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Does urban-rural disparity exist in nicotine and alcohol dependence among Chinese older adults? 中国老年人尼古丁和酒精依赖是否存在城乡差异?
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-02-14 DOI: 10.1080/16066359.2023.2178645
Yen-Han Lee, Yen-Chang Chang, Yu-Chi Chi, M. Shelley
Abstract Background China is a large country with substantial urban-rural disparity. With the increasing concerns related to the rapid growth of the older adult population and problems related to smoking and alcohol consumption, this study aims to examine the potential urban-rural disparity associated with nicotine or alcohol dependence among Chinese older adults. Methods We used three waves of the Chinese Longitudinal Healthy Longevity Survey and included older adults who were 65 years old or above (CLHLS; n = 18,207). The Heckman two-step selection procedure was applied to reduce potential selection bias. The first and the second steps of the Heckman two-step selection procedure all included multivariable logistic regressions. Results In the final study sample, approximately 8.1% and 4.0% of older adults reported nicotine and alcohol dependence, respectively. In the first step of the Heckman selection procedure, urban residents were less likely to become current smokers and alcohol users than rural residents (all p < .05). However, urban-rural disparity was not associated with either nicotine or alcohol dependence (all p > .05). Conclusions We did not observe the urban-rural disparity in nicotine and alcohol dependence among Chinese older adults. Chinese policymakers should continue to strengthen national policy to combat smoking and alcohol consumption, especially older adults.
背景中国是一个城乡差距较大的大国。随着老年人人口的快速增长以及与吸烟和酒精消费相关的问题越来越受到关注,本研究旨在研究中国老年人尼古丁或酒精依赖相关的潜在城乡差异。方法采用三波中国纵向健康寿命调查,纳入65岁及以上的老年人(CLHLS;n = 18,207)。采用Heckman两步选择程序来减少潜在的选择偏差。Heckman两步选择程序的第一步和第二步都包括多变量逻辑回归。结果在最后的研究样本中,大约8.1%和4.0%的老年人分别报告了尼古丁和酒精依赖。在Heckman选择程序的第一步中,城市居民成为吸烟者和酗酒者的可能性低于农村居民(均p . 0.05)。结论我们没有观察到中国老年人尼古丁和酒精依赖的城乡差异。中国的政策制定者应该继续加强国家政策,打击吸烟和饮酒,尤其是老年人。
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引用次数: 1
Evolution of the assertive community engagement model for peer recovery coaching informed by the assertive community treatment model 以自信社区治疗模式为基础的同伴康复辅导自信社区参与模式的演变
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-02-14 DOI: 10.1080/16066359.2023.2176847
Kaileigh A. Byrne, I. Pericot-Valverde, Margie L. Stevens, Trish Melling, Richelle E. Jones, A. Litwin
Abstract Peer recovery support services for Substance Use Disorder (SUD) are becoming increasingly more prevalent to support individuals in initiating and maintaining recovery. However, models that operationalize service delivery are lacking. Here we describe the Assertive Community Engagement (ACE) model, a new model that emphasizes personalization and peer recovery support with a social determinants of health focus. This article defines the tenets of the ACE model, provides evidence to support the model, and addresses applications of this model to different settings. We review literature on Assertive Community Treatment (ACT) programs and research using peer recovery coaching interventions to develop the ACE model tenets, implementation guidelines, and evidence in support of the model. The ACE model has ten core tenets for service delivery: (1) the target population is individuals with SUD; (2) peer recovery coach services as a single touchpoint; (3) service delivery relies on assertive engagement techniques; (4) comprehensive support services are provided; (5) services include long-term care; (6) community-based care is provided; (7) services have 24/7 crisis availability; (8) outcomes focus on both substance use reduction and quality of life improvements; (9) direct social support is provided; (10) services are personalized and flexible. Empirical evidence for the model includes evidence for increase engagement in treatment and other recovery support services, reduced substance use frequency, and decreased hospital utilization. The ACE model is a promising model of peer recovery support that deserves further investigation for improving substance use and quality of life outcomes.
物质使用障碍(SUD)的同伴康复支持服务越来越普遍,以支持个人开始和维持康复。然而,缺乏可操作的服务交付模型。在这里,我们描述了自信的社区参与(ACE)模型,这是一个新的模型,强调个性化和同伴康复支持与健康焦点的社会决定因素。本文定义了ACE模型的原则,提供了支持该模型的证据,并针对不同的设置介绍了该模型的应用程序。我们回顾了关于自信社区治疗(ACT)项目的文献和使用同伴康复指导干预的研究,以发展ACE模型的原则、实施指南和支持该模型的证据。ACE模式有十个核心服务原则:(1)目标人群是患有SUD的个人;(2)作为单一接触点的同伴康复教练服务;(3)服务提供依赖于自信的参与技巧;(4)提供全面的支持服务;(5)服务包括长期护理;(6)提供社区护理;(7)服务具有24/7危机可用性;(8)结果侧重于减少物质使用和改善生活质量;(9)提供直接的社会支持;(10)服务个性化、灵活性强。该模型的经验证据包括增加参与治疗和其他康复支持服务、减少物质使用频率和减少医院使用率的证据。ACE模式是一种有前途的同伴康复支持模式,值得进一步研究以改善物质使用和生活质量。
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引用次数: 0
Open data through Registered Reports can accelerate cumulative knowledge 通过注册报告开放数据可以加速知识的积累
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-02-14 DOI: 10.1080/16066359.2023.2176848
C. Pennington
The scientific ‘credibility revolution’ has, in many fields, ushered in fast-paced improvements to the way that research is conducted (Vazire 2018). Sparked by concerns regarding replication and reproducibility, open research practices including preprints, preregistration, Registered Reports, open materials, code, and data aim to change the research landscape by improving the robustness and credibility of findings (Pennington 2023). Peer Community In Registered Reports (PCI RR) is a new publishing platform that integrates all of these open science practices: researchers submit a Stage 1 Registered Report through a preprint server, and after undergoing peer-review and receiving in principle acceptance (IPA), this Stage 1 protocol is then preregistered. At Stage 2, researchers append their results and discussion to the approved protocol, along with open materials, code, and data and, upon acceptance, this final preprint is then ‘recommended’ to the research community (see Eder and Frings 2021). The aim of this modified review process is to mitigate biased research practices and publication processes and, in this respect, Registered Reports appear to be working (Chambers and Tzavella 2022). One benefit for authors submitting through the PCI RR publishing route is that they can chose to publish their work in any ‘PCI friendly’ journal without the need for additional peer review. Addiction Research & Theory is one such journal offering this publishing route, committing to accept Stage 2 manuscripts that have received a positive final recommendation through PCI RR that meet the journal’s scope and formatting requirements (see Pennington and Heim 2022). As Handling Editor, I am pleased to announce that ART has published its first Registered Report through this route. Karhulahti, Vahlo et al. (2022) assessed how ontologically diverse screening instruments for gaming-related health problems differ in identifying associated problem groups. In addition to championing the authors adherence to open science practices, the goal of this editorial is to document the value of open data that is promoted by the Registered Report publishing model. I believe strongly that it is important to document the early history of open science practices and researcher’s experiences as they navigate them, particularly to overcome some of the perceived barriers associated with them and to further encourage uptake (see Norris et al. 2022). Below I first highlight the research findings by Karhulahti and colleagues and the acceleration of recommended research directions that stemmed from this team’s adoption of open code and data, before outlining more generally the positive changes we are observing as a result of the scientific credibility revolution. In their Registered Report, Karhulahti et al. administered four central screening instruments (GAS7, IGDT10, GDT, and THL1) in gaming disorder measurement to a large, nationally representative sample of Finnish participants and showed
在许多领域,科学的“可信度革命”带来了研究方式的快速改进(Vazire 2018)。由于对复制和可重复性的担忧,包括预印本、预注册、注册报告、开放材料、代码和数据在内的开放研究实践旨在通过提高研究结果的稳健性和可信度来改变研究格局(Pennington 2023)。同行社区注册报告(PCI RR)是一个新的出版平台,它集成了所有这些开放科学实践:研究人员通过预印本服务器提交第一阶段注册报告,经过同行评审和原则上接受(IPA)后,该第一阶段协议将被预注册。在第二阶段,研究人员将他们的结果和讨论附加到批准的协议中,以及开放材料、代码和数据,在接受后,最终的预印本将被“推荐”给研究界(见Eder和Frings 2021)。这种修改后的审查过程的目的是减轻有偏见的研究实践和出版过程,在这方面,注册报告似乎是有效的(Chambers和Tzavella 2022)。通过PCI RR出版途径提交的作者的一个好处是,他们可以选择在任何“PCI友好”的期刊上发表他们的作品,而不需要额外的同行评议。《成瘾研究与理论》(Addiction Research & Theory)就是这样一家提供这种出版途径的期刊,承诺接受通过PCI RR获得积极最终推荐的第二阶段手稿,这些手稿符合期刊的范围和格式要求(见Pennington and Heim 2022)。作为负责编辑,我很高兴地宣布,ART已通过这一途径发表了第一份注册报告。Karhulahti, Vahlo等人(2022)评估了游戏相关健康问题的本体论不同筛查工具在识别相关问题群体方面的差异。除了支持作者坚持开放科学实践之外,这篇社论的目标是记录注册报告出版模式所促进的开放数据的价值。我坚信,记录开放科学实践的早期历史和研究人员的经验是很重要的,特别是为了克服与之相关的一些感知障碍,并进一步鼓励吸收(见Norris et al. 2022)。下面,我首先强调一下Karhulahti及其同事的研究成果,以及由于该团队采用开放代码和数据而加速推荐的研究方向,然后再概述我们正在观察到的科学可信度革命带来的更普遍的积极变化。在他们的注册报告中,Karhulahti等人对芬兰参与者进行了四种游戏障碍测量的中心筛查工具(GAS7, IGDT10, GDT和THL1),并显示这些工具揭示了不同的患病率和群体重叠的相当大的异质性。基于这些发现,他们认为,由于这些工具的基本本体多样性,它们可能在不同程度上测量不同的问题(或其他结构)。他们的文章最后建议研究人员(a)定义他们感兴趣的结构(例如,他们是在测量游戏障碍还是游戏相关问题),(b)为良好的结构有效性寻找证据,以确保准确的测量。通过在开放科学框架存储库上共享他们的代码、数据和材料,一个独立的研究团队能够遵循Karhulahti等人提出的这项研究的未来方向之一:使用基于项目的网络模型“绘制结构和/或仪器之间进一步的本体论差异和相似性”。Billieux和Fournier (2022a)使用原始研究中四个游戏障碍评估工具中的所有项目进行了这个探索性模型,以评估这些项目之间的潜在社区。该网络分析表明,所有项目之间的联系密度非常高,作者认为“这些工具并不可靠地区分,它们的内容非常重叠,因此测量的基本上是同质结构”(第1页)。尽管两个团队的发现不同,但作者一致认为,游戏障碍的筛查需要改进和协调其测量方法。此外,Billieux和Fournier强调了开放科学实践在推动累积科学发展方面的好处。Karhulahti, adamkovc等人(2022)随后再次使用网络分析重新分析了他们的数据,并给Billieux和Fournier写了一份回复。由于原始数据集包含了来自非游戏结构的测量,Karhulahti等人。
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引用次数: 1
Cryptocurrency trading, mental health and addiction: a qualitative analysis of reddit discussions 加密货币交易、心理健康和成瘾:对reddit讨论的定性分析
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-02-03 DOI: 10.1080/16066359.2023.2174259
Benjamin Johnson, D. Stjepanović, J. Leung, Tianze Sun, Gary C K Chan
Abstract Background: The volatility and 24/7 nature of the cryptocurrency market allows traders to engage in highly speculative trading patterns that closely resemble gambling. Considering its potential for addiction and economic loss, it is important to investigate the impact that cryptocurrency trading has on mental health. Therefore, we analyzed Reddit discussions regarding mental health, gambling, and addiction from members of the discussion board, r/cryptocurrency, during a recent downturn in the market. Method: We collected 1315 threads submitted to the subreddit r/cryptocurrency from January 3rd to February 4th 2022. A thematic analysis was employed, which included threads that discussed psychological wellbeing, mental health or gambling. Results: We thematically analyzed the content threads that discussed psychological wellbeing, mental health or gambling. Our analysis identified three main themes present in user discussion. Theme 1 (emotional state and mental health) captured users’ discussion on their wellbeing, mental health and emotional responses to the market downturn. Theme 2 (strategies for coping) examined coping strategies recommended by users to combat distress or trading urges. Theme 3 (likeness to gambling) captured a discussion on the relationship between cryptocurrency and gambling based on its fixating properties and risk profile. Conclusions: Reddit is a valuable resource for examining the experiences and attitudes of the cryptocurrency community. Discussion from users provided insight into the mental distress market downturns cause and strategies to help combat these. Our findings offer qualitative insights into the problems experienced by individuals who cryptocurrency trade and encourage further investigation into its relationship with mental health and addiction.
背景:加密货币市场的波动性和24/7的性质使交易者能够从事与赌博非常相似的高度投机交易模式。考虑到其潜在的成瘾和经济损失,调查加密货币交易对心理健康的影响是很重要的。因此,我们分析了Reddit讨论板r/cryptocurrency成员在最近市场低迷期间关于心理健康,赌博和成瘾的讨论。方法:我们收集了从2022年1月3日到2月4日提交到reddit r/cryptocurrency的1315个线程。采用了主题分析,其中包括讨论心理健康、心理健康或赌博的主题。结果:我们对讨论心理健康、心理健康或赌博的内容线程进行了主题分析。我们的分析确定了用户讨论中的三个主要主题。主题1(情绪状态和心理健康)收集了用户对他们的幸福感、心理健康和对市场低迷的情绪反应的讨论。主题2(应对策略)审查了用户建议的应对策略,以对抗痛苦或交易冲动。主题3(与赌博相似)根据其固定属性和风险概况,讨论了加密货币与赌博之间的关系。结论:Reddit是研究加密货币社区经验和态度的宝贵资源。用户的讨论提供了对市场低迷的心理困扰原因和帮助对抗这些问题的策略的见解。我们的研究结果为加密货币交易的个人所遇到的问题提供了定性的见解,并鼓励进一步调查其与心理健康和成瘾的关系。
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引用次数: 5
Commentary on Karhulahti et al. (2022): exploring gaming disorder from the harmful dysfunction analysis perspective Karhulahti et al.(2022):从有害功能障碍分析的角度探讨游戏障碍
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-02-02 DOI: 10.1080/16066359.2023.2173743
S. Amendola
I read with great interest the well-designed pre-registered study of Karhulahti et al. (2022). Their findings pose an important question regarding the ability of different selfreport instruments (Lemmens et al. 2009; Kir aly et al. 2017; Pontes et al. 2021) to converge in the identification of individuals with gaming disorder (GD) as shown by different prevalence rates and overlap of participants with GD. The authors concluded that “the scales of addictive gaming behaviors—standardly studied as a single construct—seem unable to identify mutual groups with shared problems” (p.9). The reply of Billieux et al. (2022) further discussed those results and, encouraged by and relying on the open science approach of Karhulahti et al. (2022), conducted a network analysis using all items of the instruments assessing GD and concluded “that the various GD measurement tools are not reliably distinct and that their content strongly overlaps” (p.2). Billieux et al. (2022) considered that all four instruments examine GD, despite doing so based on somewhat different approaches, criteria and, thus, item content (and response modality). Yet the authors (Billieux et al. 2022; Karhulahti et al. 2022) agreed on the need for improvements and harmonization in the assessment and screening of GD. This reply aims to apply Wakefield’s Harmful Dysfunction Analysis (HDA) (Wakefield 1992a, 1992b, 2013, 2015, 2020) to the study of GD to test whether it improves convergence in prevalence rates and identification of participants with GD as well as detects health differences between participants with GD and those without GD, using data and codes shared by Karhulahti et al. (2022) at https://osf.io/ v4cqd/. HDA may provide a useful framework for the assessment of addictive disorders (Wakefield and Schmitz 2014, 2015). According to HDA, mental disorders are harmful dysfunction: a “disorder requires both dysfunction – that is, failure of some mechanism to perform a function that it was biologically designed to perform [“when within an appropriate environment that matches the range of conditions for which it was selected” (Wakefield 2017b) (p. 60)] [... ] – and harm, where the dysfunction causes harm to the individual as judged by social values” (Wakefield 2017a) (p.40– 41). In the case of addictive disorders, dysfunctions may be caused by evolutionarily novel stimuli (e.g. technological creations) for which the brain and other biological systems were not designed (Wakefield 2017a) and that lead to failures of designed regulatory systems (Wakefield 2017b). The dysfunction that results from the novel input has been referred to as a dysfunction in self-regulation, a dysfunction of the desire/deliberation/choice system, a pathological degree of diminution of control (Wakefield 2009, 2013, 2017a, 2017b) or a motivational dysfunction (Wakefield 2018, 2020). Details on the methods of this secondary analysis are available at https://osf.io/kprj5/. In comparison to the findings of Karhulahti e
我怀着极大的兴趣阅读了Karhulahti et al.(2022)精心设计的预注册研究。他们的发现提出了一个关于不同的自我报告工具的能力的重要问题(Lemmens et al. 2009;Kir aly et al. 2017;Pontes et al. 2021)在游戏障碍(GD)个体的识别上趋于一致,这体现在不同的患病率和GD参与者的重叠上。作者总结道:“上瘾游戏行为的量表——通常作为一个单一的结构来研究——似乎无法识别出有共同问题的共同群体”(第9页)。Billieux等人(2022)的回复进一步讨论了这些结果,并在Karhulahti等人(2022)的开放科学方法的鼓励和依赖下,使用评估gdp的工具的所有项目进行了网络分析,并得出结论“各种gdp测量工具并不可靠地区分,它们的内容强烈重叠”(第2页)。Billieux等人(2022)认为所有四种工具都可以检查GD,尽管它们基于不同的方法、标准和项目内容(以及响应方式)。然而,作者(Billieux et al. 2022;Karhulahti等人(2022)同意需要改进和统一GD的评估和筛选。本回复旨在将Wakefield的有害功能障碍分析(HDA) (Wakefield 1992a, 1992b, 2013, 2015, 2020)应用于GD的研究,以测试它是否提高了GD参与者的患病率和识别的趋同性,并检测GD参与者与未GD参与者之间的健康差异,使用Karhulahti等人(2022)在https://osf.io/ v4cqd/上共享的数据和代码。HDA可以为成瘾障碍的评估提供一个有用的框架(Wakefield and Schmitz 2014, 2015)。根据HDA,精神障碍是有害的功能障碍:一种“障碍需要两种功能障碍——也就是说,某些机制无法执行生物学设计的功能[当处于与选择的条件范围相匹配的适当环境中”(Wakefield 2017b)(第60页)][…]——和伤害,即功能障碍会对个人造成伤害,这是由社会价值观判断的”(Wakefield 2017a)(第40 - 41页)。在成瘾性疾病的情况下,功能障碍可能是由进化上新的刺激(例如,技术创造)引起的,而大脑和其他生物系统并没有为这些刺激而设计(Wakefield 2017a),这导致了设计好的调节系统的失败(Wakefield 2017b)。由新输入导致的功能障碍被称为自我调节功能障碍,欲望/考虑/选择系统功能障碍,控制的病理程度减少(Wakefield 2009, 2013, 2017a, 2017b)或动机功能障碍(Wakefield 2018, 2020)。关于这种二次分析方法的详细信息可在https://osf.io/kprj5/上找到。与Karhulahti等人(2022)的研究结果相比,基于HDA的GD患病率略有增加(见补充材料),因为需要认可至少两个标准:功能障碍和危害。工具趋同基本上不受影响,这进一步支持了之前关于每种工具所依赖的不同方法和标准(例如项目内容/配方)、响应方式和研究人群在影响GD检测方面的作用的解释(Jo et al. 2019;Higuchi et al. 2021;Billieux et al. 2022;Yen et al. 2022)。事实上,根据ICD-11标准和GDT项目,对游戏的控制受损(以及其负面后果)是GD的核心;而根据DSM-5和IGDT10, GD是在更广泛的成瘾框架下研究的,在这个框架中,控制受损或失去与经典的依赖症状一起被探讨。与最初的研究结果一致,采用HDA观点的组间差异结果证实,基于GDT和GAS7(而不是IGDT10)的GD组报告的心理健康状况比一般人群差。此外,与基于IGDT10的GD组相比,基于GDT的GD组表现出更差的心理健康状况。总之,这一次要分析,尽管有其局限性(补充材料),鼓励研究人员和临床医生考虑HDA作为一种有希望的方法来识别由于功能障碍和伤害而最需要支持的GD患者。未来的研究可以检验HDA标准是否可以通过减少假阴性来帮助提高GD的检测
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引用次数: 2
An examination of peer recovery support specialist work roles and activities within the recovery ecosystems of Central Appalachia 对阿巴拉契亚中部恢复生态系统内同伴恢复支持专家工作角色和活动的审查
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-01-04 DOI: 10.1080/16066359.2022.2163387
Angela Hagaman, Kelly Foster, Morgan Kidd, Rob Pack
Abstract Background Substance use/misuse is a leading public health concern in the United States. In the midst of the COVID-19 pandemic, drug-related deaths exceeded 100,000 in a 12-month period for the first time in history. There is currently an urgent need for empirical evidence to inform community leaders and policy makers on the benefits of recovery-informed approaches to SUD prevention and treatment. The peer recovery support specialist (PRSS) is a certified professional who self-identifies as being in recovery from a substance use disorder (SUD), mental illness, or co-occurring disorder and may play an important role in positively affecting outcomes for persons with SUD. However, the evidence for PRSS services is limited in part due to methods that are ill-fitted to measure the dynamic process of recovery across time and within a complex service continuum. Methods This sequential exploratory mixed-methods study queried PRSS in five Central Appalachian states regarding their work roles and activities within the context of regional service networks also known as ‘recovery ecosystems.’ Results 565 Central Appalachian PRSS respondents indicate that they frequently provide emotional support in a broad array of regional service settings but have few professional advancement opportunities. PRSS also report that their role is frequently misunderstood. Conclusions This study expands the existing literature providing information about training, remuneration, job satisfaction, work roles and activities within the context of existing recovery ecosystems. Inclusion of peer recovery support specialist’s perspectives improved measurement of peer service delivery and should be considered when working with this vital recovery-supporting workforce.
物质使用/滥用是美国主要的公共卫生问题。在2019冠状病毒病大流行期间,与毒品有关的死亡人数在12个月内首次超过10万人。目前迫切需要经验证据,以告知社区领导人和政策制定者康复知情方法对SUD预防和治疗的好处。同伴康复支持专家(PRSS)是一名经过认证的专业人士,他们自我认定正在从物质使用障碍(SUD)、精神疾病或共患障碍中康复,并可能在积极影响SUD患者的结果方面发挥重要作用。然而,PRSS服务的证据有限,部分原因是由于方法不适合测量跨时间和复杂服务连续体内的动态恢复过程。该顺序探索性混合方法研究询问了阿巴拉契亚中部五个州的PRSS在区域服务网络(也称为“恢复生态系统”)中的工作角色和活动。565名阿巴拉契亚中部地区的PRSS受访者表示,他们经常在广泛的区域服务环境中提供情感支持,但很少有职业发展机会。减贫战略报告还指出,它们的作用经常被误解。本研究扩展了现有文献,提供了在现有恢复生态系统背景下的培训、薪酬、工作满意度、工作角色和活动的信息。纳入同伴恢复支持专家的观点可以改善对同伴服务提供的衡量,在与这些重要的恢复支持工作人员一起工作时应考虑这一点。
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引用次数: 1
Access to safer injection equipment among people who inject drugs utilizing medical services in an urban hospital in the United States 在美国城市医院使用医疗服务的注射吸毒者获得更安全的注射设备的情况
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-01-04 DOI: 10.1080/16066359.2022.2162889
D. Applewhite, S. Regan, K. Donelan, Wendy L. Macias-Konstantopoulos, Dawn Williamson, Laura G. Kehoe, C. Shaw, S. Wakeman
Abstract Injection drug use carries significant risks for injury and infection, particularly when injection supplies are reused or shared. Syringe service programs and pharmacy nonprescription sale of syringes minimize this risk by promoting access to supplies. This study aimed to characterize how individuals accessing medical care obtain supplies and the impact of perceived barriers to accessing safer injection supplies. One hundred and twenty participants reporting past seven-day injection drug use were recruited from a large urban academic medical center. Participants completed a survey about their injection drug use practices, access to injection supplies, as well as barriers to accessing supplies. Most participants (68%) reported obtaining syringes from multiple sources over the past 3 months, most commonly syringe service programs (78%) or a pharmacy (68%). Few (3%) reported obtaining supplies from medical settings. Participants who found syringes easy to obtain were less likely to report reusing a syringe >10 times (25% vs. 81%, p < .001). More participants were comfortable obtaining syringes through syringe service programs (89%) than nonprescription sale of syringes (60%, p = .001). Perceiving syringe service programs as not convenient or not comfortable reduced the odds of obtaining syringes there by 90% (p < .001) and 88% (p < .003), respectively. Perceiving pharmacies as not comfortable or not affordable reduced the odds of obtaining syringes there by 82% (p < .001) and 75% (p < .002), respectively. Even in regions with legalized syringe service programs and nonprescription sale of syringes, barriers to accessing safer injection supplies remain, and may be partially addressed by expanding syringe service program hours and locations, addressing cost of nonprescription sale of syringes, pharmacy staff training, and expansion of injection supply distribution in medical settings.
摘要注射吸毒具有重大的伤害和感染风险,特别是当注射用品被重复使用或共用时。注射器服务规划和药房非处方注射器销售通过促进获得供应品来最大限度地减少这种风险。本研究旨在描述获得医疗服务的个人如何获得供应,以及感知障碍对获得更安全注射供应的影响。从一个大型城市学术医疗中心招募了120名报告过去7天注射药物使用情况的参与者。参与者完成了一项关于其注射药物使用做法、获得注射用品以及获得用品的障碍的调查。大多数参与者(68%)报告在过去3个月内从多个来源获得注射器,最常见的是注射器服务项目(78%)或药房(68%)。很少有人(3%)报告从医疗机构获得供应。发现注射器容易获得的参与者不太可能报告重复使用注射器10次(25%对81%,p < .001)。通过注射器服务项目获得注射器的参与者(89%)多于非处方销售注射器的参与者(60%,p = .001)。认为注射器服务项目不方便或不舒适的患者获得注射器的几率分别降低了90% (p < 0.001)和88% (p < 0.003)。认为药店不舒适或负担不起的人在那里获得注射器的几率分别降低了82% (p < 0.001)和75% (p < 0.001)。即使在有合法注射器服务计划和非处方注射器销售的地区,获得更安全注射用品的障碍仍然存在,这可以通过扩大注射器服务计划的时间和地点、解决非处方注射器销售的成本、药房工作人员培训和扩大医疗机构的注射供应分配来部分解决。
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引用次数: 0
A systematic review of actors, actions, and outcomes of community-based efforts to prevent or reduce methamphetamine use. 对以社区为基础的预防或减少甲基苯丙胺使用工作的行动者、行动和成果进行系统审查
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-01-01 Epub Date: 2023-01-17 DOI: 10.1080/16066359.2023.2167982
Charles T Orjiakor, John Eze, Methodius Chinweoke, Michael Ezenwa, Ijeoma Orjiakor, Obinna Onwujekwe, Joseph Palamar

Background: There has been an increase in methamphetamine use across the globe, despite widespread control of the drug, prevention, and treatment. Community-based approaches have proven effective in tackling diverse health-related challenges including substance use; however, little is known regarding community programs targeting methamphetamine use. We conducted a systematic literature review on community programs aimed at tackling the use of methamphetamine across the globe.

Method: Relevant literature from peer-reviewed and gray literature sources were systematically identified. A grid template was used to extract and synthesize findings from retrieved literature regarding themes of actors, actions, and outcomes related to identified programs.

Results: A total of 19 documents met our inclusion criteria. Some of the dominant actors in efforts to reduce methamphetamine use in communities were local councils, drug enforcement units, influential persons in the community, people who use or had used methamphetamine, business corporations, and already-existing health promoting platforms. Actions taken were typically education/awareness/information campaigns. Drug enforcement agencies appeared to make little gains when acting alone, and appeared to drive dealers and users underground. Many of the efforts made at the community level were alluded to be beneficial; however, it was difficult to quantify the impact of programs. Community-level efforts also tended to cascade to other drugs.

Conclusion: Community-based actors and actions are diverse and critical to the prevention of methamphetamine use. There is a need to better coordinate and integrate different actors and interventions so that outcomes can be better monitored and evaluated for greater effectiveness in reducing methamphetamine use.

背景:尽管对毒品进行了广泛的控制、预防和治疗,但全球范围内甲基苯丙胺的使用仍在增加。事实证明,以社区为基础的办法在应对包括药物使用在内的各种与健康有关的挑战方面是有效的;然而,人们对针对甲基苯丙胺使用的社区项目知之甚少。我们对旨在解决全球甲基安非他明使用问题的社区项目进行了系统的文献回顾。方法系统检索同行评议文献和灰色文献。使用网格模板从检索到的文献中提取和综合与确定的项目相关的参与者、行动和结果的主题的发现。结果19篇文献符合纳入标准。在减少社区使用甲基苯丙胺的努力中,一些主要行为者是地方议会、禁毒执法单位、社区中有影响力的人、使用或曾经使用过甲基苯丙胺的人、商业公司和现有的健康促进平台。所采取的行动通常是教育/提高认识/宣传运动。禁毒执法机构在单独行动时似乎收效甚微,而且似乎迫使毒贩和吸毒者转入地下。有人提到在社区一级所作的许多努力是有益的;然而,很难量化项目的影响。社区层面的努力也倾向于扩展到其他药物。结论基于社区的行为者和行动多种多样,对预防甲基苯丙胺使用至关重要。有必要更好地协调和整合不同的行为者和干预措施,以便更好地监测和评价结果,从而更有效地减少甲基苯丙胺的使用。
{"title":"A systematic review of actors, actions, and outcomes of community-based efforts to prevent or reduce methamphetamine use.","authors":"Charles T Orjiakor, John Eze, Methodius Chinweoke, Michael Ezenwa, Ijeoma Orjiakor, Obinna Onwujekwe, Joseph Palamar","doi":"10.1080/16066359.2023.2167982","DOIUrl":"10.1080/16066359.2023.2167982","url":null,"abstract":"<p><strong>Background: </strong>There has been an increase in methamphetamine use across the globe, despite widespread control of the drug, prevention, and treatment. Community-based approaches have proven effective in tackling diverse health-related challenges including substance use; however, little is known regarding community programs targeting methamphetamine use. We conducted a systematic literature review on community programs aimed at tackling the use of methamphetamine across the globe.</p><p><strong>Method: </strong>Relevant literature from peer-reviewed and gray literature sources were systematically identified. A grid template was used to extract and synthesize findings from retrieved literature regarding themes of actors, actions, and outcomes related to identified programs.</p><p><strong>Results: </strong>A total of 19 documents met our inclusion criteria. Some of the dominant actors in efforts to reduce methamphetamine use in communities were local councils, drug enforcement units, influential persons in the community, people who use or had used methamphetamine, business corporations, and already-existing health promoting platforms. Actions taken were typically education/awareness/information campaigns. Drug enforcement agencies appeared to make little gains when acting alone, and appeared to drive dealers and users underground. Many of the efforts made at the community level were alluded to be beneficial; however, it was difficult to quantify the impact of programs. Community-level efforts also tended to cascade to other drugs.</p><p><strong>Conclusion: </strong>Community-based actors and actions are diverse and critical to the prevention of methamphetamine use. There is a need to better coordinate and integrate different actors and interventions so that outcomes can be better monitored and evaluated for greater effectiveness in reducing methamphetamine use.</p>","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10659144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81458866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
"A lot better than it used to be": A qualitative study of adolescents' dynamic social recovery capital. "比以前好多了":青少年动态社会恢复资本的定性研究。
IF 1.9 3区 医学 Q2 SOCIAL ISSUES Pub Date : 2023-01-01 Epub Date: 2022-08-29 DOI: 10.1080/16066359.2022.2114076
Jordan Jurinsky, Kiefer Cowie, Sophia Blyth, Emily A Hennessy

Background: Substance use recovery is a dynamic process for youth, and social networks are tied to the recovery process. The Recovery Capital for Adolescents Model (RCAM) situates the resources accessible through social networks - social recovery capital (SRC) - in a larger framework of developmentally-informed recovery resources. This study aims to investigate the social network experiences among recovering youth enrolled in a recovery high school to understand how social influences help to build, or act as barriers to building, recovery capital.

Methods: To gain insight into these networks, Social Identity Maps and semi-structured interviews were conducted with ten youth ages 17-19 years (80% male; 50% non-Hispanic White). Study visits were conducted virtually, recorded, transcribed, and thematically analyzed using the RCAM as an organizing framework.

Results: Results supported that adolescent social networks play a unique and multifaceted role in the recovery journey. Three key nuances emerged: change permeates adolescent networks throughout the treatment and recovery process; shared substance use history and non-stigmatizing attitudes play a key role in connecting with others; and SRC is interconnected with human, financial, and community recovery capital.

Conclusions: With adolescent recovery receiving increased attention from policy makers, practitioners, and researchers, the RCAM may be a useful way to contextualize available resources. Findings suggest SRC as a crucial, yet complex component intertwined with all other forms of recovery capital.

背景:对于青少年来说,药物使用康复是一个动态的过程,而社会网络与康复过程息息相关。青少年康复资本模型(Recovery Capital for Adolescents Model,RCAM)将可通过社会网络获得的资源--社会康复资本(Social recovery capital,SRC)--置于一个更大的以发展为基础的康复资源框架中。本研究旨在调查就读于康复高中的康复青少年的社会网络经验,以了解社会影响如何帮助建立康复资本或成为建立康复资本的障碍:为了深入了解这些网络,我们对十名 17-19 岁的青少年(80% 为男性;50% 为非西班牙裔白人)进行了社会身份图和半结构化访谈。研究访问以虚拟方式进行,使用 RCAM 作为组织框架进行记录、转录和主题分析:结果:研究结果表明,青少年社交网络在康复过程中发挥着独特的、多方面的作用。结果表明,青少年社交网络在康复过程中发挥着独特而多方面的作用。其中有三个关键的细微差别:变化贯穿于青少年网络的整个治疗和康复过程;共同的药物使用历史和不轻蔑的态度在与他人建立联系方面发挥着关键作用;SRC 与人力、财力和社区康复资本相互关联:随着青少年康复越来越受到政策制定者、从业人员和研究人员的关注,RCAM 可能会成为一种有用的方法,将可用资源具体化。研究结果表明,青少年康复资本是一个重要而又复杂的组成部分,与所有其他形式的康复资本交织在一起。
{"title":"\"A lot better than it used to be\": A qualitative study of adolescents' dynamic social recovery capital.","authors":"Jordan Jurinsky, Kiefer Cowie, Sophia Blyth, Emily A Hennessy","doi":"10.1080/16066359.2022.2114076","DOIUrl":"10.1080/16066359.2022.2114076","url":null,"abstract":"<p><strong>Background: </strong>Substance use recovery is a dynamic process for youth, and social networks are tied to the recovery process. The <i>Recovery Capital for Adolescents Model</i> (RCAM) situates the resources accessible through social networks - social recovery capital (SRC) - in a larger framework of developmentally-informed recovery resources. This study aims to investigate the social network experiences among recovering youth enrolled in a recovery high school to understand how social influences help to build, or act as barriers to building, recovery capital.</p><p><strong>Methods: </strong>To gain insight into these networks, Social Identity Maps and semi-structured interviews were conducted with ten youth ages 17-19 years (80% male; 50% non-Hispanic White). Study visits were conducted virtually, recorded, transcribed, and thematically analyzed using the RCAM as an organizing framework.</p><p><strong>Results: </strong>Results supported that adolescent social networks play a unique and multifaceted role in the recovery journey. Three key nuances emerged: change permeates adolescent networks throughout the treatment and recovery process; shared substance use history and non-stigmatizing attitudes play a key role in connecting with others; and SRC is interconnected with human, financial, and community recovery capital.</p><p><strong>Conclusions: </strong>With adolescent recovery receiving increased attention from policy makers, practitioners, and researchers, the <i>RCAM</i> may be a useful way to contextualize available resources. Findings suggest SRC as a crucial, yet complex component intertwined with all other forms of recovery capital.</p>","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9336138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Resilience profiles predict polysubstance use in adolescents with a history of childhood maltreatment. 复原力特征可预测有童年虐待史的青少年使用多种物质的情况。
IF 2.9 3区 医学 Q2 Medicine Pub Date : 2023-01-01 Epub Date: 2022-10-18 DOI: 10.1080/16066359.2022.2132237
Giorgia Picci, Ashley N Linden-Carmichael, Emma J Rose

Background: Childhood maltreatment (CM) can be an impediment to normative development and consistently predicts increased risk for substance misuse and polysubstance use (polySU). Yet, a subset of individuals who experience CM exhibit successful adaptations across the lifespan. Although there is an expansive literature on socioemotional and cognitive protective factors that mitigate impacts of CM, less is known about other, intra-individual resilience-promoting factors (e.g., positive future orientation) known to assuage high-risk SU patterns during adolescence.

Method: This study examined heterogeneity in individual-level resilience characteristics in maltreated youth as it related to CM characteristics and SU patterns during adolescence. Participants included maltreated youth from the longitudinal LONGSCAN sample (N=355; 181 females). Latent Profile Analysis was used to identify subgroups of CM-exposed individuals based on 5 resilience indicator variables (i.e., commitment to goals, engaging in demanding activities, self-reliance, positive future orientation, and externalizing behaviors). Tests for differences in SU patterns and CM characteristics between the resultant profiles were performed.

Results: Data models revealed 3 latent profiles based on participants' resilience traits (i.e., Low Resilience, Average Resilience, and High Resilience). There were no profile differences on the basis of CM characteristics. Those in the High Resilience profile were less likely to engage in polySU compared to the Average Resilience profile.

Implications: These findings highlight the promise of individual-level resilience factors that are not necessarily dependent upon caregiver or environmental inputs as protective against polySU following CM. This work represents a promising avenue for future preventative intervention efforts targeting emergent SU behaviors in high-risk youth.

背景:童年虐待(CM)可能会阻碍儿童的正常发展,并一直预示着药物滥用和多种物质使用(polySU)风险的增加。然而,在经历过儿童虐待的人中,有一部分人在整个生命周期中都表现出了成功的适应能力。尽管有大量文献介绍了可减轻CM影响的社会情感和认知保护因素,但人们对其他可缓解青春期高风险SU模式的个体内部复原力促进因素(如积极的未来取向)却知之甚少:本研究考察了受虐待青少年个体抗逆力特征的异质性,因为这与青少年时期的CM特征和SU模式有关。参与者包括来自LONGSCAN纵向样本的受虐待青少年(人数=355;181名女性)。研究人员采用潜在特征分析法,根据 5 个复原力指标变量(即对目标的承诺、参与高要求的活动、自立、积极的未来取向和外化行为)识别出受虐待青少年的亚组。结果显示,数据模型揭示了 3 个潜在特征,分别是 "SU"、"CM "和 "SU":数据模型显示了基于参与者复原力特质的三个潜在特征(即低复原力、一般复原力和高复原力)。在 CM 特征基础上没有特征差异。与抗逆能力一般的人相比,抗逆能力强的人更少参与 polySU:这些研究结果突出表明,个人层面的抗逆力因素(不一定依赖于护理人员或环境因素)有望保护儿童在接受中医治疗后不发生多发性SU。这项研究为未来针对高危青少年新出现的 SU 行为的预防性干预工作提供了一个很有前景的途径。
{"title":"Resilience profiles predict polysubstance use in adolescents with a history of childhood maltreatment.","authors":"Giorgia Picci, Ashley N Linden-Carmichael, Emma J Rose","doi":"10.1080/16066359.2022.2132237","DOIUrl":"10.1080/16066359.2022.2132237","url":null,"abstract":"<p><strong>Background: </strong>Childhood maltreatment (CM) can be an impediment to normative development and consistently predicts increased risk for substance misuse and polysubstance use (polySU). Yet, a subset of individuals who experience CM exhibit successful adaptations across the lifespan. Although there is an expansive literature on socioemotional and cognitive protective factors that mitigate impacts of CM, less is known about other, intra-individual resilience-promoting factors (e.g., positive future orientation) known to assuage high-risk SU patterns during adolescence.</p><p><strong>Method: </strong>This study examined heterogeneity in individual-level resilience characteristics in maltreated youth as it related to CM characteristics and SU patterns during adolescence. Participants included maltreated youth from the longitudinal LONGSCAN sample (<i>N</i>=355; 181 females). Latent Profile Analysis was used to identify subgroups of CM-exposed individuals based on 5 resilience indicator variables (i.e., commitment to goals, engaging in demanding activities, self-reliance, positive future orientation, and externalizing behaviors). Tests for differences in SU patterns and CM characteristics between the resultant profiles were performed.</p><p><strong>Results: </strong>Data models revealed 3 latent profiles based on participants' resilience traits (i.e., Low Resilience, Average Resilience, and High Resilience). There were no profile differences on the basis of CM characteristics. Those in the High Resilience profile were less likely to engage in polySU compared to the Average Resilience profile.</p><p><strong>Implications: </strong>These findings highlight the promise of individual-level resilience factors that are not necessarily dependent upon caregiver or environmental inputs as protective against polySU following CM. This work represents a promising avenue for future preventative intervention efforts targeting emergent SU behaviors in high-risk youth.</p>","PeriodicalId":47851,"journal":{"name":"Addiction Research & Theory","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9163077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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