JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE最新文献

This randomized feasibility trial aimed to 1) assess methodology for a subsequent efficacy trial and 2) examine the usability and acceptability of Project BETTER's hybrid technology-delivered educational intervention for pregnant people receiving medication for opioid use disorder within a perinatal addiction treatment clinic. Participants were randomized to the technology-delivered educational intervention or standard practice control (brochure). Project BETTER's intervention offers three modules (pregnancy-to-postpartum transition, Neonatal Opioid Withdrawal Syndrome, child welfare interactions) via Computerized Intervention Authoring System (CIAS 3.0). Inclusion criteria were: ≥18 years of age, <34 weeks pregnant, currently receiving medication for opioid use disorder (MOUD), and had engaged in care ≤10 weeks during their current pregnancy. Study visits included an online survey, brief interview, and medical record review. Mean perceived helpfulness scores were compared by study condition using independent samples t-test. The screening process identified 49 potential participants, n=31 (63%) of whom were recruited. Twenty-nine participants were randomized (intervention: n=16, control: n=13). Participants (n=29) were reproductive age [M = 30.0 years (SD = 4.4)], 66% white and 31% Black with a median estimated gestational age of 24 weeks. Most participants (69%) received buprenorphine. Study completion rate was 83%. Most participants completed study components remotely. Among participants in the intervention group, 56% completed at least one module. Participants perceived the intervention to be as helpful as the brochure (intervention: 5.28 ± 0.98, control: 5.39 ± 0.56, p=0.387) and highly acceptable. With protocol modifications, scale up to a larger clinical trial is feasible and acceptable to pregnant people receiving MOUD.

Beginning in adolescence, lesbian, gay, and bisexual (LGB) individuals exhibit higher levels of problem alcohol use relative to heterosexual populations. Based in minority stress theory, psychological mediation frameworks of LGB psychopathology typically serve as explanatory models of these disparities, suggesting that LGB identity-related stressors lead to social and affect-related mechanisms that proximally influence alcohol use disorder risk. While stress and its psychological consequences are considered universal risk factors, minority stress research has yet to be synthesized with theory and evidence from general adolescent studies of alcohol use. This is needed to translate and refine minority stress theory to the developmental context of emerging use, and to determine plausible targets for prevention and early intervention of alcohol-related health risk. Here, I compare theories from LGB and general youth populations articulating psychological mechanisms linking stress with the development of problem drinking behaviors. I then review studies examining these mechanisms in the prediction of LGB alcohol behaviors in youth. Finally, incorporating multidisciplinary findings, I highlight understudied areas of inquiry in a developmental pathway model of sexual minority alcohol use and disorder that may guide future alcohol research involving LGB youth. This review demonstrated that while studies have focused primarily on negative affect-based mechanisms of alcohol risk, few have examined stress-related changes in positive affect, social contexts, and interactions among these pathways. Studies addressing a confluence of these mechanisms of risk over time are critically needed to better inform etiology, prevention, and intervention of problem alcohol use among younger LGB populations.