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Rossouw J, Suliman S, Nothling J, Lombard C, Bröcker E, Hewett M, Simmons C, Shorter GW, Seedat S, Milanak ME, Armour C. A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD. Eur J Psychotraumatol 2024; 15:2350217. [PMID: 38774992 DOI: 10.1080/20008066.2024.2350217] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = -2.18, p = .029), mean slope = -0.2 (95% CI: -0.37 to -0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: -22.43 to -0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.
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Affiliation(s)
- Jaco Rossouw
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Sharain Suliman
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Faculty of Medicine and Health Sciences, South African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Jani Nothling
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Carl Lombard
- South African Medical Research Council - Biostatistics Unit, Cape Town, South Africa
| | - Erine Bröcker
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Maryke Hewett
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Candice Simmons
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Gillian W Shorter
- School of Psychology, David Keir Building, Queen's University Belfast, Belfast, Northern Ireland
| | - Soraya Seedat
- Faculty of Medicine and Health Sciences, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- Faculty of Medicine and Health Sciences, South African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Melissa E Milanak
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Cherie Armour
- Faculty of Medicine and Health Sciences, South African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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Black N, Chung S, Tisdale C, Fialho LS, Aramrattana A, Assanangkornchai S, Blaszczynski A, Bowden-Jones H, van den Brink W, Brown A, Brown QL, Cottler LB, Elsasser M, Ferri M, Florence M, Gueorguieva R, Hampton R, Hudson S, Kelly PJ, Lintzeris N, Murphy L, Nadkarni A, Neale J, Rosen D, Rumpf HJ, Rush B, Segal G, Shorter GW, Torrens M, Wait C, Young K, Farrell M. An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders. J Clin Med 2024; 13:2154. [PMID: 38610919 PMCID: PMC11012938 DOI: 10.3390/jcm13072154] [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] [Received: 02/22/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally.
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Affiliation(s)
- Nicola Black
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
| | - Sophie Chung
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Calvert Tisdale
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
| | - Luz Sousa Fialho
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Apinun Aramrattana
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sawitri Assanangkornchai
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Alex Blaszczynski
- School of Psychology, Brain and Mind Centre, Faculty of Science, University of Sydney, Sydney 2006, Australia;
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University College London, London NW1 2AE, UK
- Department of Psychiatry, Cambridge University, Cambridge CB2 1QW, UK
| | - Wim van den Brink
- Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Adrian Brown
- Northwick Park Hospital, Central and North West London Trust, London HA1 3UJ, UK
| | - Qiana L. Brown
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Medicine & Public Health and Health Professions, University of Florida, Homestead, FL 33031, USA
| | | | - Marica Ferri
- Department of Psychology, Faculty of Community and Health, European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal;
| | - Maria Florence
- Department of Biostatistics, School of Public Health, University of the Western Cape, Cape Town 7535, South Africa;
| | - Ralitza Gueorguieva
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT 06511, USA
| | | | - Suzie Hudson
- Network of Alcohol and Other Drugs Agencies, Sydney 2751, Australia;
| | - Peter J. Kelly
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong 2522, Australia;
| | - Nicholas Lintzeris
- Discipline of Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia;
| | | | - Abhijit Nadkarni
- Addictions and Related Research Group, Sangath, Bardez 403501, Goa, India
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Joanne Neale
- Addictions Department, King’s College London, London SE1 9NH, UK
| | - Daniel Rosen
- School of Social Work, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Hans-Jürgen Rumpf
- Translational Psychiatry Unit, Universität zu Lübeck, 23562 Lübeck, Germany
| | - Brian Rush
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Gabriel Segal
- Department of Philosophy, King’s College London, London SE1 9NH, UK;
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast BT9 5AJ, UK
- Institute of Mental Health Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Marta Torrens
- Addiction Service, Hospital del Mar, 08003 Barcelona, Spain
| | | | - Katherine Young
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
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Holland A, Copeland CS, Shorter GW, Connolly DJ, Wiseman A, Mooney J, Fenton K, Harris M. Nitazenes-heralding a second wave for the UK drug-related death crisis? Lancet Public Health 2024; 9:e71-e72. [PMID: 38224702 DOI: 10.1016/s2468-2667(24)00001-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024]
Affiliation(s)
- Adam Holland
- Faculty of Public Health Drugs Special Interest Group, London, UK; School of Psychological Science, University of Bristol, Bristol BS8 2BN, UK; School of Population Health Sciences, University of Bristol, Bristol BS8 2BN, UK; Department of Public Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Caroline S Copeland
- Institute of Pharmaceutical Science, King's College London, London, UK; National Programme on Substance Abuse Deaths, King's College London, London, UK
| | - Gillian W Shorter
- Faculty of Public Health Drugs Special Interest Group, London, UK; Drug and Alcohol Research Network, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Dean J Connolly
- Faculty of Public Health Drugs Special Interest Group, London, UK; Department of Public Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK; National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alice Wiseman
- Faculty of Public Health Drugs Special Interest Group, London, UK; Association of Directors of Public Health, London, UK
| | - John Mooney
- Faculty of Public Health Drugs Special Interest Group, London, UK; Public Health Directorate, NHS Grampian, Aberdeen, UK; School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Magdalena Harris
- Faculty of Public Health Drugs Special Interest Group, London, UK; Department of Public Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Saab MM, Shetty VN, McCarthy M, Davoren MP, Flynn A, Kirby A, Robertson S, Shorter GW, Murphy D, Rovito MJ, Shiely F, Hegarty J. Promoting 'testicular awareness': Co-design of an inclusive campaign using the World Café Methodology. Health Expect 2023; 27:e13898. [PMID: 37877701 PMCID: PMC10726274 DOI: 10.1111/hex.13898] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/25/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
INTRODUCTION Testicular cancer is the most common cancer in men aged 15-44 years in many countries. Most men with testicular cancer present with a lump. Testicular symptoms are more likely to occur secondary to benign diseases like epididymo-orchitis, a common sexually transmitted infection. Gender and sexual minorities are at an increased risk of testicular diseases and health disparities. The aim of this study was to co-design an inclusive community-based campaign to promote testicular awareness. METHODS This study uses the World Café methodology. Participation was sought from Lesbian, Gay, Bisexual, Transgender and Queer+ friendly organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers. Participants engaged in three rounds of conversations to co-design the campaign. Data were collected using drawing sheets, artefact cards, sticky notes, coloured markers and a voice recorder. Deductive thematic analysis was conducted. RESULTS Seventeen individuals participated in the study. Six themes emerged from the analysis as follows: (i) online communication; (ii) offline communication; (iii) behavioural targeting and education; (iv) campaign frequency and reach; (v) demographic segmentation; and (vi) campaign identity. The use of social media for campaign delivery featured strongly in all conversations. Participants also recommended offline communication using posters and radio/television advertisements to scale up the campaign and achieve wider reach. Advertisements to overcome embarrassment surrounding testicular health were particularly recommended. Participants emphasised that campaign delivery must be dynamic whilst ensuring that the health-promoting messages are not diluted or lost. They stressed the importance of being inclusive and tailoring the campaign to different age groups, gender identities and sexual orientations. CONCLUSIONS Study recommendations will be used to design and deliver the campaign. Future research will be needed to evaluate the feasibility, acceptability, cost and effect of the campaign on promoting testicular awareness and early detection of testicular diseases. PATIENT OR PUBLIC CONTRIBUTION A participatory research approach was used to co-design the campaign with members of Lesbian, Gay, Bisexual, Transgender and Queer+ (LGBTQ+) friendly organisations, LGBTQ+ student bodies, LGBTQ+ staff networks, LGBTQ+ sports clubs, men's health organisations, testicular cancer survivors, health policy makers, media and marketing experts and graphic designers.
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Affiliation(s)
- Mohamad M. Saab
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Varsha N. Shetty
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Megan McCarthy
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Martin P. Davoren
- Sexual Health CentreCorkIreland
- School of Public HealthUniversity College CorkCorkIreland
| | - Angela Flynn
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
| | - Ann Kirby
- Department of Economics, Cork University Business SchoolUniversity College CorkCorkIreland
| | - Steve Robertson
- School of Allied Health Professions, Nursing & Midwifery, Faculty of HealthUniversity of SheffieldSheffieldUK
| | | | - David Murphy
- School of Computer Science & Information TechnologyUniversity College CorkCorkIreland
| | - Michael J. Rovito
- Department of Health Sciences, College of Health Professions and SciencesUniversity of Central FloridaOrlandoFloridaUSA
| | - Frances Shiely
- School of Public HealthUniversity College CorkCorkIreland
- HRB Clinical Research FacilityUniversity College CorkCorkIreland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and MidwiferyUniversity College CorkCorkIreland
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Chater AM, Brook-Rowland P, Tolani F, Christopher E, Hart J, Byrne-Davis LMT, Moffat A, Shorter GW, Epton T, Kamal A, O’Connor DB, Whittaker E, Lewis LJM, McBride E, Swanson V, Arden MA. Understanding a constellation of eight COVID-19 disease prevention behaviours using the COM-B model and the theoretical domains framework: a qualitative study using the behaviour change wheel. Front Public Health 2023; 11:1130875. [PMID: 37475767 PMCID: PMC10355219 DOI: 10.3389/fpubh.2023.1130875] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/30/2023] [Indexed: 07/22/2023] Open
Abstract
Background The use of behavioural science and behaviour change within local authorities and public health has supported healthful change; as evidenced by its importance and contribution to reducing harm during the COVID-19 pandemic. It can provide valuable information to enable the creation of evidence-based intervention strategies, co-created with the people they are aimed at, in an effective and efficient manner. Aim This study aimed to use the COM-B model to understand the Capability, Opportunity and Motivation of performing a constellation of eight COVID-19 disease prevention behaviours related to the slogans of 'Hands, Face, Space, Fresh Air'; 'Find, Isolate, Test, (FIT), and Vaccinate' in those employed in workplaces identified as high risk for transmission of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) to support intervention development. Methods This qualitative study recruited twenty-three participants (16 female, 7 male), who were interviewed from three environments (schools, care homes, warehouses) across three local authorities. Semi-structured interviews were analysed using thematic analysis. Findings Ten core themes were identified inductively; (1) knowledge and skills, (2) regulating the behaviour, (3) willingness to act, (4) necessity and concerns, (5) emotional impact, (6) conducive environment, (7) societal influence, (8) no longer united against COVID-19, (9) credible leadership, and (10) inconsistent adherence to COVID-19 prevention behaviours. Themes were then deductively mapped to the COM-B model of behaviour change and the theoretical domains framework and a logic model using the behaviour change wheel (BCW) was produced to inform intervention design. Conclusion This study offers a novel approach to analysis that has included eight behaviours within a single thematic analysis and COM-B diagnosis. This will enable local authorities to direct limited resources to overarching priorities. Of key importance, was the need for supportive and credible leadership, alongside developing interventions collaboratively with the target audience. COVID-19 has had an emotional toll on those interviewed, however, promoting the value of disease prevention behaviours, over and above their costs, can facilitate behaviour. Developing knowledge and skills, through education, training, marketing and modelling can further facilitate behaviour. This supports guidance produced by the British Psychological Society COVID-19 behavioural science and disease prevention taskforce.
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Affiliation(s)
- Angel M. Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Phoebe Brook-Rowland
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
| | - Foyeke Tolani
- Bedford Borough, Central Bedfordshire and Milton Keynes Councils’ Shared Public Health Services, Bedford, United Kingdom
| | - Emily Christopher
- Bedford Borough, Central Bedfordshire and Milton Keynes Councils’ Shared Public Health Services, Bedford, United Kingdom
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Abby Moffat
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research, University of Bedfordshire, Bedford, United Kingdom
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester, United Kingdom
| | - Atiya Kamal
- School of Social Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Daryl B. O’Connor
- Laboratory for Stress and Health Research, University of Leeds, Leeds, United Kingdom
| | - Eleanor Whittaker
- North Yorkshire County Council, Northallerton, North Yorkshire, United Kingdom
| | - Lesley J. M. Lewis
- Behavioural Science Unit, Public Health, Somerset County Council, Taunton, United Kingdom
| | - Emily McBride
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Vivien Swanson
- Psychology Division, University of Stirling, Stirling, United Kingdom
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, United Kingdom
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Miller NM, Campbell C, Shorter GW. Barriers and facilitators of naloxone and safe injection facility interventions to reduce opioid drug-related deaths: A qualitative analysis. Int J Drug Policy 2023; 117:104049. [PMID: 37247475 DOI: 10.1016/j.drugpo.2023.104049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Opioid drug-related deaths continue to be a significant public health concern in the Republic of Ireland (ROI) and Northern Ireland (NI). While both regions have implemented naloxone to reduce drug related deaths, there remains a gap in the implementation of a supervised injection facility (SIF). This study aimed to identify barriers and facilitators to implementing naloxone and a SIF to reduce opioid drug-related deaths in ROI and NI. METHODS Semi-structured interviews (n=23) were conducted in ROI and NI with experts by experience (n=8), staff from low threshold services (n=9), and individuals involved in policy making (n= 6). Data were analyzed using coding reliability Thematic Analysis and were informed by the Risk Environmental Framework. RESULTS The findings illustrated that stigma within the media, health centers, and the community was a significant barrier to naloxone distribution and SIF implementation. Policing and community intimidation were reported to hinder naloxone carriage in both the ROI and NI, while threats of paramilitary violence towards people who use drugs were unique to NI. Municipal government delays and policy maker apathy were reported to hinder SIF implementation in the ROI. Participants suggested peer-to-peer naloxone delivery and amending legislation to facilitate non-prescription naloxone would increase naloxone uptake. Participants recommended using webinars, Town Halls, and a Citizens' Assembly as tools to advocate for SIF implementation. CONCLUSION Local and regional stigma reduction campaigns are needed in conjunction with policy changes to advance naloxone and a SIF. Tailoring stigma campaigns to incorporate the lived experience of people who use drugs, their family members, and the general community can aid in educating the public and change negative perceptions. This study highlights the need for ongoing efforts to reduce stigma and increase accessibility to evidence-based interventions to address opioid drug-related deaths in the ROI, NI, and internationally.
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Affiliation(s)
| | | | - Gillian W Shorter
- Drug and Alcohol Research Network & Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
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Williams ADN, Hood K, Bracken K, Shorter GW. The importance of NOT being Other: Time to address the invisibility of nuanced gender and sexuality in clinical trials. Trials 2023; 24:242. [PMID: 36998055 PMCID: PMC10064725 DOI: 10.1186/s13063-023-07278-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Representation of all members of society within research, especially those typically underserved, is needed to ensure that trial evidence applies to the relevant population, and that effective interventions are available to all. The lack of appropriate and representative options in demographic questions around sex, gender and sexuality may result in the exclusion of LGBTQIA + people from health research. MAIN BODY Sex and gender are not the same, yet this is rarely recognised in trial data collection, with the terms sex and gender often being used interchangeably. Sex or gender is often used as a stratification factor at randomisation and/or to define sub-groups at the time of data analysis, so correct data collection is essential for producing high-quality science. Sexuality also suffers from 'othering' with identities not being acknowledged but simply provided as an alternative to the perceived main identities. When collecting sexuality information, it is important to consider the purposes of collecting this data. CONCLUSION We call on those involved in trials to consider how sex, gender and sexuality data are collected, with an active consideration of inclusivity. Through the description of all non-straight, non-cisgender people as 'other' you may be ignoring the needs of these populations and doing science, yourself, and them a disservice. Inclusivity may require small but important changes to ensure your research findings are inclusive and develop the evidence base for often overlooked populations.
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Affiliation(s)
| | - Kerenza Hood
- Centre for Trials Research, Cardiff University, Cardiff, Wales, UK
| | - Karen Bracken
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
| | - Gillian W Shorter
- Drug and Alcohol Research Network, Queen's University Belfast, Belfast, Northern Ireland, UK
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Bendtsen M, Garnett C, Toner P, Shorter GW. The effect of question order on outcomes in the orbital core outcome set for alcohol brief interventions among online help-seekers (QOBCOS): Findings from a randomised factorial trial. Digit Health 2023; 9:20552076231155684. [PMID: 36798888 PMCID: PMC9926362 DOI: 10.1177/20552076231155684] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Objective A core outcome set (COS) has been developed in alcohol brief intervention (ABI) research through international consensus. This study aimed to estimate order effects among questions in the COS. Methods Individuals aged 18 or older who searched online for alcohol-related help were invited to complete the COS. The order of questions was randomised following a factorial design. Primary outcomes were order effects among the COS items and patterns of attrition. Results Between 21/10/2020 and 26/11/2020, we randomised 7334 participants, of which 5256 responded to at least one question and were available for analyses. Current non-drinkers were excluded. We found evidence of higher self-reported average consumption and odds of harmful and hazardous drinking was found among those who first answered questions on recent consumption and impact of alcohol use. Lower self-reported recent consumption was found among those first asked about average consumption. Quality of life (QoL) was reported lower among those who first responded to when questions on impact of alcohol use were asked first, which in turn was lower among those who first answered question on when average consumption and QoL were asked first. Attrition was lowest when average consumption was asked first, and highest when QoL or impact of alcohol use was asked first. Median completion time for the COS was 4.3 min. Conclusions Question order affects outcomes and attrition. If the aim is to minimize attrition, consumption measures should be asked before QoL and impact of alcohol use; however, this order impacts self-reported alcohol consumption and so researchers should be guided by study priorities. At a minimum, all participants should be asked the same questions in the same order. Trial registration The trial was prospectively registered (ISRCTN17954645).
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Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden,Marcus Bendtsen, Department of Health, Medicine and Caring Sciences, Linköping University, Sweden.
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, London, UK
| | - Paul Toner
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK
| | - Gillian W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK,Drug and Alcohol Research Network, Queen's University Belfast, Belfast, UK
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Williams J, Howlett N, Shorter GW, Zakrzewski-Fruer JK, Chater AM. What roles does physical activity play following the death of a parent as a young person? A qualitative investigation. BMC Public Health 2023; 23:210. [PMID: 36721110 PMCID: PMC9887747 DOI: 10.1186/s12889-022-14542-6] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/03/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Physical activity benefits physical and mental health. However, limited research investigates if physical activity can improve outcomes from the grieving process following the death of a parent. METHODS Semi-structured interviews were conducted with 14 individuals (n = 8 female; age M = 31.2 years), who had experienced the death of a parent when they were aged between 10 and 24 years old, using retrospective recall. Data were analysed inductively using thematic analysis. RESULTS Six themes were identified. Physical activity was seen as; 1) 'Therapeutic'; providing an 2) 'Emotional Outlet' and created a strong sense of 3) 'Social Support'. Alongside it 4) 'Builds Confidence', and led to 5) 'Finding Yourself' and 6) 'Improved Health and wellbeing' (physical and psychological). CONCLUSION Physical activity has the potential to provide positive experiences following a parental bereavement. It can provide a sense of freedom and was seen to alleviate grief outcomes, build resilience, enable social support and create a stronger sense of self. Bereavement support services for young people who have experienced death of a parent should consider physical activity as a viable intervention to support the grieving process.
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Affiliation(s)
- Jane Williams
- grid.15034.330000 0000 9882 7057Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA UK ,grid.15034.330000 0000 9882 7057School of Psychology, University of Bedfordshire, Luton, LU1 3JU UK
| | - Neil Howlett
- grid.5846.f0000 0001 2161 9644Department of Psychology, Sport and Geography, University of Hertfordshire, Hatfield, AL10 9AB UK
| | - Gillian W. Shorter
- grid.4777.30000 0004 0374 7521Centre for Improving Health Related Quality of Life, Queens University Belfast, School of Psychology, Belfast, BT9 5BN UK ,grid.4777.30000 0004 0374 7521Drug and Alcohol Research Network, Queens University Belfast, School of Psychology, Belfast, BT9 5BN UK
| | - Julia K. Zakrzewski-Fruer
- grid.15034.330000 0000 9882 7057Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA UK
| | - Angel Marie Chater
- Centre for Health, Wellbeing and Behaviour Change, Institute for Sport and Physical Activity Research (ISPAR), University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK. .,Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
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10
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Holland A, Stevens A, Harris M, Lewer D, Sumnall H, Stewart D, Gilvarry E, Wiseman A, Howkins J, McManus J, Shorter GW, Nicholls J, Scott J, Thomas K, Reid L, Day E, Horsley J, Measham F, Rae M, Fenton K, Hickman M. Analysis of the UK Government's 10-Year Drugs Strategy-a resource for practitioners and policymakers. J Public Health (Oxf) 2022:6779883. [PMID: 36309802 DOI: 10.1093/pubmed/fdac114] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/10/2022] [Indexed: 11/12/2022] Open
Abstract
In 2021, during a drug-related death crisis in the UK, the Government published its ten-year drugs strategy. This article, written in collaboration with the Faculty of Public Health and the Association of Directors of Public Health, assesses whether this Strategy is evidence-based and consistent with international calls to promote public health approaches to drugs, which put 'people, health and human rights at the centre'. Elements of the Strategy are welcome, including the promise of significant funding for drug treatment services, the effects of which will depend on how it is utilized by services and local commissioners and whether it is sustained. However, unevidenced and harmful measures to deter drug use by means of punishment continue to be promoted, which will have deleterious impacts on people who use drugs. An effective public health approach to drugs should tackle population-level risk factors, which may predispose to harmful patterns of drug use, including adverse childhood experiences and socioeconomic deprivation, and institute evidence-based measures to mitigate drug-related harm. This would likely be more effective, and just, than the continuation of policies rooted in enforcement. A more dramatic re-orientation of UK drug policy than that offered by the Strategy is overdue.
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Affiliation(s)
- Adam Holland
- Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Alex Stevens
- School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, CT2 7NZ
| | - Magdalena Harris
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Dan Lewer
- Public Health Specialty Registrar, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK
| | - Harry Sumnall
- Public Health Institute, Liverpool John Moores University, Liverpool, L3 5UX, UK
| | - Daniel Stewart
- Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Eilish Gilvarry
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, NE1 7RU, UK
| | - Alice Wiseman
- Association of Directors of Public Health, London, EC4Y 0HA, UK
| | - Joshua Howkins
- Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | - Jim McManus
- Association of Directors of Public Health, London, EC4Y 0HA, UK
| | | | - James Nicholls
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Jenny Scott
- Department of Pharmacy & Pharmacology, University of Bath, Bath, BA2 7AY
| | - Kyla Thomas
- Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
| | | | - Edward Day
- Institute of Mental Health, University of Birmingham, Birmingham, B15 2TT
| | - Jason Horsley
- National Institute for Health Research Evaluation Trials and Studies Coordinating Centre, University of Southampton, Southampton, SO17 1BJ, UK
| | - Fiona Measham
- Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, L69 3BX
| | - Maggie Rae
- Epidemiological and Public Health Section, Royal Society of Medicine, London, W1G 0AE, UK
| | | | - Matthew Hickman
- Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK
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11
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Epton T, Ghio D, Ballard LM, Allen SF, Kassianos AP, Hewitt R, Swainston K, Fynn WI, Rowland V, Westbrook J, Jenkinson E, Morrow A, McGeechan GJ, Stanescu S, Yousuf AA, Sharma N, Begum S, Karasouli E, Scanlan D, Shorter GW, Arden MA, Armitage CJ, O'Connor DB, Kamal A, McBride E, Swanson V, Hart J, Byrne-Davis L, Chater A, Drury J. Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review. Soc Sci Med 2022; 303:114946. [PMID: 35605431 PMCID: PMC8957361 DOI: 10.1016/j.socscimed.2022.114946] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Physical distancing, defined as keeping 1-2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-CoV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs). METHODS Six databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post-intervention; randomized controlled trial), and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention. RESULTS Six articles (with seven studies and 19 comparisons) indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), demonstration (e.g., beliefs about capabilities), and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems, and posters with loss-framed messages that demonstrated the behaviors. CONCLUSIONS The evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights gaps that should be the focus of future research.
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Affiliation(s)
- Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, UK,Corresponding author. Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester, M13 9PT, UK
| | - Daniela Ghio
- Manchester Centre for Health Psychology, University of Manchester, UK
| | | | - Sarah F. Allen
- School of Social Sciences, Humanities and Law, Teesside University, UK
| | | | | | - Katherine Swainston
- Psychology, Centre for Applied Psychological Science, Teesside University, UK
| | | | | | | | - Elizabeth Jenkinson
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | | | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Nisha Sharma
- Department of Clinical Health Psychology, Royal National Orthopaedic Hospital, UK
| | - Suhana Begum
- Department of Psychology, City University of London, UK,Surrey County Council, UK
| | | | - Daniel Scanlan
- Research and Communication, Education Support, London, N5 1EW, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, Queen's University Belfast, UK
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, UK
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, UK,Manchester University NHS Foundation Trust, University of Manchester, UK,Manchester Academic Health Science Centre, University of Manchester, UK,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, UK
| | | | - Atiya Kamal
- Department of Psychology, Birmingham City University, UK
| | - Emily McBride
- Department of Behavioural Science and Health, University College London, UK
| | | | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, UK,Division of Medical Education, University of Manchester, UK
| | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, UK,Division of Medical Education, University of Manchester, UK
| | | | - John Drury
- School of Psychology, University of Sussex, UK
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12
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Shorter GW, Harris M, McAuley A, Trayner KM, Stevens A. The United Kingdom's first unsanctioned overdose prevention site; A proof-of-concept evaluation. Int J Drug Policy 2022; 104:103670. [PMID: 35523063 DOI: 10.1016/j.drugpo.2022.103670] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The United Kingdom (UK) is currently experiencing a public health crisis of drug-related deaths. The government has rejected recommendations to open overdose prevention services, under the Misuse of Drugs Act 1971. To report on the operation and use of an unsanctioned overdose prevention service which operated in Glasgow city centre from September 2020 to May 2021. METHODS Description of the service, with analysis of data collected on its use. RESULTS The service operated for nine months without permission or funding from official sources. We report on the 894 injections supervised and recorded, and nine successful interventions with overdose events (seven opioid/two cocaine). Powder cocaine injection predominated either alone (60.6%) or with heroin (22.1%). Injection was mostly in the groin (68.0%) or arm (16.8%). More injections were recorded by males (70.1%). Around 65% of injection events featured an individual who was on a buprenorphine/methadone prescription. CONCLUSION It is feasible for an overdose prevention service to operate successfully in the UK without being shut down by the police or with negative consequences for the community. Future sites in the UK must tailor to the substances used by their potential clients, international trends (e.g. for fentanyl use) did not apply here. There is an urgent need and demand for these services in the UK to reduce harm, prevent and intervene during overdose, and provide vital psychosocial support for health and wellbeing in a highly marginalised population.
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Affiliation(s)
- Gillian W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, UK; Drug and Alcohol Research Network, Queen's University Belfast, UK.
| | - Magdalena Harris
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrew McAuley
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Kirsten Ma Trayner
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Alex Stevens
- School of Social Policy, Sociology and Social Research, University of Kent, Medway, UK
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13
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Shorter GW, Heather N, Berman AH, Giles EL, Barbosa C, Monteiro MG, Cowell AJ, Toner P, Bray JW. The ORBITAL Core Outcome Set: Response to de Bejczy et al. (2022) on Biomarkers and Methodological Innovation in Core Outcome Sets. J Stud Alcohol Drugs 2022; 83:298-300. [PMID: 35254254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- Gillian W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology Queen's University Belfast, United Kingdom
- Drug and Alcohol Research Network, Queen's University Belfast, United Kingdom
| | - Nick Heather
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Anne H Berman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Emma L Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | | | | | - Alex J Cowell
- Carolina Complete Health Network, Durham, North Carolina, United States
| | - Paul Toner
- Centre for Improving Health Related Quality of Life, School of Psychology Queen's University Belfast, United Kingdom
| | - Jeremy W Bray
- Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, North Carolina, United States
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14
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Shorter GW, Heather N, Berman AH, Giles EL, Barbosa C, Monteiro MG, Cowell AJ, Toner P, Bray JW. The ORBITAL Core Outcome Set: Response to on Biomarkers and Methodological Innovation in Core Outcome Sets. J Stud Alcohol Drugs 2022. [DOI: 10.15288/jsad.2022.83.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology Queen's University Belfast, United Kingdom
- Drug and Alcohol Research Network, Queen's University Belfast, United Kingdom
| | - Nick Heather
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Anne H. Berman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Emma L. Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | | | | | - Alex J. Cowell
- Carolina Complete Health Network, Durham, North Carolina, United States
| | - Paul Toner
- Centre for Improving Health Related Quality of Life, School of Psychology Queen's University Belfast, United Kingdom
| | - Jeremy W. Bray
- Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, North Carolina, United States
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15
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Miller NM, Waterhouse-Bradley B, Campbell C, Shorter GW. How do naloxone-based interventions work to reduce overdose deaths: a realist review. Harm Reduct J 2022; 19:18. [PMID: 35197057 PMCID: PMC8867850 DOI: 10.1186/s12954-022-00599-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Naloxone-based interventions as part of health systems can reverse an opioid overdose. Previous systematic reviews have identified the effectiveness of naloxone; however, the role of context and mechanisms for its use has not been explored. This realist systematic review aims to identify a theory of how naloxone works based on the contexts and mechanisms that contribute to the success of the intervention for improved outcomes. METHODS Pre-registered at PROSPERO, this realist review followed RAMESES standards of reporting. Keywords included 'naloxone' and ' opioid overdose'. All study designs were included. Data extraction using 55 relevant outputs based on realist logic produced evidence of two middle-range theories: Naloxone Bystander Intervention Theory and Skills Transfer Theory. RESULTS Harm reduction and/or low threshold contexts provide a non-judgemental approach which support in-group norms of helping and empower the social identity of the trained and untrained bystander. This context also creates the conditions necessary for skills transfer and diffusion of the intervention into social networks. Stigma and negative attitudes held by first responders and stakeholders involved in the implementation process, such as police or GPs, can prohibit the bystander response by inducing fear in responding. This interferes with skills transfer, naloxone use and carriage of naloxone kits. CONCLUSIONS The findings provide theoretically informed guidance regarding the harm reduction contexts that are essential for the successful implementation of naloxone-based interventions. Peer-to-peer models of training are helpful as it reinforces social identity and successful skills transfer between bystanders. Health systems may want to assess the prevalence of, and take steps to reduce opioid-related stigma with key stakeholders in contexts using a low threshold training approach to build an environment to support positive naloxone outcomes. TRIAL REGISTRATION PROSPERO 2019 CRD42019141003.
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Affiliation(s)
- Nicole M Miller
- Institute of Mental Health Sciences, School of Psychology, Ulster University, Coleraine, UK
| | | | | | - Gillian W Shorter
- Drug and Alcohol Research Network & Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, UK.
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16
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McGlinchey E, Ross J, Murphy D, Shorter GW, Armour C. Disentangling the Symptom-Level Nuances in Comorbid Posttraumatic Stress Disorder and Problematic Alcohol Use in Northern Irish Military Veterans: A Network Analysis. J Trauma Stress 2022; 35:32-41. [PMID: 33743187 DOI: 10.1002/jts.22666] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 01/09/2023]
Abstract
Posttraumatic stress disorder (PTSD) and alcohol use are highly prevalent among military veteran populations. Several theories have been proposed to account for the comorbidity between PTSD and problematic alcohol use, but research examining the symptom-level associations between the two is limited. The current study used network analysis to examine the associations between PTSD and problematic alcohol use. Data were collected through a cross-sectional survey of veterans of the United Kingdom Armed Forces living in Northern Ireland. The sample comprised 511 (91.2% male) veterans with a history of trauma exposure and current alcohol use. A network consisting of PTSD symptoms from the PTSD Checklist for DSM-5 (PCL-5) and items from the Alcohol Use Disorders Identification Test (AUDIT) was constructed, and the bridge centrality of all items was estimated to identify items with the highest number of associations and the strongest associations between the two constructs. The PTSD symptom "reckless behavior" (2.43) had the highest bridge centrality values and thus the strongest connections and most connections to the alcohol use items. For the alcohol use items, "not being able to stop drinking" (2.31) and "number of drinks" (1.24) demonstrated the strongest bridge connections to the PTSD items. These results highlight the role of specific PTSD symptoms involved in the interaction between PTSD and problematic alcohol use.
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Affiliation(s)
- Emily McGlinchey
- Research Centre for Stress Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Jana Ross
- Research Centre for Stress Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Dominic Murphy
- Research Department, Combat Stress, Leatherhead, United Kingdom.,King's Centre for Military Health Research, King's College London, London, United Kingdom
| | - Gillian W Shorter
- Research Centre for Stress Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Cherie Armour
- Research Centre for Stress Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
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17
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Tiburcio M, Monteiro MG, Shorter GW, Martínez-Vélez N, Ronzani T, Maiga LA. Prioritizing Variables for Evaluating the Efficacy and Effectiveness of Brief Interventions for Reducing Alcohol Consumption: A Latin American Perspective. J Stud Alcohol Drugs 2022. [DOI: 10.15288/jsad.2022.83.153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Marcela Tiburcio
- Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Maristela G. Monteiro
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, D.C
| | - Gillian W. Shorter
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, United Kingdom
| | - Nora Martínez-Vélez
- Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Telmo Ronzani
- Federal University of Juiz de Fora, Campus Universitário, Martelos, 36036-900 Juiz de Fora, MG, Brazil
| | - Lalla A. Maiga
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, D.C
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18
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Tiburcio M, Monteiro MG, Shorter GW, Martínez-Vélez N, Ronzani T, Maiga LA. Prioritizing Variables for Evaluating the Efficacy and Effectiveness of Brief Interventions for Reducing Alcohol Consumption: A Latin American Perspective. J Stud Alcohol Drugs 2022; 83:153-158. [PMID: 35040771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE The purpose of this study was to identify priority variables to evaluate alcohol brief interventions from the perspective of experts in the field in Latin America. METHOD A two-round Delphi procedure was carried out through online surveys of 465 individuals from 18 Latin American countries, including core outcome set developers, researchers, health professionals, users of healthcare services, journal editors, members of nongovernmental organizations, and policymakers. The questionnaire, in Spanish and Portuguese, rated 101 variables according to their relevance to the efficacy and effectiveness of brief interventions. RESULTS Round 1 yielded 47 variables that met the consensus criterion of at least 70% of participants; Round 2 yielded 63 variables. To reduce the possible effect of varying levels of expertise, data were analyzed by subgroup, with consensus defined as 70% of each subgroup rating a variable as critical. Seventeen outcome variables met this criterion, 14 from the initial set and 3 suggested by the participants in Round 1. CONCLUSIONS Only four outcomes coincide with the findings of a similar international Delphi study that underrepresented Latin American countries. The findings point to the importance of including a wider variety of professionals and cultural backgrounds in international consensus panels to minimize the risk of predominance of a single perspective.
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Affiliation(s)
- Marcela Tiburcio
- Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Maristela G Monteiro
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, D.C
| | - Gillian W Shorter
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, United Kingdom
| | - Nora Martínez-Vélez
- Department of Social Sciences in Health, Direction of Epidemiological and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Telmo Ronzani
- Federal University of Juiz de Fora, Campus Universitário, Martelos, 36036-900 Juiz de Fora, MG, Brazil
| | - Lalla A Maiga
- Mental Health and Substance Use Unit, Pan American Health Organization, Washington, D.C
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19
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Chater AM, Shorter GW, Swanson V, Kamal A, Epton T, Arden MA, Hart J, Byrne-Davis LMT, Drury J, Whittaker E, Lewis LJM, McBride E, Chadwick P, O’Connor DB, Armitage CJ. Template for Rapid Iterative Consensus of Experts (TRICE). Int J Environ Res Public Health 2021; 18:10255. [PMID: 34639553 PMCID: PMC8508030 DOI: 10.3390/ijerph181910255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Public health emergencies require rapid responses from experts. Differing viewpoints are common in science, however, "mixed messaging" of varied perspectives can undermine credibility of experts; reduce trust in guidance; and act as a barrier to changing public health behaviours. Collation of a unified voice for effective knowledge creation and translation can be challenging. This work aimed to create a method for rapid psychologically-informed expert guidance during the COVID-19 response. METHOD TRICE (Template for Rapid Iterative Consensus of Experts) brings structure, peer-review and consensus to the rapid generation of expert advice. It was developed and trialled with 15 core members of the British Psychological Society COVID-19 Behavioural Science and Disease Prevention Taskforce. RESULTS Using TRICE; we have produced 18 peer-reviewed COVID-19 guidance documents; based on rapid systematic reviews; co-created by experts in behavioural science and public health; taking 4-156 days to produce; with approximately 18 experts and a median of 7 drafts per output. We provide worked-examples and key considerations; including a shared ethos and theoretical/methodological framework; in this case; the Behaviour Change Wheel and COM-B. CONCLUSION TRICE extends existing consensus methodologies and has supported public health collaboration; co-creation of guidance and translation of behavioural science to practice through explicit processes in generating expert advice for public health emergencies.
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Affiliation(s)
- Angel M. Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford MK41 9EA, UK
- Centre for Behavioural Medicine, University College London, BMA House, Tavistock Square, London WC1H 9JP, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Northern Ireland BT7 1NN, UK;
| | - Vivien Swanson
- Psychology Division, University of Stirling, Stirling FK9 4LA, UK;
- NHS Education for Scotland, 2 Central Quay, 89, Hydepark Street, Glasgow G3 8BW, UK
| | - Atiya Kamal
- School of Social Sciences, Department of Psychology, Birmingham City University, Birmingham B4 7BD, UK;
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
| | - Madelynne A. Arden
- Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield S10 2BQ, UK;
| | - Jo Hart
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - Lucie M. T. Byrne-Davis
- School of Medical Sciences, University of Manchester, Stopford Building, Manchester M13 9PT, UK; (J.H.); (L.M.T.B.-D.)
| | - John Drury
- School of Psychology, University of Sussex, Falmer BN1 9QN, UK;
| | - Ellie Whittaker
- North Yorkshire County Council, County Hall, Northallerton, North Yorkshire DL7 8DD, UK;
| | - Lesley J. M. Lewis
- Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK;
| | - Emily McBride
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK;
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London WC1E 7HB, UK;
| | - Daryl B. O’Connor
- Laboratory for Stress and Health Research, University of Leeds, Leeds LS2 9JT, UK;
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Oxford Road, Manchester M13 9PT, UK; (T.E.); (C.J.A.)
- Manchester University NHS Foundation Trust and NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester M13 9PL, UK
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Shorter GW, Bray JW, Heather N, Berman AH, Giles EL, Clarke M, Barbosa C, O'Donnell AJ, Holloway A, Riper H, Daeppen JB, Monteiro MG, Saitz R, McNeely J, McKnight-Eily L, Cowell A, Toner P, Newbury-Birch D. The "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) Core Outcome Set: International Consensus on Outcomes to Measure in Efficacy and Effectiveness Trials of Alcohol Brief Interventions. J Stud Alcohol Drugs 2021; 82:638-646. [PMID: 34546911 PMCID: PMC8819610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 06/07/2021] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVE The purpose of this study was to report the "Outcome Reporting in Brief Intervention Trials: Alcohol" (ORBITAL) recommended core outcome set (COS) to improve efficacy and effectiveness trials/evaluations for alcohol brief interventions (ABIs). METHOD A systematic review identified 2,641 outcomes in 401 ABI articles measured by 1,560 different approaches. These outcomes were classified into outcome categories, and 150 participants from 19 countries participated in a two-round e-Delphi outcome prioritization exercise. This process prioritized 15 of 93 outcome categories for discussion at a consensus meeting of key stakeholders to decide the COS. A psychometric evaluation determined how to measure the outcomes. RESULTS Ten outcomes were voted into the COS at the consensus meeting: (a) typical frequency, (b) typical quantity, (c) frequency of heavy episodic drinking, (d) combined consumption measure summarizing alcohol use, (e) hazardous or harmful drinking (average consumption), (f) standard drinks consumed in the past week (recent, current consumption), (g) alcohol-related consequences, (h) alcohol-related injury, (i) use of emergency health care services (impact of alcohol use), and (j) quality of life. CONCLUSIONS The ORBITAL COS is an international consensus standard for future ABI trials and evaluations. It can improve the synthesis of new findings, reduce redundant/selective reporting (i.e., reporting only some, usually significant outcomes), improve between-study comparisons, and enhance the relevance of trial and evaluation findings to decision makers. The COS is the recommended minimum and does not exclude other, additional outcomes.
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Affiliation(s)
- Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
- Drug and Alcohol Research Network, Queen’s University Belfast, Belfast, United Kingdom
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, United Kingdom
| | - Jeremy W. Bray
- Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Nick Heather
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Anne H. Berman
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Emma L. Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen’s University Belfast, Belfast, United Kingdom
| | - Carolina Barbosa
- Behavioral Health Economics Program, RTI International, Research Triangle Park, North Carolina
| | - Amy J. O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Aisha Holloway
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Heleen Riper
- Faculty of Behavioural and Movement Sciences, Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jean-Bernard Daeppen
- Département universitaire de médecine et santé communautaires (DUMSC), Lausanne University Hospital, Lausanne, Switzerland
| | | | - Richard Saitz
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, Massachusetts
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, School of Medicine, Boston University, Boston, Massachusetts
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts
| | - Jennifer McNeely
- New York University Grossman School of Medicine, New York, New York
| | | | - Alex Cowell
- Behavioral Health Economics Program, RTI International, Research Triangle Park, North Carolina
| | - Paul Toner
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Dorothy Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, United Kingdom
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21
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Shorter GW, Bray JW, Heather N, Berman AH, Giles EL, Clarke M, Barbosa C, O'Donnell AJ, Holloway A, Riper H, Daeppen JB, Monteiro MG, Saitz R, McNeely J, McKnight-Eily L, Cowell A, Toner P, Newbury-Birch D. The “Outcome Reporting in Brief Intervention Trials: Alcohol” (ORBITAL) Core Outcome Set: International Consensus on Outcomes to Measure in Efficacy and Effectiveness Trials of Alcohol Brief Interventions. J Stud Alcohol Drugs 2021. [PMID: 34546911 PMCID: PMC8819610 DOI: 10.15288/jsad.2021.82.638] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The purpose of this study was to report the “Outcome Reporting in Brief Intervention Trials: Alcohol” (ORBITAL) recommended core outcome set (COS) to improve efficacy and effectiveness trials/evaluations for alcohol brief interventions (ABIs). Method: A systematic review identified 2,641 outcomes in 401 ABI articles measured by 1,560 different approaches. These outcomes were classified into outcome categories, and 150 participants from 19 countries participated in a two-round e-Delphi outcome prioritization exercise. This process prioritized 15 of 93 outcome categories for discussion at a consensus meeting of key stakeholders to decide the COS. A psychometric evaluation determined how to measure the outcomes. Results: Ten outcomes were voted into the COS at the consensus meeting: (a) typical frequency, (b) typical quantity, (c) frequency of heavy episodic drinking, (d) combined consumption measure summarizing alcohol use, (e) hazardous or harmful drinking (average consumption), (f) standard drinks consumed in the past week (recent, current consumption), (g) alcohol-related consequences, (h) alcohol-related injury, (i) use of emergency health care services (impact of alcohol use), and (j) quality of life. Conclusions: The ORBITAL COS is an international consensus standard for future ABI trials and evaluations. It can improve the synthesis of new findings, reduce redundant/selective reporting (i.e., reporting only some, usually significant outcomes), improve between-study comparisons, and enhance the relevance of trial and evaluation findings to decision makers. The COS is the recommended minimum and does not exclude other, additional outcomes.
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Affiliation(s)
- Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
- Drug and Alcohol Research Network, Queen’s University Belfast, Belfast, United Kingdom
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, United Kingdom
| | - Jeremy W. Bray
- Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Nick Heather
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Anne H. Berman
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Emma L. Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen’s University Belfast, Belfast, United Kingdom
| | - Carolina Barbosa
- Behavioral Health Economics Program, RTI International, Research Triangle Park, North Carolina
| | - Amy J. O'Donnell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Aisha Holloway
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Heleen Riper
- Faculty of Behavioural and Movement Sciences, Clinical Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jean-Bernard Daeppen
- Département universitaire de médecine et santé communautaires (DUMSC), Lausanne University Hospital, Lausanne, Switzerland
| | | | - Richard Saitz
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, Massachusetts
- Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, School of Medicine, Boston University, Boston, Massachusetts
- Grayken Center for Addiction, Boston Medical Center, Boston, Massachusetts
| | - Jennifer McNeely
- New York University Grossman School of Medicine, New York, New York
| | | | - Alex Cowell
- Behavioral Health Economics Program, RTI International, Research Triangle Park, North Carolina
| | - Paul Toner
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Dorothy Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, United Kingdom
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22
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Williams J, Shorter GW, Howlett N, Zakrzewski-Fruer J, Chater AM. Can Physical Activity Support Grief Outcomes in Individuals Who Have Been Bereaved? A Systematic Review. Sports Med Open 2021; 7:26. [PMID: 33830368 PMCID: PMC8028581 DOI: 10.1186/s40798-021-00311-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 03/04/2021] [Indexed: 11/11/2022]
Abstract
Background In 2018, there were 616,014 registered deaths in the United Kingdom (UK). Grief is a natural consequence. Many mental health concerns, which can be identified as grief outcomes (e.g. anxiety and depression) in those who have experienced a bereavement, can be improved through physical activity. The objective of this review was to identify from the existing literature if physical activity can benefit grief outcomes in individuals who have been bereaved. Methods A systematic review of nine databases was performed. Included studies (qualitative and quantitative) explored physical activity to help individuals (of any age) who had experienced a human bereavement (excluding national loss). Results From 1299 studies screened, 25 met the inclusion criteria, detailing eight types of bereavement (parental (n = 5), spousal (n = 6), patient (n = 4), pre-natal (n = 3), later life (n = 1), caregiver (n = 1), multiple (n = 4) and non-defined (n = 1). Activities including yoga, running, walking and martial arts were noted as beneficial. Physical activity allowed a sense of freedom, to express emotions, provided a distraction and an escape from grief, whilst enhancing social support. Conclusion There is some evidence that physical activity may provide benefit for the physical health and psychological wellbeing of those who have been bereaved, including when the loss has happened at a young age. This review is timely, given the wide-scale national loss of life due to COVID-19 and extends knowledge in this area. More research is needed to explore the benefits of physical activity for those who have been bereaved. In particular, there is a need for well-designed interventions which are tailored to specific activities, populations and grief outcomes.
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Affiliation(s)
- Jane Williams
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, MK41 9EA, UK
| | - Gillian W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, BT9 7NN, UK
| | - Neil Howlett
- Department of Psychology and Sport Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Julia Zakrzewski-Fruer
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, MK41 9EA, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, MK41 9EA, UK.
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23
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Bendtsen M, Garnett C, Toner P, Shorter GW. Correction: The Effect of Question Order on Outcomes in the Core Outcome Set for Brief Alcohol Interventions Among Online Help-Seekers: Protocol for a Factorial Randomized Trial. JMIR Res Protoc 2021; 10:e26578. [PMID: 33523824 PMCID: PMC7884211 DOI: 10.2196/26578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/14/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Paul Toner
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom
| | - Gillian W Shorter
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom
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24
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Lawes-Wickwar S, Ghio D, Tang MY, Keyworth C, Stanescu S, Westbrook J, Jenkinson E, Kassianos AP, Scanlan D, Garnett N, Laidlaw L, Howlett N, Carr N, Stanulewicz N, Guest E, Watson D, Sutherland L, Byrne-Davis L, Chater A, Hart J, Armitage CJ, Shorter GW, Swanson V, Epton T. A Rapid Systematic Review of Public Responses to Health Messages Encouraging Vaccination against Infectious Diseases in a Pandemic or Epidemic. Vaccines (Basel) 2021; 9:72. [PMID: 33498395 PMCID: PMC7909419 DOI: 10.3390/vaccines9020072] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 01/08/2023] Open
Abstract
Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of airborne-, droplet- and fomite-spread viruses. Included studies were assessed for quality using the Mixed Methods Appraisal Tool (MMAT) or the Assessment of Multiple Systematic Reviews (AMSTAR), and for patient and public involvement (PPI) in the research. Thirty-five articles were included. Most reported messages for seasonal influenza (n = 11; 31%) or H1N1 (n = 11; 31%). Evidence from moderate to high quality studies for improving vaccine uptake included providing information about virus risks and vaccination safety, as well as addressing vaccine misunderstandings, offering vaccination reminders, including vaccination clinic details, and delivering mixed media campaigns across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when: shorter, risk-reducing or relative risk framing messages were used; the benefits of vaccination to society were emphasised; and beliefs about capability and concerns among target populations (e.g., vaccine safety) were addressed. Clear, credible, messages in a language target groups can understand were associated with higher acceptability. Two studies (6%) described PPI in the research process. Future campaigns should consider the beliefs and information needs of target populations in their design, including ensuring that vaccine eligibility and availability is clear, and messages are accessible. More high quality research is needed to demonstrate the effects of messaging interventions on actual vaccine uptake.
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Affiliation(s)
- Sadie Lawes-Wickwar
- Department of Primary Care and Population Health, University College London, London NW3 2PF, UK
| | - Daniela Ghio
- Department of Psychology, Faculty of Health and Society, University of Salford, Manchester M6 6PU, UK;
| | - Mei Yee Tang
- Behavioural Science Policy Research Unit, Population Health Sciences, Newcastle University, Newcastle upon Tyne NE2 4AX, UK;
| | - Chris Keyworth
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
| | - Sabina Stanescu
- School of Psychology, University of Southampton, Southampton SO17 1BJ, UK;
| | | | - Elizabeth Jenkinson
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Angelos P. Kassianos
- Department of Applied Health Research, University College London, London WC1E 6BT, UK;
| | - Daniel Scanlan
- Department of Communication, Policy, and Research, Education Support, London N5 1EW, UK;
| | - Natalie Garnett
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Lynn Laidlaw
- Public Contributor, Health Psychology Exchange Patient and Public Involvement (PPI) Group, UK;
| | - Neil Howlett
- Department of Psychology, Sports, and Geography, School of Life and Medical Sciences, University of Hertfordshire, College Lane, Hertfordshire AL10 9AB, UK;
| | - Natalie Carr
- Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Manchester M15 6BH, UK;
| | - Natalia Stanulewicz
- Faculty of Health and Life Sciences, School of Applied Social Sciences, De Montfort University, Leicester LE1 9BH, UK;
| | - Ella Guest
- Department of Health and Social Sciences, University of West England, Bristol BS16 1QY, UK; (E.J.); (N.G.); (E.G.)
| | - Daniella Watson
- Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK;
| | | | - Lucie Byrne-Davis
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- Division of Medical Education, University of Manchester, Manchester M13 9PT, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, Bedfordshire MK41 9EA, UK;
| | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- Division of Medical Education, University of Manchester, Manchester M13 9PT, UK
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester M13 9WL, UK
- Manchester Academic Health Science Centre, Health Innovation Manchester, Manchester M13 9NQ, UK
| | - Gillian W. Shorter
- Centre for Improving Health Related Quality of Life, Queen’s University Belfast, Belfast BT7 1NN, UK;
| | - Vivien Swanson
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK;
| | - Tracy Epton
- Manchester Centre for Health Psychology, University of Manchester, Manchester M13 9PL, UK; (C.K.); (L.B.-D.); (J.H.); (C.J.A.); (T.E.)
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25
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Bendtsen M, Garnett C, Toner P, Shorter GW. The Effect of Question Order on Outcomes in the Core Outcome Set for Brief Alcohol Interventions Among Online Help-Seekers: Protocol for a Factorial Randomized Trial. JMIR Res Protoc 2020; 9:e24175. [PMID: 33242024 PMCID: PMC7728524 DOI: 10.2196/24175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 11/25/2022] Open
Abstract
Background A core outcome set (COS) for trials and evaluations of the effectiveness and efficacy of alcohol brief interventions (ABIs) has recently been established through international consensus to address the variability of outcomes evaluated. Objective This is a protocol for studies to assess if there are order effects among the questions included in the COS. Methods The 10 items of the COS are organized into 4 clusters. A factorial design will be used with 24 arms, where each arm represents 1 order of the 4 clusters. Individuals searching online for help will be asked to complete a questionnaire, and consenting participants will be randomized to 1 of the 24 arms (double-blind with equal allocation). Participants will be included if they are 18 years or older. The primary analyses will (1) estimate how the order of the clusters of outcomes affects how participants respond and (2) investigate patterns of abandonment of the questionnaire. Results Data collection is expected to commence in November 2020. A Bayesian group sequential design will be used with interim analyses planned for every 50 participants completing the questionnaire. Data collection will end no more than 24 months after commencement, and the results are expected to be published no later than December 2023. Conclusions Homogenizing the outcomes evaluated in studies of ABIs is important to support synthesis, and the COS is an important step toward this goal. Determining whether there may be issues with the COS question order may improve confidence in using it and speed up its dissemination in the research community. We encourage others to adopt the protocol as a study within their trial as they adopt the ORBITAL (Outcome Reporting in Brief Intervention Trials: Alcohol) COS to build a worldwide repository and provide materials to support such analysis. Trial Registration ISRCTN Registry ISRCTN17954645; http://www.isrctn.com/ISRCTN17954645 International Registered Report Identifier (IRRID) PRR1-10.2196/24175
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Affiliation(s)
- Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Claire Garnett
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Paul Toner
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom
| | - Gillian W Shorter
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, United Kingdom
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26
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Coulman KD, Nicholson A, Shaw A, Daykin A, Selman LE, Macefield R, Shorter GW, Cramer H, Sydes MR, Gamble C, Pick ME, Taylor G, Lane JA. Understanding and optimising patient and public involvement in trial oversight: an ethnographic study of eight clinical trials. Trials 2020; 21:543. [PMID: 32552907 PMCID: PMC7302397 DOI: 10.1186/s13063-020-04495-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 04/10/2019] [Accepted: 06/10/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Trial oversight is important for trial governance and conduct. Patients and/or lay members of the public are increasingly included in trial oversight committees, influenced by international patient and public involvement (PPI) initiatives to improve the quality and relevance of research. However, there is a lack of guidance on how to undertake PPI in trial oversight and tokenistic PPI remains an issue. This paper explores how PPI functions in existing trial oversight committees and provides recommendations to optimise PPI in future trials. This was part of a larger study investigating the role and function of oversight committees in trials facing challenges. METHODS Using an ethnographic study design, we observed oversight meetings of eight UK trials and conducted semi-structured interviews with members of their trial steering committees (TSCs) and trial management groups (TMGs) including public contributors, trial sponsors and funders. Thematic analysis of data was undertaken, with findings integrated to provide a multi-perspective account of how PPI functions in trial oversight. RESULTS Eight TSC and six TMG meetings from eight trials were observed, and 66 semi-structured interviews conducted with 52 purposively sampled oversight group members, including three public contributors. PPI was reported as beneficial in trial oversight, with public members contributing a patient voice and fulfilling a patient advocacy role. However, public contributors were not always active at oversight meetings and were sometimes felt to have a tokenistic role, with trialists reporting a lack of understanding of how to undertake PPI in trial oversight. To optimise PPI in trial oversight, the following areas were highlighted: the importance of planning effective strategies to recruit public contributors; considering the level of oversight and stage(s) of trial to include PPI; support for public contributors by the trial team between and during oversight meetings. CONCLUSIONS We present evidence-based recommendations to inform future PPI in trial oversight. Consideration should be given at trial design stage on how to recruit and involve public contributors within trial oversight, as well as support and mentorship for both public contributors and trialists (in how to undertake PPI effectively). Findings from this study further strengthen the evidence base on facilitating meaningful PPI within clinical trials.
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Affiliation(s)
- K D Coulman
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK.
| | - A Nicholson
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - A Shaw
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - A Daykin
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - L E Selman
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - R Macefield
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - G W Shorter
- Centre for Improving Health Related Quality of Life, School of Psychology, Queen's University Belfast, Belfast, BT9 5BN, UK
| | - H Cramer
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, WC1J 6JL, UK
- MRC London Hub for Trial Methodology Research, London, UK
| | - C Gamble
- MRC North West Hub for Trials Methodology Research, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3BX, UK
| | - M E Pick
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - G Taylor
- Bristol Randomised Trials Collaboration, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
| | - J A Lane
- MRC ConDuCT-II Hub for Trials Methodology Research, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, UK
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27
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Harris J, Shorter GW, Davidson G, Best P. Risk perception, changing social context, and norms prevent transition to regular injection among people who smoke heroin. Drug Alcohol Depend 2020; 208:107878. [PMID: 32014646 DOI: 10.1016/j.drugalcdep.2020.107878] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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] [Received: 09/13/2019] [Revised: 01/03/2020] [Accepted: 01/18/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is a lack of research examining what prevents people who smoke heroin from transitioning to regular injection. This qualitative study aims to improve understanding of environmental influences preventing people who smoke heroin from transitioning to regular injection. METHODS In-depth, semi-structured interviews (n = 15) were conducted with people who currently smoked heroin but never injected (n = 10) and those who injected on a few occasions but did not transition to regular injection (n = 5) in Northern Ireland. Multiple recruitment strategies were utilized to generate a community-based sample. Interviews were thematically analysed. MAIN FINDINGS Participants identified two main, interconnected influences preventing transition to injecting heroin. Firstly, resistance towards injecting was rooted in micro level perceptions of risks primarily arising from meso level social interactions with people who inject drugs and, to a lesser extent, harm reduction agencies. Secondly, participants identified meso and macro environments defined as changing social contexts and normative beliefs surrounding the acceptability of injecting within their drug-using social networks, facilitated by expanding heron markets, negative interactions with people who inject drugs and new groups of people choosing to smoke heroin due to perceptions of injection risks. CONCLUSIONS Findings illuminate environmental influences surrounding and shaping drug consumption practices. Harm reduction strategies should develop and implement safer smoking rooms, community and peer interventions, and improve accessibility to opioid substitution therapy and low threshold outreach services to prevent transitioning to regular heroin injecting.
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Affiliation(s)
- Julie Harris
- School of Applied Social and Policy Sciences, Ulster University, Jordanstown, Shore Road, Newtownabbey, BT37 0QB, United Kingdom; School of Social Sciences, Education and Social Work, Queen's University Belfast, 6 College Park Avenue, Belfast, BT7 1PS, United Kingdom.
| | - Gillian W Shorter
- Institute of Mental Health Sciences, School of Psychology, Ulster University, Coleraine, Cromore Road, Coleraine, BT52 1SA, United Kingdom.
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, 6 College Park Avenue, Belfast, BT7 1PS, United Kingdom.
| | - Paul Best
- School of Social Sciences, Education and Social Work, Queen's University Belfast, 6 College Park Avenue, Belfast, BT7 1PS, United Kingdom.
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Parkinson B, Meacock R, Sutton M, Fichera E, Mills N, Shorter GW, Treweek S, Harman NL, Brown RCH, Gillies K, Bower P. Designing and using incentives to support recruitment and retention in clinical trials: a scoping review and a checklist for design. Trials 2019; 20:624. [PMID: 31706324 PMCID: PMC6842495 DOI: 10.1186/s13063-019-3710-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 09/09/2019] [Indexed: 02/05/2023] Open
Abstract
Background Recruitment and retention of participants are both critical for the success of trials, yet both remain significant problems. The use of incentives to target participants and trial staff has been proposed as one solution. The effects of incentives are complex and depend upon how they are designed, but these complexities are often overlooked. In this paper, we used a scoping review to ‘map’ the literature, with two aims: to develop a checklist on the design and use of incentives to support recruitment and retention in trials; and to identify key research topics for the future. Methods The scoping review drew on the existing economic theory of incentives and a structured review of the literature on the use of incentives in three healthcare settings: trials, pay for performance, and health behaviour change. We identified the design issues that need to be considered when introducing an incentive scheme to improve recruitment and retention in trials. We then reviewed both the theoretical and empirical evidence relating to each of these design issues. We synthesised the findings into a checklist to guide the design of interventions using incentives. Results The issues to consider when designing an incentive system were summarised into an eight-question checklist. The checklist covers: the current incentives and barriers operating in the system; who the incentive should be directed towards; what the incentive should be linked to; the form of incentive; the incentive size; the structure of the incentive system; the timing and frequency of incentive payouts; and the potential unintended consequences. We concluded the section on each design aspect by highlighting the gaps in the current evidence base. Conclusions Our findings highlight how complex the design of incentive systems can be, and how crucial each design choice is to overall effectiveness. The most appropriate design choice will differ according to context, and we have aimed to provide context-specific advice. Whilst all design issues warrant further research, evidence is most needed on incentives directed at recruiters, optimal incentive size, and testing of different incentive structures, particularly exploring repeat arrangements with recruiters.
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Affiliation(s)
- Beth Parkinson
- Health Organisation, Policy and Economics (HOPE), University of Manchester, Manchester, UK
| | - Rachel Meacock
- Health Organisation, Policy and Economics (HOPE), University of Manchester, Manchester, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics (HOPE), University of Manchester, Manchester, UK
| | | | - Nicola Mills
- MRC ConDuCT-II Hub, University of Bristol, Bristol, UK
| | - Gillian W Shorter
- Institute of Mental Health Sciences, School of Psychology, Ulster University, Coleraine, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Nicola L Harman
- MRC North West Hub for Trials Methodology Research, University of Liverpool, Liverpool, UK
| | | | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Peter Bower
- MRC North West Hub for Trials Methodology Research, University of Liverpool, Liverpool, UK.
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Shorter GW, Bray JW, Giles EL, O’Donnell AJ, Berman AH, Holloway A, Heather N, Barbosa C, Stockdale KJ, Scott SJ, Clarke M, Newbury-Birch D. The Variability of Outcomes Used in Efficacy and Effectiveness Trials of Alcohol Brief Interventions: A Systematic Review. J Stud Alcohol Drugs 2019. [DOI: 10.15288/jsad.2019.80.286] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Gillian W. Shorter
- Institute of Mental Health Sciences, School of Psychology, Ulster University, Coleraine, Northern Ireland
- School of Health and Social Care, Teesside University, Middlesbrough, England
| | - Jeremy W. Bray
- Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Emma L. Giles
- School of Health and Social Care, Teesside University, Middlesbrough, England
| | - Amy J. O’Donnell
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
| | - Anne H. Berman
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aisha Holloway
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
| | - Nick Heather
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England
| | - Carolina Barbosa
- Behavioral Health Economics Program, RTI International, Chicago, Illinois
| | - Kelly J. Stockdale
- School of Psychological and Social Sciences, York St. John University,York, England
| | - Stephanie J. Scott
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, England
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen’s University Belfast, Belfast, Northern Ireland
| | - Dorothy Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, England
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Shorter GW, Bray JW, Giles EL, O'Donnell AJ, Berman AH, Holloway A, Heather N, Barbosa C, Stockdale KJ, Scott SJ, Clarke M, Newbury-Birch D. The Variability of Outcomes Used in Efficacy and Effectiveness Trials of Alcohol Brief Interventions: A Systematic Review. J Stud Alcohol Drugs 2019; 80:286-298. [PMID: 31250793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVE The purpose of this study was to characterize recent alcohol brief intervention (ABI) efficacy and effectiveness trials, summarize outcomes, and show how variability in outcomes and reporting compromises the evidence base. METHOD A systematic review and narrative synthesis of articles from 10 databases were undertaken (January 2000-November 2017); study selection represented recent, readily available publications. The National Institute of Care Excellence (NICE) Public Health Guideline 24 (Alcohol use disorders: prevention) informed ABI definitions. The review was conducted using Centre for Reviews and Dissemination (CRD) guidance and pre-registered on PROSPERO (CRD42016047185). Seven a priori specified domains were used to classify outcomes: biomarkers, alcohol-related outcomes, economic factors/resource use, health measures, life impact, intervention factors, and psychological/behavioral factors. RESULTS The search identified 405 trials from 401 eligible papers. In 405 trials, 2,641 separate outcomes were measured in approximately 1,560 different ways. The most common outcomes used were the number of drinks consumed in a week and frequency of heavy episodic drinking. Biomarkers were least frequently used. The most common primary outcome was weekly drinks. By trial type, the most frequent outcome in efficacy and effectiveness trials was frequency of heavy drinking. CONCLUSIONS Consumption outcomes predominated; however, no single outcome was found in all trials. This comprehensive outcome map and methodological detail on ABI effectiveness and efficacy trials can aid decision making in future trials. There was a diversity of instruments, time points, and outcome descriptions in methods and results sections. Compliance with reporting guidance would support data synthesis and improve trial quality. This review establishes the need for a core outcome set (COS)/minimum data standard and supports the Outcome Reporting in Brief Interventions: Alcohol initiative (ORBITAL) to improve standards in the ABI field through a COS for effectiveness and efficacy randomized trials.
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Affiliation(s)
- Gillian W Shorter
- Institute of Mental Health Sciences, School of Psychology, Ulster University, Coleraine, Northern Ireland
- School of Health and Social Care, Teesside University, Middlesbrough, England
| | - Jeremy W Bray
- Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Emma L Giles
- School of Health and Social Care, Teesside University, Middlesbrough, England
| | - Amy J O'Donnell
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
| | - Anne H Berman
- Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aisha Holloway
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, Scotland
| | - Nick Heather
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, England
| | - Carolina Barbosa
- Behavioral Health Economics Program, RTI International, Chicago, Illinois
| | - Kelly J Stockdale
- School of Psychological and Social Sciences, York St. John University, York, England
| | - Stephanie J Scott
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, England
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen's University Belfast, Belfast, Northern Ireland
| | - Dorothy Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, England
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Shorter GW, Heather N, Bray JW, Berman AH, Giles EL, O'Donnell AJ, Barbosa C, Clarke M, Holloway A, Newbury-Birch D. Prioritization of Outcomes in Efficacy and Effectiveness of Alcohol Brief Intervention Trials: International Multi-Stakeholder e-Delphi Consensus Study to Inform a Core Outcome Set. J Stud Alcohol Drugs 2019; 80:299-309. [PMID: 31250794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVE Outcomes used in alcohol brief intervention trials vary considerably. Achieving consensus about key outcomes can enhance evidence synthesis and improve healthcare guidelines. This international, e-Delphi study sought to prioritize outcomes for alcohol brief intervention trials as part of a larger program of work develop an alcohol brief intervention core outcome set. METHOD In total, 150 registrants from 19 countries, representing researchers, policymakers, and patients, participated in a two-round e-Delphi study. In Round 1, participants (n = 137) rated 86 outcomes, derived from a review of the literature and a patient and public involvement panel, by importance. In Round 2, participants (n = 114) received feedback on importance ratings for each outcome, and a reminder of their personal rating, before rating the outcomes for importance a second time. Seven additional outcomes suggested in Round 1 were added to the Round 2 questionnaire. We defined consensus a priori as 70% agreement across all stakeholder groups. RESULTS Seven consumption outcomes met inclusion criteria: typical frequency, typical quantity, frequency of heavy drinking, alcohol-related problems, weekly drinks, at-risk drinking, and combined consumption measures. Others meeting the threshold were alcohol-related injury, quality of life, readiness to change, and intervention fidelity. CONCLUSIONS This is the first international e-Delphi study to identify and prioritize outcomes for use in alcohol brief intervention trials. The use and reporting of outcomes in future alcohol brief intervention trials should improve evidence synthesis in systematic reviews and meta-analyses. Further work is required to refine these outcomes into a core outcome set that includes guidance for measurement of outcomes.
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Affiliation(s)
- Gillian W Shorter
- Institute for Mental Health Sciences, School of Psychology, Ulster University, Coleraine, Northern Ireland
- School of Health and Social Care, Teesside University, Middlesbrough, England
| | - Nick Heather
- Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, England
| | - Jeremy W Bray
- Bryan School of Business & Economics, University of North Carolina at Greensboro, Greensboro, North Carolina
| | - Anne H Berman
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Sweden
| | - Emma L Giles
- School of Health and Social Care, Teesside University, Middlesbrough, England
| | - Amy J O'Donnell
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, England
| | - Carolina Barbosa
- Behavioral Health Economics Program, RTI International, Chicago, Illinois
| | - Mike Clarke
- Northern Ireland Methodology Hub, Queen's University of Belfast, Belfast, Northern Ireland
| | - Aisha Holloway
- Nursing Studies, School of Health in Social Sciences, The University of Edinburgh, Edinburgh, Scotland
| | - Dorothy Newbury-Birch
- School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, England
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Cunningham JA, Shorter GW, Murphy M, Kushnir V, Rehm J, Hendershot CS. Randomized Controlled Trial of a Brief Versus Extended Internet Intervention for Problem Drinkers. Int J Behav Med 2018; 24:760-767. [PMID: 27770293 PMCID: PMC5608868 DOI: 10.1007/s12529-016-9604-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Purpose Brief Internet interventions have been shown to reduce alcohol consumption. This trial intended to compare the effects of one such brief intervention to an extended Internet intervention for problem drinkers. Method Using online advertising, 490 participants, 18 years or older, were recruited and randomized to receive a brief (CheckYourDrinking.net) versus an extended (AlcoholHelpCentre.net) Internet intervention and were followed up at 6, 12, and 24 months. The per protocol primary analysis assessed difference between condition at the 12-month follow-up. Results The follow-up rate at 12 months was 83.3 %. ANCOVAs of the primary (Alcohol Use Disorder Identification Test (AUDIT)-C) and secondary outcome variables (drinks in a typical week, highest number of drinks on one occasion—baseline drinking as covariate) revealed no significant (p > 0.05) differences between the interventions. Similarly, combined analyses of the 6-, 12-, and 24-month follow-up revealed no significant differences between interventions at all time points. Conclusion The present study does not provide support for the added benefit of an extended Internet intervention for problem drinkers over a brief Internet intervention.
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Affiliation(s)
- John A Cunningham
- Centre for Addiction and Mental Health, 33 Russell St., Toronto, ON, M5S 2S1, Canada.
- Australian National University, Canberra, Australia.
- University of Toronto, Toronto, ON, Canada.
| | - Gillian W Shorter
- Australian National University, Canberra, Australia
- Ulster University, Coleraine, UK
- Inspire, Belfast, UK
- Teesside University, Middlesbrough, UK
| | - Michelle Murphy
- Centre for Addiction and Mental Health, 33 Russell St., Toronto, ON, M5S 2S1, Canada
| | - Vladyslav Kushnir
- Centre for Addiction and Mental Health, 33 Russell St., Toronto, ON, M5S 2S1, Canada
- University of Toronto, Toronto, ON, Canada
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, 33 Russell St., Toronto, ON, M5S 2S1, Canada
- University of Toronto, Toronto, ON, Canada
- Technische Universität, Dresden, Germany
| | - Christian S Hendershot
- Centre for Addiction and Mental Health, 33 Russell St., Toronto, ON, M5S 2S1, Canada
- University of Toronto, Toronto, ON, Canada
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Daykin A, Selman LE, Cramer H, McCann S, Shorter GW, Sydes MR, Gamble C, Macefield R, Lane JA, Shaw A. 'We all want to succeed, but we've also got to be realistic about what is happening': an ethnographic study of relationships in trial oversight and their impact. Trials 2017; 18:612. [PMID: 29273060 PMCID: PMC5741863 DOI: 10.1186/s13063-017-2305-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/01/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The oversight and conduct of a randomised controlled trial involves several stakeholders, including a Trial Steering Committee (TSC), Trial Management Group (TMG), Data Monitoring Committee (DMC), funder and sponsor. We aimed to examine how the relationships between these stakeholders affect the trial oversight process and its rigour, to inform future revision of Good Clinical Practice guidelines. METHODS Using an ethnographic study design, we observed the oversight processes of eight trials and conducted semi-structured interviews with members of the trials' TSCs and TMGs, plus other relevant informants, including sponsors and funders of trials. Data were analysed thematically, and findings triangulated and integrated to give a multi-perspective account of current oversight practices in the UK. RESULTS Eight TSC and six TMG meetings from eight trials were observed and audio-recorded, and 66 semi-structured interviews conducted with 52 purposively sampled key informants. Five themes are presented: (1) Collaboration within the TMG and role of the CTU; (2) Collaboration and conflict between oversight committees; (3) Priorities; (4) Communication between trial oversight groups and (5) Power and accountability. There was evidence of collaborative relationships, based on mutual respect, between CTUs, TMGs and TSCs, but also evidence of conflict. Relationships between trial oversight committees were influenced by stakeholders' priorities, both organisational and individual. Good communication following specific, recognised routes played a central role in ensuring that relationships were productive and trial oversight efficient. Participants described the possession of power over trials as a shifting political landscape, and there was lack of clarity regarding the roles and accountability of each committee, the sponsor and funder. Stakeholders' perceptions of their own power over a trial, and the power of others, influenced relationships between those involved in trial oversight. CONCLUSIONS Recent developments in trial design and conduct have been accompanied by changes in roles and relationships between trial oversight groups. Recognising and respecting the value of differing priorities among those involved in running trials is key to successful relationships between committees, funders and sponsors. Clarity regarding appropriate lines of communication, roles and accountability is needed. We present 10 evidence-based recommendations to inform updates to international trial guidance, particularly the Medical Research Council guidelines.
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Affiliation(s)
- Anne Daykin
- MRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK
| | - Lucy E. Selman
- MRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Helen Cramer
- MRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK
| | - Sharon McCann
- Formerly: Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Gillian W. Shorter
- Psychotraumatology, Mental Health and Suicidal Behaviour, Psychology Research Institute, Ulster University, Belfast, UK
- School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - Matthew R. Sydes
- MRC Clinical Trials Unit at UCL, London, UK
- MRC London Hub for Trial Methodology Research, London, UK
| | - Carrol Gamble
- MRC North West Hub for Trials Methodology Research, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Rhiannon Macefield
- MRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK
| | - J. Athene Lane
- MRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, University of Bristol, Bristol, UK
| | - Alison Shaw
- MRC ConDuCT Hub for Trials Methodology Research, Population Health Sciences, University of Bristol, Bristol, UK
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Shorter GW, Heather N, Bray JW, Giles EL, Holloway A, Barbosa C, Berman AH, O'Donnell AJ, Clarke M, Stockdale KJ, Newbury-Birch D. The 'Outcome Reporting in Brief Intervention Trials: Alcohol' (ORBITAL) framework: protocol to determine a core outcome set for efficacy and effectiveness trials of alcohol screening and brief intervention. Trials 2017; 18:611. [PMID: 29273070 PMCID: PMC5741954 DOI: 10.1186/s13063-017-2335-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/31/2017] [Indexed: 11/12/2022] Open
Abstract
Background The evidence base to assess the efficacy and effectiveness of alcohol brief interventions (ABI) is weakened by variation in the outcomes measured and by inconsistent reporting. The ‘Outcome Reporting in Brief Intervention Trials: Alcohol’ (ORBITAL) project aims to develop a core outcome set (COS) and reporting guidance for its use in future trials of ABI in a range of settings. Methods/design An international Special Interest Group was convened through INEBRIA (International Network on Brief Interventions for Alcohol and Other Drugs) to inform the development of a COS for trials of ABI. ORBITAL will incorporate a systematic review to map outcomes used in efficacy and effectiveness trials of ABI and their measurement properties, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria. This will support a multi-round Delphi study to prioritise outcomes. Delphi panellists will be drawn from a range of settings and stakeholder groups, and the Delphi study will also be used to determine if a single COS is relevant for all settings. A consensus meeting with key stakeholder representation will determine the final COS and associated guidance for its use in trials of ABI. Discussion ORBITAL will develop a COS for alcohol screening and brief intervention trials, with outcomes stratified into domains and guidance on outcome measurement instruments. The standardisation of ABI outcomes and their measurement will support the ongoing development of ABI studies and a systematic synthesis of emerging research findings. We will track the extent to which the COS delivers on this promise through an exploration of the use of the guidance in the decade following COS publication.
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Affiliation(s)
- G W Shorter
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK.,Psychotraumatology, Mental Health & Suicidal Behaviour Research Group, Psychology Research Institute, Ulster University, Coleraine, UK.,Inspire, Belfast, UK.,College of Medicine, Biology and Environment, Australian National University, Canberra, ACT, Australia
| | - N Heather
- Faculty of Health and Life Science, Northumbria University, Newcastle upon Tyne, UK
| | - Jeremy W Bray
- Department of Economics, Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, NC, USA.
| | - E L Giles
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK
| | - A Holloway
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - C Barbosa
- Behavioral Health Economics Program, RTI International, Chicago, IL, USA
| | - A H Berman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - A J O'Donnell
- Institute of Health and Society, Newcastle University, Newcastle Upon Tyne, UK
| | - M Clarke
- Northern Ireland Methodology Hub, Queen's University of Belfast, Belfast, UK
| | - K J Stockdale
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK.,School of Psychological and Social Sciences, York St. John University, York, UK
| | - D Newbury-Birch
- Alcohol and Public Health Research Team, School of Health and Social Care, Teesside University, Middlesbrough, UK
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Holloway AS, Ferguson J, Landale S, Cariola L, Newbury-Birch D, Flynn A, Knight JR, Sherritt L, Harris SK, O’Donnell AJ, Kaner E, Hanratty B, Loree AM, Yonkers KA, Ondersma SJ, Gilstead-Hayden K, Martino S, Adam A, Schwartz RP, Wu LT, Subramaniam G, Sharma G, McNeely J, Berman AH, Kolaas K, Petersén E, Bendtsen P, Hedman E, Linderoth C, Müssener U, Sinadinovic K, Spak F, Gremyr I, Thurang A, Mitchell AM, Finnell D, Savage CL, Mahmoud KF, Riordan BC, Conner TS, Flett JAM, Scarf D, McRee B, Vendetti J, Gallucci KS, Robaina K, Clark BJ, Jones J, Reed KD, Hodapp RM, Douglas I, Burnham EL, Aagaard L, Cook PF, Harris BR, Yu J, Wolff M, Rogers M, Barbosa C, Wedehase BJ, Dunlap LJ, Mitchell SG, Dusek KA, Gryczynski J, Kirk AS, Oros MT, Hosler C, O’Grady KE, Brown BS, Angus C, Sherborne S, Gillespie D, Meier P, Brennan A, de Vargas D, Soares J, Castelblanco D, Doran KM, Wittman I, Shelley D, Rotrosen J, Gelberg L, Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Deng Y, Dziura J, Fiellin LE, O’Connor PG, Bedimo R, Gibert C, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Justice AC, Bryant KJ, Fiellin DA, Giles EL, Coulton S, Deluca P, Drummond C, Howel D, McColl E, McGovern R, Scott S, Stamp E, Sumnall H, Vale L, Alabani V, Atkinson A, Boniface S, Frankham J, Gilvarry E, Hendrie N, Howe N, McGeechan GJ, Ramsey A, Stanley G, Clephane J, Gardiner D, Holmes J, Martin N, Shevills C, Soutar M, Chi FW, Weisner C, Ross TB, Mertens J, Sterling SA, Shorter GW, Heather N, Bray J, Cohen HA, McPherson TL, Adam C, López-Pelayo H, Gual A, Segura-Garcia L, Colom J, Ornelas IJ, Doyle S, Donovan D, Duran B, Torres V, Gaume J, Grazioli V, Fortini C, Paroz S, Bertholet N, Daeppen JB, Satterfield JM, Gregorich S, Alvarado NJ, Muñoz R, Kulieva G, Vijayaraghavan M, Adam A, Cunningham JA, Díaz E, Palacio-Vieira J, Godinho A, Kushir V, O’Brien KHM, Aguinaldo LD, Sellers CM, Spirito A, Chang G, Blake-Lamb T, LaFave LRA, Thies KM, Pepin AL, Sprangers KE, Bradley M, Jorgensen S, Catano NA, Murray AR, Schachter D, Andersen RM, Rey GN, Vahidi M, Rico MW, Baumeister SE, Johansson M, Sinadinovic C, Hermansson U, Andreasson S, O’Grady MA, Kapoor S, Akkari C, Bernal C, Pappacena K, Morley J, Auerbach M, Neighbors CJ, Kwon N, Conigliaro J, Morgenstern J, Magill M, Apodaca TR, Borsari B, Hoadley A, Scott Tonigan J, Moyers T, Fitzgerald NM, Schölin L, Barticevic N, Zuzulich S, Poblete F, Norambuena P, Sacco P, Ting L, Beaulieu M, Wallace PG, Andrews M, Daley K, Shenker D, Gallagher L, Watson R, Weaver T, Bruguera P, Oliveras C, Gavotti C, Barrio P, Braddick F, Miquel L, Suárez M, Bruguera C, Brown RL, Capell JW, Paul Moberg D, Maslowsky J, Saunders LA, McCormack RP, Scheidell J, Gonzalez M, Bauroth S, Liu W, Lindsay DL, Lincoln P, Hagle H, Wallhed Finn S, Hammarberg A, Andréasson S, King SE, Vargo R, Kameg BN, Acquavita SP, Van Loon RA, Smith R, Brehm BJ, Diers T, Kim K, Barker A, Jones AL, Skinner AC, Hinman A, Svikis DS, Thacker CL, Resnicow K, Beatty JR, Janisse J, Puder K, Bakshi AS, Milward JM, Kimergard A, Garnett CV, Crane D, Brown J, West R, Michie S, Rosendahl I, Andersson C, Gajecki M, Blankers M, Donoghue K, Lynch E, Maconochie I, Phillips C, Pockett R, Phillips T, Patton R, Russell I, Strang J, Stewart MT, Quinn AE, Brolin M, Evans B, Horgan CM, Liu J, McCree F, Kanovsky D, Oberlander T, Zhang H, Hamlin B, Saunders R, Barton MB, Scholle SH, Santora P, Bhatt C, Ahmed K, Hodgkin D, Gao W, Merrick EL, Drebing CE, Larson MJ, Sharma M, Petry NM, Saitz R, Weisner CM, Young-Wolff KC, Lu WY, Blosnich JR, Lehavot K, Glass JE, Williams EC, Bensley KM, Chan G, Dombrowski J, Fortney J, Rubinsky AD, Lapham GT, Forray A, Olmstead TA, Gilstad-Hayden K, Kershaw T, Dillon P, Weaver MF, Grekin ER, Ellis JD, McGoron L, McGoron L. Proceedings of the 14th annual conference of INEBRIA. Addict Sci Clin Pract 2017. [PMCID: PMC5606215 DOI: 10.1186/s13722-017-0087-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Handscomb L, Hall DA, Hoare DJ, Shorter GW. Erratum to: Confirmatory factor analysis of Clinical Outcomes in Routine Evaluation (CORE-OM) used as a measure of emotional distress in people with tinnitus. Health Qual Life Outcomes 2017; 15:91. [PMID: 28468658 PMCID: PMC5415729 DOI: 10.1186/s12955-017-0668-y] [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] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 04/26/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- L Handscomb
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, University of Nottingham, 113 The Ropewalk, Nottingham, NG1 5DU, UK. .,UCL Ear Institute, 332 Gray's Inn Road, London, WC1X 8EE, UK.
| | - D A Hall
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, University of Nottingham, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - D J Hoare
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, University of Nottingham, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - G W Shorter
- Alcohol and Public Health Team, Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BA, UK.,Northern Ireland Association for Mental Health, 80 University St, Belfast, BT7 1HE, UK.,Psychotraumatology, Mental Health, and Suicidal Behaviour Group, Psychology Research Institute, Ulster University, Coleraine, BT52 1SA, UK
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Henihan AM, McCombe G, Klimas J, Swan D, Leahy D, Anderson R, Bury G, Dunne CP, Keenan E, Lambert JS, Meagher D, O'Gorman C, O'Toole TP, Saunders J, Shorter GW, Smyth BP, Kaner E, Cullen W. Feasibility of alcohol screening among patients receiving opioid treatment in primary care. BMC Fam Pract 2016; 17:153. [PMID: 27816057 PMCID: PMC5097838 DOI: 10.1186/s12875-016-0548-2] [Citation(s) in RCA: 13] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 10/21/2016] [Indexed: 11/10/2022]
Abstract
Background Identifying and treating problem alcohol use among people who also use illicit drugs is a challenge. Primary care is well placed to address this challenge but there are several barriers which may prevent this occurring. The objective of this study was to determine if a complex intervention designed to support screening and brief intervention for problem alcohol use among people receiving opioid agonist treatment is feasible and acceptable to healthcare providers and their patients in a primary care setting. Methods A randomised, controlled, pre-and-post design measured feasibility and acceptability of alcohol screening based on recruitment and retention rates among patients and practices. Efficacy was measured by screening and brief intervention rates and the proportion of patients with problem alcohol use. Results Of 149 practices that were invited, 19 (12.8 %) agreed to participate. At follow up, 13 (81.3 %) practices with 81 (62.8 %) patients were retained. Alcohol screening rates in the intervention group were higher at follow up than in the control group (53 % versus 26 %) as were brief intervention rates (47 % versus 19 %). Four (18 %) people reduced their problem drinking (measured by AUDIT-C), compared to two (7 %) in the control group. Conclusions Alcohol screening among people receiving opioid agonist treatment in primary care seems feasible. A definitive trial is needed. Such a trial would require over sampling and greater support for participating practices to allow for challenges in recruitment of patients and practices. Electronic supplementary material The online version of this article (doi:10.1186/s12875-016-0548-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anne Marie Henihan
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Geoff McCombe
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland
| | - Jan Klimas
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.,British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Davina Swan
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland.,Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, London, SE5 8BB, UK
| | - Dorothy Leahy
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Rolande Anderson
- Addiction Counsellor, Suite 33, The Morrison Chambers, 32, Nassau Street, Dublin 2, Ireland
| | - Gerard Bury
- UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland
| | - Colum P Dunne
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Eamon Keenan
- Addiction Services, Health Services Executive, Dublin, Ireland
| | - John S Lambert
- UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland
| | - David Meagher
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Clodagh O'Gorman
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland
| | - Tom P O'Toole
- Brown-Alpert Medical School, Providence, Rhode Island, USA.,Department of Veterans' Affairs, Washington DC, USA
| | - Jean Saunders
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland.,CSTAR Centre, University of Limerick (UL), Limerick, Ireland
| | - Gillian W Shorter
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Bobby P Smyth
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.,Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Walter Cullen
- Graduate Entry Medical School, Faculty of Education & Health Sciences, University of Limerick, Limerick, Ireland. .,UCD School of Medicine, University College Dublin , Belfield, Dublin 4, Ireland. .,Department of Veterans' Affairs, Washington DC, USA.
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Handscomb L, Hall DA, Shorter GW, Hoare DJ. Online Data Collection to Evaluate a Theoretical Cognitive Model of Tinnitus. Am J Audiol 2016; 25:313-317. [PMID: 27768195 DOI: 10.1044/2016_aja-16-0007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 06/14/2016] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this article is to describe data collection considerations, methods, and response rates for a survey available both online and on paper. Methodological issues in the design of online data collection, and advantages and disadvantages of different data collection methods are discussed. METHOD A survey was compiled that included 9 full or partial clinical questionnaires designed to measure different components relevant to tinnitus distress. It was completed once by 342 members of the public with tinnitus. Respondents could choose whether to complete the survey online or on paper. RESULTS Ninety-five percent of participants chose to complete the survey online. The advantages of an online self-administered questionnaire include low numbers of unanswered questions, convenience (particularly in a longer survey such as this), a fast return rate, and reduced expense. Age emerged as an important variable, with those opting to complete the paper-based version of the survey being older. CONCLUSIONS Online data collection has several advantages to both participants and researchers. However, cross-sectional studies such as that presented here should also offer paper questionnaires to avoid excluding certain subgroups of the population. Ethics and reporting guidelines for Internet-delivered questionnaire studies are available. These can usefully inform study design and guide high-quality reporting.
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Affiliation(s)
- Lucy Handscomb
- National Institute of Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, Nottingham, United Kingdom
- UCL Ear Institute, London, United Kingdom
| | - Deborah A. Hall
- National Institute of Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, Nottingham, United Kingdom
| | - Gillian W. Shorter
- National Institute for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
- School of Nursing and Midwifery, Trinity College, University of Dublin, Ireland
| | - Derek J. Hoare
- National Institute of Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, Nottingham, United Kingdom
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Handscomb L, Hall DA, Hoare DJ, Shorter GW. Confirmatory factor analysis of Clinical Outcomes in Routine Evaluation (CORE-OM) used as a measure of emotional distress in people with tinnitus. Health Qual Life Outcomes 2016; 14:124. [PMID: 27600656 PMCID: PMC5012012 DOI: 10.1186/s12955-016-0524-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 08/20/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with troublesome tinnitus often experience emotional distress. Therefore a psychometrically sound instrument which can evaluate levels of distress and change over time is necessary to understand this experience. Clinical Outcomes in Routine Evaluation (CORE-OM) is a measure of emotional distress which has been widely used in mental health research. Although originally designed as a 4-factor questionnaire, factor analyses have not supported this structure and a number of alternative factor structures have been proposed in different samples. The aims of this study were to test the factor structure of the CORE-OM using a large representative tinnitus sample and to use it to investigate levels of emotional distress amongst people with a range of tinnitus experience. METHODS The CORE-OM was completed by 342 people experiencing tinnitus who self-rated their tinnitus on a 5-point scale from 'not a problem' to 'a very big problem'. Confirmatory factor analysis was used to test all ten factor models which have been previously derived across a range of population samples. Model fit was assessed using fit criterion and theoretical considerations. Mean scores on the full questionnaire and its subscales were compared between tinnitus problem categories using one-way ANOVA. RESULTS The best fitting model included 33 of the 34 original items and was divided into three factors: negatively worded items, positively worded items and risk. The full questionnaire and each factor were found to have good internal consistency and factor loadings were high. There was a statistically significant difference in total CORE-OM scores across the five tinnitus problem categories. However there was no significant difference between those who rated their tinnitus 'not a problem', and 'a small problem' or 'a moderate problem.' CONCLUSION This study found a 3-factor structure for the CORE-OM to be a good fit for a tinnitus population. It also found evidence of a relationship between emotional distress as measured by CORE-OM and perception of tinnitus as a problem. Its use in tinnitus clinics is to be recommended, particularly when emotional distress is a target of therapy.
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Affiliation(s)
- L Handscomb
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, University of Nottigham, 113 The Ropewalk, Nottingham, NG1 5DU, UK. .,UCL Ear Institute, 332 Gray's Inn Road, London, WC1X 8EE, UK.
| | - D A Hall
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, University of Nottigham, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - D J Hoare
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Otology and Hearing Group, Division of Clinical Neuroscience, University of Nottigham, 113 The Ropewalk, Nottingham, NG1 5DU, UK
| | - G W Shorter
- Alcohol and Public Health Team, Health and Social Care Institute, Teesside University, Middlesbrough, TS1 3BA, UK.,Northern Ireland Association for Mental Health, 80 University St, Belfast, BT7 1HE, UK.,Psychotraumatology, Mental Health, and Suicidal Behaviour Group, Psychology Research Institute, Ulster University, Coleraine, BT52 1SA, UK
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Watson R, Morris J, Isitt J, Barrio P, Ortega L, Gual A, Conner K, Stecker T, Maisto S, Paroz S, Graap C, Grazioli VS, Daeppen JB, Collins SE, Bertholet N, McNeely J, Kushnir V, Cunningham JA, Crombie IK, Cunningham KB, Irvine L, Williams B, Sniehotta FF, Norrie J, Melson A, Jones C, Briggs A, Rice P, Achison M, McKenzie A, Dimova E, Slane PW, Grazioli VS, Collins SE, Paroz S, Graap C, Daeppen JB, Baggio S, Dupuis M, Studer J, Gmel G, Magill M, Grazioli VS, Tait RJ, Teoh L, Kelty E, Geelhoed E, Mountain D, Hulse GK, Renko E, Mitchell SG, Lounsbury D, Li Z, Schwartz RP, Gryczynski J, Kirk AS, Oros M, Hosler C, Dusek K, Brown BS, Finnell DS, Holloway A, Wu LT, Subramaniam G, Sharma G, Wallhed Finn S, Andreasson S, Dvorak RD, Kramer MP, Stevenson BL, Sargent EM, Kilwein TM, Harris SK, Sherritt L, Copelas S, Knight JR, Mdege ND, McCambridge J, Bischof G, Bischof A, Freyer-Adam J, Rumpf HJ, Fitzgerald N, Schölin L, Toner P, Böhnke JR, Veach LJ, Currin O, Dongre LZ, Miller PR, White E, Williams EC, Lapham GT, Bobb JJ, Rubinsky AD, Catz SL, Shortreed S, Bensley KM, Bradley KA, Milward J, Deluca P, Khadjesari Z, Watson R, Fincham-Campbell S, Drummond C, Angus K, Bauld L, Baumann S, Haberecht K, Schnuerer I, Meyer C, Rumpf HJ, John U, Gaertner B, Barrault-Couchouron M, Béracochéa M, Allafort V, Barthélémy V, Bonnefoi H, Bussières E, Garguil V, Auriacombe M, Saint-Jacques M, Dorval M, M’Bailara K, Segura-Garcia L, Ibañez-Martinez N, Mendive-Arbeloa JM, Anoro-Perminger M, Diaz-Gallego P, Piñar-Mateos MA, Colom-Farran J, Deligianni M, Yersin B, Adam A, Weisner C, Chi F, Lu W, Sterling S, Kraemer KL, McGinnis KA, Fiellin DA, Skanderson M, Gordon AJ, Robbins J, Zickmund S, Korthuis PT, Edelman EJ, Hansen NB, Cutter CJ, Dziura J, Fiellin LE, O’Connor PG, Maisto SA, Bedimo R, Gilbert C, Marconi VC, Rimland D, Rodriguez-Barradas M, Simberkoff M, Justice AC, Bryant KJ, Berman AH, Shorter GW, Bray JW, Barbosa C, Johansson M, Hester R, Campbell W, Souza Formigoni MLO, Andrade ALM, Sartes LMA, Sundström C, Eék N, Kraepelien M, Kaldo V, Fahlke C, Hernandez L, Becker SJ, Jones RN, Graves HR, Spirito A, Diestelkamp S, Wartberg L, Arnaud N, Thomasius R, Gaume J, Grazioli V, Fortini C, Malan Z, Mash B, Everett-Murphy K, Grazioli VS, Studer J, Mohler-Kuo M, Bertholet N, Gmel G, Doi L, Cheyne H, Jepson R, Luna V, Echeverria L, Morales S, Barroso T, Abreu Â, Aguiar C, Stewart D, Abreu A, Brites RM, Jomar R, Marinho G, Parreira P, Seale JP, Johnson JA, Henry D, Chalmers S, Payne F, Tuck L, Morris A, Gonçalves C, Besser B, Casajuana C, López-Pelayo H, Balcells MM, Teixidó L, Miquel L, Colom J, Hepner KA, Hoggatt KJ, Bogart A, Paddock SM, Hardoon SL, Petersen I, Hamilton FL, Nazareth I, White IR, Marston L, Wallace P, Godfrey C, Murray E, Sovinová H, Csémy L. Proceedings of the 13th annual conference of INEBRIA. Addict Sci Clin Pract 2016; 11:13. [PMID: 27654147 PMCID: PMC5032602 DOI: 10.1186/s13722-016-0062-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Daykin A, Selman LE, Cramer H, McCann S, Shorter GW, Sydes MR, Gamble C, Macefield R, Lane JA, Shaw A. What are the roles and valued attributes of a Trial Steering Committee? Ethnographic study of eight clinical trials facing challenges. Trials 2016; 17:307. [PMID: 27369866 PMCID: PMC4930562 DOI: 10.1186/s13063-016-1425-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 08/03/2015] [Accepted: 06/03/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Clinical trials oversight by a Trial Steering Committee (TSC) is mandated by Good Clinical Practice. This study used qualitative methods to explore the role and valued attributes of the TSC to inform planned updates of Medical Research Council guidance and TSC terms of reference. METHODS An ethnographic study was conducted during 2013-2014. TSC and Trial Management Group meetings from eight trials were observed and audio-recorded, and semi-structured interviews conducted with purposively sampled key informants: independent and non-independent TSC members, trial sponsor representatives, funder representatives and chief investigators. The selected trials were currently recruiting and dealing with challenging scenarios. Data were analysed thematically and findings triangulated and integrated to give a multi-perspective account of the role and valued attributes of a TSC. RESULTS Eight TSC meetings and six Trial Management Group meetings were observed. Sixty-five interviews were conducted with 51 informants. The two main roles played by the TSC were quality assurance and patient advocacy. Quality assurance involved being a 'critical friend' or a provider of 'tough love'. Factors influencing the ability of the TSC to fulfil this role included the TSC Chair, other independent TSC members and the model of the TSC and its fit with the trial subject. The role of the TSC as an advocate for patient well-being was perceived as paramount. Two attributes of TSC members emerged as critical: experience (of running a trial, trial oversight or in a clinical/methodological area) and independence. While independence was valued for giving impartiality, the lack of consensus about its definition and strict requirements of some funders made it difficult to operationalise. CONCLUSIONS We found tensions and ambiguities in the roles expected of TSCs and the attributes valued of TSC members. In particular, the requirements of independence and experience could conflict, impacting the TSCs' quality assurance role. Concerns were raised regarding whose interests are served by funders' criteria of independence; in particular, funders' selection of TSC members was thought to potentially inhibit TSCs' ability to fulfil their patient advocacy role. These findings should be incorporated in revising guidance and terms of reference for TSCs.
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Affiliation(s)
- Anne Daykin
- MRC ConDuCT Hub for Trials Methodology Research, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK.
| | - Lucy E Selman
- MRC ConDuCT Hub for Trials Methodology Research, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK
| | - Helen Cramer
- MRC ConDuCT Hub for Trials Methodology Research, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK
| | - Sharon McCann
- Formerly: Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Gillian W Shorter
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Belfast, BT12 6BJ, UK
- National Institute for Mental Health Research, ANU College of Medicine Biology & Environment, The Australian National University, Canberra, ACT 0200, Australia
| | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, London, WC2B 6NH, UK
- MRC London Hub for Trial Methodology Research, London, UK
| | - Carrol Gamble
- MRC North West Hub for Trials Methodology Research, Institute of Translational Medicine, University of Liverpool, Liverpool, L69 3BX, UK
| | - Rhiannon Macefield
- MRC ConDuCT Hub for Trials Methodology Research, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK
| | - J Athene Lane
- MRC ConDuCT Hub for Trials Methodology Research, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK
| | - Alison Shaw
- MRC ConDuCT Hub for Trials Methodology Research, School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK
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McGuinness B, Barrett SL, McIlvenna J, Passmore AP, Shorter GW. Predicting conversion to dementia in a memory clinic: A standard clinical approach compared with an empirically defined clustering method (latent profile analysis) for mild cognitive impairment subtyping. Alzheimers Dement (Amst) 2015; 1:447-54. [PMID: 27239523 PMCID: PMC4879478 DOI: 10.1016/j.dadm.2015.10.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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] [Indexed: 11/10/2022]
Abstract
Introduction Mild cognitive impairment (MCI) has clinical value in its ability to predict later dementia. A better understanding of cognitive profiles can further help delineate who is most at risk of conversion to dementia. We aimed to (1) examine to what extent the usual MCI subtyping using core criteria corresponds to empirically defined clusters of patients (latent profile analysis [LPA] of continuous neuropsychological data) and (2) compare the two methods of subtyping memory clinic participants in their prediction of conversion to dementia. Methods Memory clinic participants (MCI, n = 139) and age-matched controls (n = 98) were recruited. Participants had a full cognitive assessment, and results were grouped (1) according to traditional MCI subtypes and (2) using LPA. MCI participants were followed over approximately 2 years after their initial assessment to monitor for conversion to dementia. Results Groups were well matched for age and education. Controls performed significantly better than MCI participants on all cognitive measures. With the traditional analysis, most MCI participants were in the amnestic multidomain subgroup (46.8%) and this group was most at risk of conversion to dementia (63%). From the LPA, a three-profile solution fit the data best. Profile 3 was the largest group (40.3%), the most cognitively impaired, and most at risk of conversion to dementia (68% of the group). Discussion LPA provides a useful adjunct in delineating MCI participants most at risk of conversion to dementia and adds confidence to standard categories of clinical inference.
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Affiliation(s)
- Bernadette McGuinness
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Suzanne L Barrett
- School of Psychology, Queen's University Belfast, Belfast, Northern Ireland
| | - John McIlvenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Anthony Peter Passmore
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Gillian W Shorter
- National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia; All Ireland Hub for Trials Methodology Research, Ulster University, Londonderry, Northern Ireland
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Hoare DJ, Whitham D, Henry JA, Shorter GW. Neuromodulation (desynchronisation) for tinnitus in adults. Cochrane Database of Systematic Reviews 2015. [DOI: 10.1002/14651858.cd011760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Derek J Hoare
- University of Nottingham; National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit; Ropewalk House, 113 The Ropewalk Nottingham UK NG1 5DU
| | - Diane Whitham
- Queen's Medical Centre; Nottingham Clinical Trials Unit; Room 2201 Clinical Trials Unit C Floor, South Block Nottingham UK NG7 2UH
| | - James A Henry
- VA Medical Center - NCRAR; National Center for Rehabilitative Auditory Research; 3710 SW US Veterans Hospital Road Portland USA OR 97239
- Oregon Hearing Research Center; Department of Otolaryngology; Oregon Health & Science University 3181 SW Sam Jackson Park Road Portland USA OR 97239-3098
| | - Gillian W Shorter
- University of Ulster; Bamford Centre for Mental Health and Wellbeing; Room MI020, Magee Campus Londonderry UK BT48 7JL
- University of Ulster; MRC All Ireland Hub for Trials Methodology Research; Northland Road Londonderry UK BT48 7JL
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Iqbal N, McCambridge O, Edgar L, Young C, Shorter GW. Health-care professionals' attitudes across different hospital departments regarding alcohol-related presentations. Drug Alcohol Rev 2015; 34:487-494. [PMID: 25693922 DOI: 10.1111/dar.12243] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/20/2014] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND AIMS Attitudes to individuals presenting with alcohol-related issues are important in developing therapeutic relationships and applying alcohol-related interventions. This study explores staff attitudes to these individuals across a range of roles and departments. DESIGN AND METHODS Data were gathered from 204 staff in the Southern Health and Social Care Trust in Northern Ireland. Regression models were used to predict attitudes as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ). RESULTS Two hundred and four people participated in the study. The sample comprised doctors, nurses, allied health professionals and other staff who had face-to-face contact with patients. Staff worked in accident and emergency (A&E), medical, surgical, addiction or psychiatry departments. Staff working in addiction and psychiatry departments had significantly higher levels of role adequacy compared with those in A&E. Staff in addictions also demonstrated higher levels of role legitimacy, motivation and role satisfaction than those in A&E. Doctors had higher role adequacy and role legitimacy than nursing staff. DISCUSSION AND CONCLUSIONS There are critical differences in staff attitudes to patients presenting with alcohol-related issues in a range of hospital settings; training and working in a specialist setting have a significant positive influence on staff attitudes. This suggests that further training and support would positively enhance the attitudes of staff in a variety of professional roles and across a range of hospital settings in the management of patients presenting with alcohol-related difficulties. [Iqbal N, McCambridge O, Edgar L, Young C, Shorter GW. Health-care professionals' attitudes across different hospital departments regarding alcohol-related presentations. Drug Alcohol Rev 2015;34:487-94].
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Affiliation(s)
- Nauman Iqbal
- Home Treatment Team Department, St Luke's Hospital, Armagh, UK
| | | | - Lauren Edgar
- Bluestone Unit, Craigavon Area Hospital, Portadown, UK
| | - Ciara Young
- Old Age Psychiatry Department, Knockbracken Healthcare Park, Belfast, UK
| | - Gillian W Shorter
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Londonderry, UK.,MRC All Ireland Trials Methodology Hub, Ulster University, Londonderry, UK
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Kuss DJ, Shorter GW, van Rooij AJ, van de Mheen D, Griffiths MD. The Internet addiction components model and personality: Establishing construct validity via a nomological network. Computers in Human Behavior 2014. [DOI: 10.1016/j.chb.2014.07.031] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McClatchley K, Shorter GW, Chalmers J. Deconstructing alcohol use on a night out in England: promotions, preloading and consumption. Drug Alcohol Rev 2014; 33:367-75. [PMID: 24810162 DOI: 10.1111/dar.12150] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 04/08/2014] [Indexed: 12/01/2022]
Abstract
INTRODUCTION AND AIMS To examine alcohol consumed during a drinking event (a single drinking occasion) by those attending public house/on-trade establishments on nights with standard pricing and nights with promotional prices. DESIGN AND METHODS Data (n = 425) were collected in an ecological momentary assessment over eight nights in two locations (Midlands and London) on both promotional and standard (Saturday) nights. Multiple regression was used to predict event alcohol consumption by sex, age, type of night, alcohol preloading behaviour, marital and employment status, education, Alcohol Use Disorders Identification Test alcohol consumption questions separately or total AUDIT-C and social group size. RESULTS Mean (UK) units consumed were 11.8 (London) and 14.4 (Midlands). In London, consumption was similar on promotional and standard nights, but in the Midlands, standard night consumption was three units higher. Preloading was reported by 30%; more common on standard nights. Regression analyses revealed being male, preloading and past-year total AUDIT-C were associated with higher event consumption. However, when AUDIT-C questions were added separately, being a standard night was associated with increased event consumption and different AUDIT-C questions were significantly associated with event consumption in each location. DISCUSSION AND CONCLUSIONS Event consumption reflected heavy episodic drinking and was influenced by price. Promotional night consumption either matched standard Saturday night consumption or was slightly lower. In London, there was a significant preference for drinking at least one promotional beverage on promotional nights. On standard nights, consumption was over a wider range of venues, and preloading with off-trade alcohol was more likely.
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Affiliation(s)
- Kirstie McClatchley
- Division of Psychology, Nottingham Trent University, Nottingham, UK; Highland Council Psychological Service, Inverness, UK
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Abstract
Gambling has typically been considered a predominately male activity. However, recent prevalence surveys have shown greater numbers of females are now gambling. Much of the gambling literature suggests online gamblers are more likely to be male, and that problem gamblers are more likely to be male. Males and females are also likely to be gambling for different reasons and have a preference for different gambling activities. Little is known about the pattern of play among female online gamblers. The aim of this survey was to develop a better profile of female online gamblers and to examine any gender differences between males and females in terms of how and why they gamble online, their frequency of online gambling, patterns of play, as well as attitudes to online gambling. The survey was posted on 32 international online gambling websites and was completed by 975 online gamblers (including 175 female online gamblers). Chi-square tests of association were conducted to examine the association between gender and a range of variables. The results showed that females had been gambling online for a shorter duration of time than males, had much shorter online gambling sessions, different motivations for gambling online (i.e., to practice for free, to spend less money and out of boredom), and experienced online gambling differently to males, with increased feelings of guilt and shame for gambling online. This suggests there is still a stigma around gambling particularly evident among females in this study. The findings indicate that clinicians and treatment providers need to be aware of these potential gender differences in online gambling to develop appropriately tailored interventions.
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Affiliation(s)
- Abby McCormack
- School of Clinical Sciences, The University of Nottingham, Nottingham, UK,
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Wood RTA, Shorter GW, Griffiths MD. Rating the Suitability of Responsible Gambling Features for Specific Game Types: A Resource for Optimizing Responsible Gambling Strategy. Int J Ment Health Addict 2014. [DOI: 10.1007/s11469-013-9473-y] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Armour C, Shorter GW, Elhai JD, Elklit A, Christoffersen MN. Polydrug Use Typologies and Childhood Maltreatment in a Nationally Representative Survey of Danish Young Adults. J Stud Alcohol Drugs 2014; 75:170-8. [DOI: 10.15288/jsad.2014.75.170] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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