Walters D. A Mixed Media Campaign to Promote Bystander Intervention and Reduce Alcohol Use Among College Students: A Pilot Study. Health Promot Pract 2022; 23:973-983. [PMID: 34338037 DOI: 10.1177/15248399211027542] [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] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study examined the limited efficacy of a mixed media campaign that promoted bystander intervention as a sexual violence (SV) prevention strategy and aimed to decrease alcohol use. A quasi-experimental design was used to assess the limited efficacy of the Be a Watch Dawg mixed media campaign implemented at a large Southeastern public university in 2017. Social marketing along with social cognitive theory, social norms theory, and theory of planned behavior were utilized as the framework for the campaign. Be a Watch Dawg promoted bystander intervention in SV risk situations and targeted bystanders' alcohol use via social media (e.g., Facebook, Instagram, and Twitter) and printed materials (e.g., posters, stickers, and handbills). Participants included 244 undergraduate students 18 to 24 years of age. Study outcomes included bystander intervention, intentions to intervene, and alcohol use. Adjusted linear regression and logistic regression models were used to examine differences in outcomes between pre and postcampaign samples as well as associations with campaign exposure. Significant increases in bystander intervention were observed between the pre and postcampaign samples. Campaign exposure was marginally related to intentions to intervene but was not significantly associated with bystander intervention. Social media analytics revealed that the campaign reached 39,466 social media users and received 50,854 impressions and 19,523 views. A mixed media campaign may be a promising and low-resource approach to increase bystander intervention as a strategy to combat campus SV.
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Johnson JM, Naeher LP, Yu X, Sosnoff C, Wang L, Rathbun SL, De Jesús VR, Xia B, Holder C, Muilenburg JL, Wang JS. A biomonitoring assessment of secondhand exposures to electronic cigarette emissions. Int J Hyg Environ Health 2019; 222:816-823. [PMID: 31085112 PMCID: PMC6938228 DOI: 10.1016/j.ijheh.2019.04.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 02/15/2019] [Accepted: 04/26/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Electronic cigarette (e-cigarette) conventions regularly bring together thousands of users around the world. In these environments, secondhand exposures to high concentrations of e-cigarette emissions are prevalent. Some biomarkers for tobacco smoke exposure may be used to characterize secondhand e-cigarette exposures in such an environment. METHODS Participants who did not use any tobacco product attended four separate e-cigarette events for approximately six hours. Urine and saliva samples were collected from participants prior to the event, immediately after the event, 4-h after the event, and the next morning (first void). Urine samples from 34 participants were analyzed for cotinine, trans-3'-hydroxycotinine, S-(3-hydroxypropyl)-N-acetylcysteine (3-HPMA), S-carboxyethyl-N-acetylcysteine (CEMA), select tobacco-specific nitrosamines (TSNAs), and 8-isoprostane. Saliva samples were analyzed for cotinine and trans-3'-hydroxycotinine. RESULTS Data from 28 of 34 participants were used in the data analysis. Creatinine-adjusted urinary cotinine concentrations increased up to 13-fold and peaked 4-h after completed exposure (range of adjusted geometric means [AGMs] = 0.352-2.31 μg/g creatinine). Salivary cotinine concentrations were also the highest 4-h after completed exposure (range of AGMs = 0.0373-0.167 ng/mL). Salivary cotinine and creatinine-corrected concentrations of urinary cotinine, trans-3'-hydroxycotinine, CEMA, and 3-HPMA varied significantly across sampling times. Urinary and salivary cotinine, urinary trans-3'-hydroxycotinine, and urinary 3-HPMA concentrations also varied significantly across events. CONCLUSION Secondhand e-cigarette exposures lasting six hours resulted in significant changes in exposure biomarker concentrations of both nicotine and acrolein but did not change exposure to tobacco-specific nitrosamines. Additional research is needed to understand the relationship between biomarker concentrations and environmental concentrations of toxicants in e-cigarette emissions.
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Affiliation(s)
- Jona M Johnson
- Environmental Health Science Department, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, USA.
| | - Luke P Naeher
- Environmental Health Science Department, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, USA
| | - Xiaozhong Yu
- Environmental Health Science Department, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, USA
| | - Connie Sosnoff
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Lanqing Wang
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Stephen L Rathbun
- Epidemiology and Biostatistics Department, College of Public Health, University of Georgia, 206 Miller Hall, Health Sciences Campus, Athens, GA, 30602, USA
| | - Víctor R De Jesús
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Baoyun Xia
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Cory Holder
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA; Oak Ridge Institute for Science and Education, Oak Ridge, TN, 37831, USA
| | - Jessica L Muilenburg
- Health Promotion and Behavior Department, College of Public Health, University of Georgia, 233 Wright Hall, Health Sciences Campus, Athens, GA, 30602, USA
| | - Jia-Sheng Wang
- Environmental Health Science Department, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, USA.
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Johnson JM, Naeher LP, Yu X, Rathbun SL, Muilenburg JL, Wang JS. Air monitoring at large public electronic cigarette events. Int J Hyg Environ Health 2018; 221:541-547. [PMID: 29477829 DOI: 10.1016/j.ijheh.2018.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/24/2018] [Accepted: 02/08/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Electronic cigarette (e-cigarette) conventions bring hundreds to thousands of e-cigarette users together socially regularly across the world. E-cigarette secondhand exposures to chemicals in this environment, likely the public setting with the highest concentration of e-cigarette secondhand aerosol, have not been characterized. METHODS Air sampling for formaldehyde, acetaldehyde, acrolein, nicotine, and propylene glycol was conducted at three e-cigarette conventions and one smaller event from April 2016 to March 2017 in three states in the Southeastern United States. Volunteers attended the events as members of the public and wore backpacks containing air sampling pumps. Control sampling was conducted when venues were crowded for non-e-cigarette events. Additional control sampling was conducted in two venues when they were empty. RESULTS Formaldehyde and acetaldehyde concentrations during e-cigarette events were comparable to background concentrations. The median formaldehyde concentrations during events, crowded control events, and empty control events were 12.0, 10.5, and 12.5 μg/m3, respectively. The median acetaldehyde concentrations during events, crowded control events, and empty control events were 9.7, 15.5, and 3.5 μg/m3, respectively. Propylene glycol and nicotine were not detected during control sampling. The median nicotine concentration during events was 1.1 μg/m3. The median propylene glycol concentration during events was 305.5 μg/m3. CONCLUSION Results indicate e-cigarette secondhand exposures are sources of elevated nicotine and propylene glycol exposures. Secondhand exposures to e-cigarettes did not contain consistently elevated concentrations of formaldehyde or acetaldehyde. Additional research is needed to characterize exposures via inhalation to propylene glycol at concentrations measured in this study.
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Affiliation(s)
- Jona M Johnson
- Department of Environmental Health Science, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, United States.
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, United States.
| | - Xiaozhong Yu
- Department of Environmental Health Science, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, United States.
| | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 206 Miller Hall, Health Sciences Campus, Athens, GA, 30602, United States.
| | - Jessica L Muilenburg
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, 233 Wright Hall, Health Sciences Campus, Athens, GA, 30602, United States.
| | - Jia-Sheng Wang
- Department of Environmental Health Science, College of Public Health, University of Georgia, 206 Environmental Health Science Building, Athens, GA, 30602, United States.
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Johnson JM, Muilenburg JL, Rathbun SL, Yu X, Naeher LP, Wang JS. Elevated Nicotine Dependence Scores among Electronic Cigarette Users at an Electronic Cigarette Convention. J Community Health 2017; 43:164-174. [DOI: 10.1007/s10900-017-0399-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Muilenburg JL, Laschober TC, Eby LT, Moore ND. Prevalence of and Factors Related to Tobacco Ban Implementation in Substance Use Disorder Treatment Programs. Adm Policy Ment Health 2017; 43:241-9. [PMID: 25677250 DOI: 10.1007/s10488-015-0636-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 11/28/2022]
Abstract
This study examined the prevalence of and factors (psychological climate for change and staff attributes) related to indoor and outdoor tobacco bans for patients, employees, and visitors in U.S. substance use disorder treatment programs. Data were collected from a random sample of 1,026 program administrators. Almost all programs banned tobacco use indoors and around one third banned tobacco use outdoors. When there was no tobacco ban, the majority of programs restricted smoking to designated indoor and/or outdoor areas. Further, all psychological climate for change factors (perceived program support, perceived tobacco culture, and tobacco ban beliefs) but none of the staff attributes (percentage licensed/certified clinicians, percentage clinicians with master's degrees, total staff with education in health-related field) were significantly related to the implementation of comprehensive tobacco bans (both indoors and outdoors).
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Affiliation(s)
- Jessica L Muilenburg
- Department of Health Promotion and Behavior, University of Georgia, Athens, GA, USA
| | - Tanja C Laschober
- Owens Institute for Behavioral Research, University of Georgia, 325 Psychology Building, Athens, GA, 30602, USA.
| | - Lillian T Eby
- Owens Institute for Behavioral Research, University of Georgia, 325 Psychology Building, Athens, GA, 30602, USA.,Industrial-Organizational Psychology Program, University of Georgia, Athens, GA, USA
| | - Nancy D Moore
- Department of Health Promotion and Behavior, University of Georgia, Athens, GA, USA
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Laschober TC, Muilenburg JL, Eby LT. Factors Linked to Substance Use Disorder Counselors' (Non)Implementation Likelihood of Tobacco Cessation 5 A's, Counseling, and Pharmacotherapy. ACTA ACUST UNITED AC 2015; 4. [PMID: 26005696 DOI: 10.4172/2324-9005.1000134] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 11/09/2022]
Abstract
STUDY BACKGROUND Despite efforts to promote the use of tobacco cessation services (TCS), implementation extensiveness remains limited. This study investigated three factors (cognitive, behavioral, environmental) identified by social cognitive theory as predictors of substance use disorder counselors' likelihood of use versus non-use of tobacco cessation (TC) 5 A's (ask patients about tobacco use, advise to quit, assess willingness to quit, assist in quitting, arrange for follow-up contact), counseling, and pharmacotherapy with their patients who smoke cigarettes. METHODS Data were collected in 2010 from 942 counselors working in 257 treatment programs that offered TCS. Cognitive factors included perceived job competence and TC attitudes. Behavioral factors encompassed TC-related skills and general training. External factors consisted of TC financial resource availability and coworker TC attitudes. Data were analyzed using logistic regression models with nested data. RESULTS Approximately 86% of counselors used the 5 A's, 76% used counseling, and 53% used pharmacotherapy. When counselors had greater TC-related skills and greater general training they were more likely to implement the 5 A's. Implementation of counseling was more likely when counselors had more positive attitudes toward TC treatment, greater general training, greater financial resource availability, and when coworkers had more positive attitudes toward TC treatment. Implementation of pharmacotherapy was more likely when counselors had more positive attitudes toward TC treatment, greater general training, and greater financial resource availability. CONCLUSION Findings indicate that interventions to promote TCS implementation should consider all three factors simultaneously as suggested by social cognitive theory.
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Affiliation(s)
- Tanja C Laschober
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA ; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA
| | - Jessica L Muilenburg
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA ; Department of Health Promotion and Behavior, 325 Psychology Building, Athens, GA 30602, USA
| | - Lillian T Eby
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA ; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA ; Industrial-Organizational Psychology Program, 325 Psychology Building, Athens, GA 30602, USA
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Muilenburg JL, Laschober TC, Eby LT. Relationship between Low-Income Patient Census and Substance Use Disorder Treatment Programs' Availability of Tobacco Cessation Services. J Drug Issues 2014; 45:69-79. [PMID: 25530629 DOI: 10.1177/0022042614552020] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Low income adults with substance use disorders (SUDs) have a high prevalence of tobacco use and often limited access to tobacco cessation treatment. This study examines the relationship between low-income SUD patient census (i.e., percentage of patients whose treatment costs are covered by Medicaid and Federal block grants) and SUD programs' availability of three evidence-based tobacco cessation services: behavioral treatments, system-level support, and pharmacotherapy. Data were collected from a random sample of 1,006 program administrators in 2010. Mixed-effects models results show that the percentage of low-income patients is significantly positively associated with the availability of behavioral treatments and system-level support but not pharmacotherapy. Thus, low-income patients may have similar access to tobacco cessation pharmacotherapy but greater access to behavioral treatments and system-level support. However, the availability of tobacco cessation services is not widespread overall, which may hamper access to extensive services to address low-income SUD patients' high smoking rates.
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Affiliation(s)
- Jessica L Muilenburg
- University of Georgia, 322 Psychology Building, Athens, GA 30602, USA, , ; Department of Health Promotion and Behavior
| | - Tanja C Laschober
- University of Georgia, 322 Psychology Building, Athens, GA 30602, USA, , ; Owens Institute for Behavioral Research
| | - Lillian T Eby
- University of Georgia, 322 Psychology Building, Athens, GA 30602, USA, , ; Owens Institute for Behavioral Research ; Industrial-Organizational Psychology Program
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Eby LT, Laschober TC, Muilenburg JL. Sustained, new, never, and discontinued tobacco cessation services adopters. J Subst Abuse Treat 2014; 49:8-14. [PMID: 25178991 DOI: 10.1016/j.jsat.2014.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 01/05/2014] [Revised: 07/21/2014] [Accepted: 07/29/2014] [Indexed: 11/17/2022]
Abstract
This study examined longitudinal adoption patterns of tobacco cessation (TC) counseling and TC pharmacotherapy in substance use disorder treatment programs and baseline predictors (program characteristics and program culture) of these patterns 12-months later. Telephone survey data were collected in 2010 from 685 randomly sampled program administrators working in geographically representative treatment programs across the U.S. Regarding TC counseling, about 41% of programs never adopt, 33% sustain, and 27% change adoption patterns. Concerning TC pharmacotherapy, about 62% of programs never adopt, 19% sustain, and 18% change adoption patterns. The three most consistent predictors of counseling adoption patterns are TC reimbursement, TC financial resource availability, and smoking culture. For TC pharmacotherapy adoption patterns, the most consistent predictors include profit status, TC reimbursement, level of care, TC financial resource availability, and smoking culture. Findings provide insights into program characteristics and program culture as both potential barriers and facilitators of longitudinal TCS adoption.
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Affiliation(s)
- Lillian T Eby
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA; Industrial-Organizational Psychology Program, 325 Psychology Building, Athens, GA 30602, USA.
| | - Tanja C Laschober
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA
| | - Jessica L Muilenburg
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Department of Health Promotion and Behavior, 325 Psychology Building, Athens, GA 30602, USA
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11
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Eby LT, Laschober TC, Muilenburg JL. Understanding counselors' implementation of tobacco cessation services with patients. J Subst Abuse Treat 2014; 47:314-20. [PMID: 25082757 DOI: 10.1016/j.jsat.2014.06.007] [Citation(s) in RCA: 11] [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] [Received: 01/30/2014] [Revised: 05/15/2014] [Accepted: 06/18/2014] [Indexed: 01/30/2023]
Abstract
This study aimed to understand substance use disorder counselors' implementation of evidence-based tobacco cessation services (TCS) with their patients who smoke. Drawing from an established adoption of innovations framework, we investigated the association between counselors' perceptions of the availability of TCS (both pharmacotherapies and behavioral treatments) in their treatment program and the implementation of TCS (both pharmacotherapies and behavioral treatments) with their patients who smoke and whether this association is moderated by the strength of an organization's climate for implementation and the fit of the innovation with users' values. Data were collected in 2010 from 682 counselors working in 239 treatment programs across the U.S. that offer evidence-based TCS. Mixed-effect models showed that perceived availability of TCS was related with greater TCS implementation. This relationship was moderated by several indicators of climate for implementation but not by the fit of the innovation with users' values.
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Affiliation(s)
- Lillian T Eby
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA; Industrial-Organizational Psychology Program, 325 Psychology Building, Athens, GA 30602, USA.
| | - Tanja C Laschober
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA.
| | - Jessica L Muilenburg
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Department of Health Promotion and Behavior, 325 Psychology Building, Athens, GA 30602, USA.
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12
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Muilenburg JL, Laschober TC, Eby LT. Climate for innovation, 12-step orientation, and tobacco cessation treatment. J Subst Abuse Treat 2013; 46:447-55. [PMID: 24355811 DOI: 10.1016/j.jsat.2013.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 06/05/2013] [Revised: 10/10/2013] [Accepted: 10/29/2013] [Indexed: 11/30/2022]
Abstract
This study examined the relationship between (1) three indicators of climate for innovation (clinician skills, absence of program obstacles, policy-related incentives) and adoption extensiveness of both behavioral treatments for tobacco cessation (TC) and system-level support for TC in substance use disorder treatment programs, (2) a program's 12-step treatment orientation and adoption extensiveness, and (3) whether 12-step treatment orientation moderates the relationship between climate for innovation and adoption extensiveness. Data were obtained from a random sample of 1006 program administrators. Hierarchical regression results showed that both absence of program obstacles and policy-related incentives are positively related to adoption extensiveness. Twelve-step treatment orientation is neither related to adoption extensiveness nor a moderator of the relationship between climate for innovation and adoption extensiveness. Although the adoption of both behavioral treatments for TC and system-level support for TC is not extensive, we conclude that a 12-step treatment orientation neither hampers nor promotes adoption extensiveness.
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Affiliation(s)
- Jessica L Muilenburg
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Department of Health Promotion and Behavior, 325 Psychology Building, Athens, GA 30602, USA.
| | - Tanja C Laschober
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA.
| | - Lillian T Eby
- University of Georgia, 325 Psychology Building, Athens, GA 30602, USA; Owens Institute for Behavioral Research, 325 Psychology Building, Athens, GA 30602, USA; Industrial-Organizational Psychology Program, 325 Psychology Building, Athens, GA 30602, USA.
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Abstract
Background The purpose of this study was to examine attitudes towards attempts to limit second-hand smoke (SHS) in five Eastern European nations. Methods The data consist of a Eurobarometer (64.3) survey distributed from November to December 2005. Logistic regression was employed to investigate support levels for indoor smoking bans across the five political units. Results Across nations, there is more support for smoking bans in offices and indoor work spaces and indoor public space as opposed to restaurants and bars and pubs. Personal smoking behaviours are linked strongly with the smoking bans. Most importantly, it is specific knowledge about the health dangers of smoking which fosters support for indoor smoking bans. Conclusion Policy implications suggest that government and the media must disseminate accurate information about the harm of smoking to broader segments of the population to gain support for policies that affect the dangers of SHS in these nations.
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Affiliation(s)
- J L Muilenburg
- College of Public Health, University of Georgia, Athens, Georgia, USA
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Affiliation(s)
- Lucy Annang
- Lucy Annang, PhD, MPH, is an Assistant Professor at University of South Carolina, Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, Columbia, South Carolina; Jessica L. Muilenburg, PhD, MPH, is an Assistant Professor, University of Georgia, Department of Health Promotion and Behavior, Athens, Georgia. Sheryl M. Strasser, PhD, MPH, MSW, is an Assistant Professor, Georgia State University, Institute of Public Health, Atlanta, Georgia
| | - Jessica L. Muilenburg
- Lucy Annang, PhD, MPH, is an Assistant Professor at University of South Carolina, Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, Columbia, South Carolina; Jessica L. Muilenburg, PhD, MPH, is an Assistant Professor, University of Georgia, Department of Health Promotion and Behavior, Athens, Georgia. Sheryl M. Strasser, PhD, MPH, MSW, is an Assistant Professor, Georgia State University, Institute of Public Health, Atlanta, Georgia
| | - Sheryl M. Strasser
- Lucy Annang, PhD, MPH, is an Assistant Professor at University of South Carolina, Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, Columbia, South Carolina; Jessica L. Muilenburg, PhD, MPH, is an Assistant Professor, University of Georgia, Department of Health Promotion and Behavior, Athens, Georgia. Sheryl M. Strasser, PhD, MPH, MSW, is an Assistant Professor, Georgia State University, Institute of Public Health, Atlanta, Georgia
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Hofmeister EH, Muilenburg JL, Kogan L, Elrod SM. Over-the-counter stimulant, depressant, and nootropic use by veterinary students. J Vet Med Educ 2010; 37:403-16. [PMID: 21135409 DOI: 10.3138/jvme.37.4.403] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
US veterinary students are subject to significant stress throughout their veterinary education. In this article, the authors characterize the use of over-the-counter (OTC) medications and relate their use to stress in a veterinary student population. Of the students sampled, 35% were OTC medication users; 33% of these were regular OTC medication users. Forty-three percent of students were energy drink (ED) users; 45% of these were regular ED users. OTC medication users had significantly higher stress scores than non-OTC medication users, and ED users had significantly higher anxiety scores than non-ED users. The most common reasons for use given by OTC medication users were to help with studying and to fall asleep at night. Depression scores were significantly higher for juniors and sophomores than for freshmen. Depression, stress, and anxiety scores were all lower in the Colorado State University students when compared with the University of Georgia students. OTC medication and ED veterinary student users had distinct characteristics that differed from those of nonusers. Users suffered from more stress and anxiety and had more difficulties with sleep, which may have affected their overall health and academic performance. Educating veterinary students about the consequences of using OTC medication and ED and providing counseling support may be of benefit to veterinary students' psychological well-being.
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Affiliation(s)
- Erik H Hofmeister
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, USA.
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Muilenburg JL, Legge JS. Investigating adolescents' sources of information concerning tobacco and the resulting impact on attitudes toward public policy. J Cancer Educ 2009; 24:148-153. [PMID: 19431033 DOI: 10.1080/08858190902854798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND In this study, we investigated different sources of information concerning the use of tobacco and the impact that these sources may have on attitudes toward tobacco policies. METHODS We surveyed 4336 high school students gathered from 5 high schools in the Southeastern United States. RESULTS The results indicate that just over half of these youth are supportive of public policies targeting bans on smoking in public places and having a minimum age to purchase tobacco products. Race is significant in impacting both age restriction and prohibition of smoking in public places, with African American youth being less supportive of both dependent variables. However, holding this variable constant in an ordinal logistic regression, we found that attitudes toward policy are impacted by the environment related to smoking in which the youth lives; the extent to which the youth believes he/she is well informed; and more important, the amount of correct and accurate information on smoking the youth possess. CONCLUSIONS Communicating accurate information is vital in increasing youth support for pending or already existing tobacco policies.
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Affiliation(s)
- Jessica L Muilenburg
- College of Public Health, Department of Health Promotion and Behavior, University of Georgia, 311 Ramsey Center, Athens, GA 30602, USA.
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Muilenburg JL, Legge JS. African American adolescents and menthol cigarettes: smoking behavior among secondary school students. J Adolesc Health 2008; 43:570-5. [PMID: 19027645 DOI: 10.1016/j.jadohealth.2008.08.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 08/19/2008] [Accepted: 08/27/2008] [Indexed: 11/17/2022]
Abstract
PURPOSE This paper examines the impact of smoking menthol cigarettes among secondary students, primarily African Americans, across five measures of smoking behavior. METHODS Data were gathered from a 2006 survey of six secondary schools in a large urban area in the southeastern United States. Ordered logit analysis is employed to estimate race and menthol effects on cigarette consumption. RESULTS African American youth smoke at lower rates than white adolescents; menthol smokers consume cigarettes at higher rates irrespective of race. Most importantly, there is a strong interaction effect with black menthol smokers demonstrating the highest levels of cigarette consumption. CONCLUSIONS There is a need to provide adolescent and adult African Americans accurate information on the dangers of menthol cigarettes. Any proposed legislation should consider the special problems of menthol and its relationship to high cigarette consumption, especially for African American adolescents.
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Affiliation(s)
- Jessica L Muilenburg
- Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, Georgia 30602, USA
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Muilenburg JL, Johnson WD, Usdan SL, Annang L, Clayton DL. Prevalence of impaired driving behaviors in a diverse, rural, southern middle school. Accid Anal Prev 2007; 39:1080-1087. [PMID: 17920829 DOI: 10.1016/j.aap.2007.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Revised: 02/05/2007] [Accepted: 02/12/2007] [Indexed: 05/25/2023]
Abstract
Little research has been reported on the risky behaviors of pre-driving adolescents revolving around alcohol use, in particular impaired driving behaviors, which in general have been shown to be higher in rural areas. This study investigated the prevalence of drinking while driving and riding with a drinking driver among 290 middle school students in a Mississippi Delta area middle school. Just under half (45.3%) responded that at least once in the past 30 days they had ridden with a drinking driver and 17% indicated they had driven an automobile after drinking alcohol. The prevalence of underage drinking, driving under the influence of alcohol, and riding with a drinking driver among our sample of middle school students is alarming. This study shows alcohol-related driving behaviors are not solely performed by those who are legally licensed to drive, but simply by those who have access to vehicles. The authors recommend that prevention programs focusing on reducing the incidence of impaired driving should start in early adolescence.
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Affiliation(s)
- Jessica L Muilenburg
- University of Georgia, Department of Health Promotion and Behavior, 311 Ramsey Center, Athens, GA 30602, United States.
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Muilenburg JL, Johnson WD, Annang L, Strasser SM. Racial disparities in tobacco use and social influences in a rural southern middle school. J Sch Health 2006; 76:195-200. [PMID: 16635204 DOI: 10.1111/j.1746-1561.2006.00094.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This study investigated racial differences of tobacco use and social exposure to tobacco products in a sample of middle school students. Questionnaires were administered in January 2005 to 290 students in a Mississippi Delta-area middle school. The participants were 51.0% female and 56.6% African American. Unadjusted odds ratios revealed that Caucasian students were statistically more likely than were African American students to (1) have ever tried smoking, (2) have ever been a daily smoker, (3) have smoked in the past 30 days, (4) live with someone who smokes, (5) have seen a parent or guardian smoke, and (6) have friends who smoke. In contrast, African Americans were more likely to report "no one is allowed to smoke" in their home. Caucasian females had the highest rates of smoking, as well as the highest exposure to social smoking behaviors. This study not only showed that Caucasians were indeed smoking more but also that African American adolescents do not have the same exposure to social smoking, particularly African American females. Of particular interest was why the differences eventually dissipate and smoking rates are virtually the same in adulthood. A greater understanding of the impact of exposure to tobacco use on an adolescent's own tobacco use is vital to prevention efforts, especially in regard to racial differences. Future research on youth tobacco prevention and cessation programs should focus on sociocultural and racial differences in the development of tobacco use in adolescents.
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Affiliation(s)
- Jessica L Muilenburg
- Division of Epidemiology, Department of Preventive Medicine, University of Mississippi Medical Center, Jackson 39216, USA.
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Annang L, Strasser SM, Muilenburg JL. Visual Communication. CALIF J HEALTH PROMOT 2005. [DOI: 10.32398/cjhp.v3i1.1742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Poster presentations are an effective method of conveying scientific information in an interactive and nonthreatening format. They are also a means of increasing authors’ visibility and recognition in their field. The authors have presented a preparatory guide to minimize stress and increase poster presentation savvy at professional conferences for either the novice or seasoned professional.
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Strasser SM, Annang L, Muilenburg JL, Etienne MO. Strategic Insight on Gaining Admittance to Graduate Study. CALIF J HEALTH PROMOT 2005. [DOI: 10.32398/cjhp.v3i1.1740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Applying to graduate school involves strategic planning and preparation. There is an array of considerations and factors that can influence the decision to pursue masters- level education and beyond. A brief synopsis of the graduate school application process is provided so that individuals pursuing a higher level of academia can gain insight on how to optimize their chance of attaining acceptance into programs of choice.
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