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Ratsch AM, Mason A, Rive L, Bogossian FE, Steadman KJ. The Pituri Learning Circle: central Australian Aboriginal women's knowledge and practices around the use of <I>Nicotiana</I> spp. as a chewing tobacco. Rural Remote Health 2017; 17:4044. [PMID: 28780876 DOI: 10.22605/rrh4044] [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: 11/03/2022] Open
Abstract
INTRODUCTION Tobacco smoking has a range of known and predictable adverse outcomes, and across the world sustained smoking reduction campaigns are targeted towards reducing individual and public risk and harm. Conversely, more than 87 million women, mostly in low- and middle-income countries, use smokeless tobacco, yet the research examining the effect of this form of tobacco exposure on women is remarkably scant. In central Australia, the chewing of wild <i>Nicotiana</i> spp., a tobacco plant, commonly known as <i>pituri</i> and <i>mingkulpa</i>, is practised by Aboriginal groups across a broad geographical area. Until recently, there had been no health research conducted on the effects of chewing <i>pituri. METHODS This article reports on one component of a multidimensional <i>pituri</i> research agenda. A narrative approach utilising the methodology of the Learning Circle was used to interview three key senior central Australian Aboriginal women representative of three large geographical language groupings. The participants were selected by a regional Aboriginal women's organisation. With the assistance of interpreters, a semistructured interview, and specific trigger resources, participants provided responses to enable an understanding of the women's ethnobotanical <i>pituri</i> knowledge and practices around the use of <i>pituri</i> within the context of Aboriginal women's lives. Data were transcribed, and by using a constant comparison analysis, emergent themes were categorised. The draft findings and manuscript were translated into the participants' language and validated by the participants. RESULTS Three themes around <i>pituri</i> emerged: (a) the plants, preparation and use; (b) individual health and wellbeing; and (c) family and community connectedness. The findings demonstrated similar participant ethnobotanical knowledge and practices across the geographical area. The participants clearly articulated the ethnopharmacological knowledge associated with mixing <i>pituri</i> with wood ash to facilitate the extraction of nicotine from <i>Nicotiana </i>spp., the results of which were biochemically verified. The participants catalogued the pleasurable and desired effects obtained from <i>pituri</i> use, the miscellaneous uses of <i>pituri</i>, as well as the adverse effects of <i>pituri</i> overdose and toxicity, the catalogue of which matched those of nicotine. The participants' overarching <i>pituri</i> theme was related to the inherent role <i>pituri</i> has in the connectiveness of people to family, friends and community. CONCLUSIONS Central Australian Aboriginal women have a firmly established knowledge and understanding of the pharmacological principles related to the content of <i>Nicotiana</i> spp. and the extraction of nicotine from the plant. Widespread use of <i>Nicotiana</i> spp. as a chewing tobacco by Aboriginal populations in the southern, central and western desert regions of Australia is attested to by participants who assert that <i>everyone uses it</i>, with girls in these remote areas commencing use between 5 and 7 years of age. Central Australian Aboriginal people who chew <i>Nicotiana</i> spp. do not consider it to be a tobacco plant, and will strongly refute that they are tobacco users. Central Australian Aboriginal people do not consider that the Western health information regarding tobacco (as a smoked product) is applicable or aligned to their use of <i>pituri</i>. <i>Nicotiana</i> spp. users will deny tobacco use at health assessment. There is a requirement to develop and provide health information on a broader range of tobacco and nicotine products in ways that are considered credible by the Aboriginal population. Health messages around <i>pituri</i> use need to account for the dominant role that <i>pituri</i> occupies in the context of central Australian Aboriginal women's lives.<br /> Information for readers: A consultative organisation of Aboriginal women has as a strategic intent and operational agenda the improvement of Aboriginal women's and children's health across the research region. The group seeks opportunities to enhance their knowledge based on legitimate collaborative research; accordingly, they sought to participate in a range of research activities regarding the use of <i>pituri</i> and women's health outcomes. Of particular note, the group's participants chose to be identified by name in the publication of this research activity. In this article, the term 'Aboriginal' has been chosen by the central Australian women to refer to both themselves and the Aboriginal people in their communities; 'Indigenous' has been chosen to refer to the wider Australian Aboriginal and Torres Strait Islander people. The term <i>Nicotiana</i> spp. is used when referring to the plants from a Western perspective; <i>pituri</i> is used when referring to the plants, the tobacco quid, and the practice of chewing from a general Aboriginal perspective; and <i>mingkulpa</i> is used when the participants are voicing their specific knowledge and practices.
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Affiliation(s)
- Angela M Ratsch
- Health and The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
| | - Andrea Mason
- Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women's Council, Alice Springs, Northern Territory, Australia.
| | - Linda Rive
- Pitjantjatjara Council Cultural Heritage Unit, Alice Springs, Northern Territory, Australia.
| | - Fiona E Bogossian
- School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
| | - Kathryn J Steadman
- Pharmacy Australia Centre of Excellence, The University of Queensland, St Lucia, Brisbane, Queensland, Australia.
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Dotson JAW, Nelson LA, Young SL, Buchwald D, Roll J. Use of cell phones and computers for health promotion and tobacco cessation by American Indian college students in Montana. Rural Remote Health 2017; 17:4014. [PMID: 28328231 DOI: 10.22605/rrh4014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Cell phones and personal computers have become popular mechanisms for delivering and monitoring health information and education, including the delivery of tobacco cessation education and support. Tobacco smoking is prevalent among American Indians (AIs) and Alaska Natives (ANs), with 26% AI/AN adult men smoking compared to 19% of Caucasian adult males and 22% of African American adult males. Smoking is even more prevalent in Northern Plains AI populations, with 42% of men <i>and</i> women reporting current smoking. The literature on the availability and use of cell phones and computers, or the acceptability of use in health promotion among AIs and ANs, is scant. The authors report findings from a survey of AI students regarding their cell phone and computer access and use. The survey was conducted to inform the development and implementation of a text messaging smoking cessation intervention modeled on a program developed and used in Australia. METHODS A 22-item paper and pencil survey was administered to students at tribal colleges in rural Montana. The survey questions included cell phone ownership and access to service, use of cell phones and computers for health information, demographics, tobacco use habits, and interest in an intervention study. The study was reviewed and determined exempt by the institutional review boards at the tribal colleges and the lead research university. The study was conducted by researchers at the tribal colleges. Survey respondents received $10 when the survey was completed and returned. Data analysis was performed with the Statistical Package for the Social Sciences. RESULTS Among 153 AI respondents, the mean age was 29 years, range was 18-64 years. Overall, 40% reported smoking cigarettes with a mean age of 16 years at initiation. A total of 131 participants (86%) had cell phones and, of those, 122 (93%) had unlimited text messaging. A total of 104 (68%) had smart phones (with internet access), although 40% of those with smart phones reported that internet access on their phone was very slow or location limited. A total of 146 (95%) participants reported having access to a computer, although 32% of those did not have daily access. Students aged less than 23 years were more likely to have cell phones with internet access. Cell phone ownership differed by site (93% vs 77%,<i> p</i>=0.007). About 60% of the respondents who smoked indicated interest in participating in the intervention study. CONCLUSIONS This study revealed that<b> </b>AI<b> </b>tribal college students in the rural communities surveyed had less<b> </b>cell phone, smart phone, and computer and internet access than that reported for undergraduate college students elsewhere in the USA.<b> </b>Research efforts and public health interventions must be culturally appropriate and technologically viable, therefore access to and acceptability of mobile technology must be evaluated when planning and implementing interventions for rural and other marginalized populations. The findings from this study contribute to the literature regarding the access to and acceptability of mobile technology for health promotion among AI/AN college students in rural and remote areas, and helped introduce the proposed study to the community and solicited useful data regarding tobacco prevalence and interest in tobacco research in the target population.
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Affiliation(s)
| | | | | | | | - John Roll
- Washington State University PO Box 1495.
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Mehus G, Mehus AG, Germeten S, Henriksen N. Young people and snowmobiling in northern Norway: accidents, injury prevention and safety strategies. Rural Remote Health 2016; 16:3713. [PMID: 27764952] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Snowmobiling among young people in Scandinavia frequently leads to accidents and injuries. Systematic studies of accidents exist, but few studies have addressed young drivers' experiences. The aim of this article is to reveal how young people experience and interpret accidents, and to outline a prevention strategy. METHODS Thirty-one girls and 50 boys aged 16-23 years from secondary schools in Northern Norway and on Svalbard, a Norwegian archipelago in the Arctic Ocean, participated in 17 focus groups segregated by gender. A content analysis identified themes addressing the research questions. RESULTS Participants described risk as being inherent to snowmobiling, and claimed that accidents followed from poor risk assessment, careless driving or mishaps. Evaluation of accidents and recommendations for preventive measures varied. Girls acknowledged the risks and wanted knowledge about outdoor life, navigation and external risks. Boys underestimated or downplayed the risks, and wanted knowledge about safety precautions while freeriding. Both genders were aware of how and why accidents occurred, and took precautions. Boys tended to challenge norms in ways that contradict the promotion of safe driving behaviour. Stories of internal justice regarding driving under the influence of alcohol occurred. CONCLUSIONS Adolescents are aware of how accidents occur and how to avoid them. Injury prevention strategies should include a general population strategy and a high-risk strategy targeted at extreme risk-seekers. Drivers, snowmobilers' organisations and the community should share local knowledge in an effort to define problem areas, set priorities and develop and implement preventive measures. Risk prevention should include preparation of safe tracks and focus on safety equipment and safe driving behaviour, but should also pay increased attention to the potential of strengthening normative regulation within peer groups regarding driving behaviour and mutual responsibility for preventing accidents.
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Affiliation(s)
- Grete Mehus
- University of Tromsø,The Arctic University of Norway, Norway.
| | | | - Sidsel Germeten
- University of Tromsø,The Arctic University of Norway, Norway.
| | - Nils Henriksen
- University of Tromsø,The Arctic University of Norway, Norway.
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Russell C, Firestone M, Kelly L, Mushquash C, Fischer B. Prescription opioid prescribing, use/misuse, harms and treatment among Aboriginal people in Canada: a narrative review of available data and indicators. Rural Remote Health 2016; 16:3974. [PMID: 27871180] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
INTRODUCTION Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated problems among Aboriginal groups, no comprehensive data review currently exists. METHODS A review of available data sources (ie journal publications, public reports and 'grey' literature) was conducted following principles of a scoping review. Information and data were identified, extracted, and organized into major indicator categories: PO prescribing/dispensing, use/abuse, morbidity/mortality harms and treatment, and narratively reported. RESULTS Data suggest that PO dispensing, use and misuse levels among Aboriginal populations are high and/or rising in select settings when compared to the general Canadian population. High levels of PO-related dependence and pregnancy harms exist (mainly in Northern Ontario); there is some indication of elevated opioid mortality among Aboriginals. Vast discrepancies in availability and access to interventions exist; some recent pilot studies suggest improved care. CONCLUSIONS Data regarding PO use and harms among Aboriginal people are limited, even though elevated problem levels are indicated; improved monitoring, and more effective yet culturally and contextually appropriate interventions for this acute problem are needed.
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Affiliation(s)
- Cayley Russell
- Centre for Addiction and Mental Health,Toronto, Ontario, Canada.
| | | | - Len Kelly
- Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Ontario, Canada.
| | - Christopher Mushquash
- Department of Pyschology and Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada.
| | - Benedikt Fischer
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Warren JC, Smalley KB, Barefoot KN. Perceived ease of access to alcohol, tobacco and other substances in rural and urban US students. Rural Remote Health 2015; 15:3397. [PMID: 26518286 PMCID: PMC4727394] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Ease of access to substances has been shown to have a direct and significant relationship with substance use for school-aged children. Previous research involving rural samples of middle and high school students reveals that perceived ease of access to substances is a significant predictor of recent use among rural adolescents; however, it is unclear if perceived access to substances varies between rural and urban areas. The purpose of the present study was to examine rural-urban differences in perceived ease of access to alcohol, smoking and chewing tobacco, marijuana, and seven other substances in the US state of Georgia in order to better inform and promote future substance use prevention and programming efforts in rural areas. METHODS Data were analyzed from the 2013 Georgia Student Health Survey II, administered in all public and interested private/charter schools in the state of Georgia. A total of 513 909 students (18.2% rural) indicated their perceived ease of access to 11 substances on a four-point Likert-type scale. Rural-urban differences were investigated using χ2 analysis. RESULTS In general, it appeared the rural-urban differences fell along legal/illicit lines. For middle school students, a significant difference in perceived ease of access was found for each substance, with rural students reporting greater access to smoking tobacco, chewing tobacco, and steroids, and urban students reporting greater access to alcohol, marijuana, cocaine, inhalants, ecstasy, methamphetamine, hallucinogens, and prescription drugs. Rural high school students reported higher access to alcohol, smoking tobacco, chewing tobacco, and steroids, with urban students reporting higher access to marijuana, cocaine, inhalants, ecstasy, and hallucinogens. Perceptions of ease of access more than doubled for each substance in both geographies between middle and high school. CONCLUSIONS The present study found multiple and fairly consistent differences between rural and urban students' perceived ease of access to a variety of substances, with rural students reporting higher levels of access to legal substances and urban students reporting higher levels of access predominantly to illicit substances. Most troubling were the high levels of perceived access to substances, particularly among high school students. Even within rural students who reported lower ease of access, more than half of students reported having at least somewhat easy access to marijuana. More than 60% of both rural and urban high school students reported easy access to alcohol. Future research should investigate ways to decrease the perceptions of access to substances in order to prevent use and abuse.
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Affiliation(s)
- Jacob C Warren
- Mercer University School of Medicine, Macon, Georgia, USA.
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Tall JA, Brew BK, Saurman E, Jones TC. Implementing an anti-smoking program in rural-remote communities: challenges and strategies. Rural Remote Health 2015; 15:3516. [PMID: 26530272] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. METHODS Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. RESULTS Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. CONCLUSIONS Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.
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Affiliation(s)
- Julie A Tall
- Level 1, 230 Howick Street, Bathurst, New South Wales, Australia.
| | - Bronwyn K Brew
- Western New South Wales Local Health District, Bathurst, New South Wales, Australia.
| | - Emily Saurman
- Broken Hill University Department of Rural Health, University of Sydney, Broken Hill, New South, Wales Australia.
| | - Therese C Jones
- Western New South Wales Local Health District, Bathurst, New South Wales, Australia.
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Branstetter SA, Lengerich E, Dignan M, Muscat J. Knowledge and perceptions of tobacco-related media in rural Appalachia. Rural Remote Health 2015; 15:3136. [PMID: 25754624] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION A critical component of the US Food and Drug Administration's new authority to regulate tobacco products is understanding communications and marketing of tobacco products and their perceived risks in different geographic, age, race, ethnic and socioeconomic groups. Such information might be particularly useful in subgroups of the population or geographic areas that experience high tobacco use and suffer a disproportionate burden from tobacco-related diseases. For certain populations, there may be additional cultural factors unique to the geographical region which may promote smoking behavior. The purpose of the present study was to examine the perceptions of tobacco-related media messages among a sample of rural Appalachian natives, a population with smoking rates higher than the national average and who are disproportionately affected by tobacco-related and other cancers. METHODS A series of four focus group sessions were conducted in a north-central area of Pennsylvania, in one of 52 counties in Pennsylvania designated as within the Appalachian region. Participants were recruited via direct mail letters, advertisements in a local newspaper, and recruiting flyers posted at the local library. The focus groups were moderated by trained professional staff from The Pennsylvania State University's Center for Survey Research (CSR). Focus group sessions sought to examine perceptions of tobacco-related media in an Appalachian region of Pennsylvania. The sessions were audiotaped and transcribed, and the data was analyzed using qualitative approaches. RESULTS Participants reported that pro-tobacco ads and favorable messages were received through the internet, direct mail, convenience stores, billboards, movies, and other sources. Anti-tobacco messages were identified primarily from television and magazines. In general, participants concluded that quitting was a matter of choice and was not influenced by pro- or anti-tobacco media. CONCLUSIONS These results indicate that both pro- and anti-tobacco messages from a variety of sources are highly recognized and remembered in detail in Appalachia, but the effectiveness of anti-tobacco messages is questionable within this group. It was found that, without exception, group members reported that no media messages - either pro- or anti-tobacco - had any meaningful impact on their current behavior. Group members did, however, recognize that media messages influenced their behavior at the time they were first starting to smoke. The failure of these messages to connect with this population may reflect the lack of specific tailoring of messages to fit the distinct culture and values of this Appalachian population.
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Affiliation(s)
| | - Eugene Lengerich
- Department of Public Health Sciences, The Pennsylvania State University, Hershey, Pennsylvania, USA.
| | - Mark Dignan
- Prevention Research Center, University of Kentucky, Lexington, Kentucky, USA.
| | - Joshua Muscat
- School of Medicine, Department of Public Health Sciences, The Pennsylvania State University, Hershey, Pennsylvania, USA Hershey, PA 17033-0855.
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DeFlavio JR, Rolin SA, Nordstrom BR, Kazal LA. Analysis of barriers to adoption of buprenorphine maintenance therapy by family physicians. Rural Remote Health 2015; 15:3019. [PMID: 25651434] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Opioid abuse has reached epidemic levels. Evidence-based treatments such as buprenorphine maintenance therapy (BMT) remain underutilized. Offering BMT in primary care settings has the potential to reduce overall costs of care, decrease medical morbidity associated with opioid dependence, and improve treatment outcomes. However, access to BMT, especially in rural areas, remains limited. This article will present a review of barriers to adoption of BMT among family physicians in a primarily rural area in the USA. METHODS An anonymous survey of family physicians practicing in Vermont or New Hampshire, two largely rural states, was conducted. The survey included both quantitative and qualitative questions, focused on BMT adoption and physician opinions of opioids. Specific factors assessed included physician factors, physicians' understanding of patient factors, and logistical issues. RESULTS One-hundred and eight family physicians completed the survey. Approximately 10% were buprenorphine prescribers. More than 80% of family physicians felt they regularly saw patients addicted to opiates. The majority (70%) felt that they, as family physicians, bore responsibility for treating opiate addiction. Potential logistical barriers to buprenorphine adoption included inadequately trained staff (88%), insufficient time (80%), inadequate office space (49%), and cumbersome regulations (37%). Common themes addressed in open-ended questions included lack of knowledge, time, or interest; mistrust of people with addiction or buprenorphine; and difficult patient population. CONCLUSIONS This study aims to quantify perceived barriers to treatment and provide insight expanding the community of family physicians offering BMT. The results suggest family physicians are excellent candidates to provide BMT, as most report regularly seeing opioid-addicted patients and believe that treating opioid addiction is their responsibility. Significant barriers remain, including inadequate staff training, lack of access to addiction experts, and perceived efficacy of BMT. Addressing these barriers may lower resistance to buprenorphine adoption and increase access to BMT in rural areas.
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Affiliation(s)
| | - Stephanie A Rolin
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
| | - Benjamin R Nordstrom
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
| | - Louis A Kazal
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
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Murphy KD, Byrne S, Sahm LJ, Lambert S, McCarthy S. Use of addiction treatment services by Irish youth: does place of residence matter? Rural Remote Health 2014; 14:2735. [PMID: 25096268] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Substance abuse treatment centres for Irish rural youth have largely been overlooked in the scientific literature. This study examined data from a substance abuse treatment centre that treats both urban and rural attendees to investigate if there are differences in usage patterns between attendee groups. METHODS A cross-sectional study was done of 436 service-users attending a treatment centre: patient characteristics, treatment referral details and substance history of the attendees from urban and rural areas were compared. Descriptive analysis of the service-user population was performed and recent substance use was investigated. Inferential tests examined for differences between urban and rural service-users. RESULTS The typical service-user was an Irish male aged between 16 and 17 years, who resided with his parents. A greater percentage of rural service-users were employed (33.3% vs 22.2%, p=0.015), while a significantly greater percentage of urban service-users were unemployed (10.3% vs 4.1%, p=0.015). A greater proportion of urban service-users had tried multiple substances in their lifetimes (73.7% vs 52.2%, p=0.001) and continued to use multiple substances regularly (49.3% vs 31.3%, p=0.003) compared with their rural counterparts. CONCLUSIONS This is the first Irish study comparing service-users from urban and rural settings. Rural service-users developed more problematic alcohol use, while more urban service-users were referred for benzodiazepine use. Prevention strategies should acknowledge the differences and similarities in urban and rural young people.
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Affiliation(s)
- Kevin D Murphy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland.
| | - Stephen Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland.
| | - Laura J Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland.
| | - Sharon Lambert
- Day Treatment Centre, Matt Talbot Services, Rockview Trabeg Lawn, Douglas, Cork, Ireland.
| | - Suzanne McCarthy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Ireland.
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