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Telehealth counseling plus mHealth intervention for cannabis use in emerging adults: Development and a remote open pilot trial 针对新兴成年人使用大麻的远程保健咨询加移动保健干预:开发和远程开放试点试验。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-08-05 DOI: 10.1016/j.josat.2024.209472

Introduction

To improve treatment access for emerging adults with cannabis use disorder (CUD), we developed a telehealth counseling-plus-mHealth intervention and remotely conducted a single-arm open pilot study to preliminarily evaluate its feasibility in primary care.

Methods

A multidisciplinary team including youth developed the intervention using the structure of the MOMENT intervention: two weekly counselor-delivered Motivational Enhancement Therapy (MET) sessions, then two weeks of smartphone surveys (4 prompted/day) querying socioemotional contexts and cannabis use, with pre-programmed messages on report of personal triggers for use (Ecological Momentary Intervention; EMI). The team adapted the MET for virtual delivery; created material to enhance self-reflection, plan behavior change, and anticipate withdrawal; shortened the sessions; and tested them with five youth actors. EMI messages were created to align with the MET and programmed to minimize repetition. Patients aged 18–25 using recreational cannabis ≥3 days/week were recruited from an urban medical practice. Participants received the intervention and responded to surveys on satisfaction and burden. At baseline, post-intervention, and two months, participants reported behavior change readiness/importance/confidence and cannabis use. EMI engagement was calculated as % days with ≥1 phone survey completed.

Results

Fourteen eligible patients enrolled; 79 % used cannabis daily/near-daily and 100 % reported use problems. All completed both MET sessions and responded to EMI surveys. All agreed/strongly agreed that they felt respected by, comfortable with, and trust for the counselor and that the activities and discussion were helpful; all rated the MET sessions as very good/excellent. Technical issues were infrequent and minor. Median EMI engagement was 100 % (≥1 report/day) in each week. Behavior change confidence was higher post-intervention and importance and confidence were higher at two months vs. baseline. By two months, 11 participants had started to change cannabis use; median percent days of use in the past 30 days declined by 27 % and average times of use per use day declined by 28 %. All rated intervention quality as good, very good, or excellent.

Conclusions

Emerging adults were highly satisfied and engaged with a telehealth MET counseling-plus-mHealth EMI intervention for cannabis use and reported higher motivation to change cannabis use and less use post-intervention and at 2-month follow-up.

简介:为了改善患有大麻使用障碍(CUD)的新成人的治疗机会,我们开发了一种远程医疗咨询加移动医疗干预措施,并远程开展了一项单臂开放式试点研究,以初步评估其在初级保健中的可行性:一个包括青少年在内的多学科团队利用 MOMENT 干预的结构开发了该干预方法:每周两次由心理咨询师提供的动机增强疗法(MET)课程,然后进行为期两周的智能手机调查(每天 4 次提示),调查内容包括社会情感背景和大麻使用情况,以及关于报告个人使用触发因素的预设信息(生态瞬间干预;EMI)。研究小组对 MET 进行了调整,使其适用于虚拟交付;制作了材料以加强自我反思、计划行为改变和预测戒断;缩短了课程;并与五名青年演员进行了测试。制作了与 MET 一致的 EMI 信息,并进行了编程,以尽量减少重复。从一家城市医疗机构招募了 18-25 岁、每周使用娱乐性大麻≥3 天的患者。参与者接受了干预,并对满意度和负担进行了调查。在基线、干预后和两个月内,参与者报告了行为改变的准备度/重要性/自信心和大麻使用情况。EMI 参与度以完成电话调查≥1 次的天数百分比计算:14 名符合条件的患者加入了 EMI;79% 的患者每天/接近每天使用大麻,100% 的患者报告了使用问题。所有患者都完成了两次 MET 课程,并对 EMI 调查做出了回应。所有人都同意/非常同意他们感到受到咨询师的尊重、与咨询师相处舒适并信任咨询师,而且活动和讨论很有帮助;所有人都将 MET 课程评为 "非常好/优秀"。技术问题不常见,也不严重。每周 EMI 参与度的中位数为 100%(≥1 次报告/天)。干预后对行为改变的信心更高,与基线相比,两个月后的重要性和信心更高。到两个月时,11 名参与者已开始改变使用大麻的行为;过去 30 天内使用大麻的天数百分比中位数下降了 27%,平均每天使用次数下降了 28%。所有参与者都将干预质量评为 "好"、"很好 "或 "优":新兴成年人对针对大麻使用的远程医疗 MET 咨询加移动医疗 EMI 干预非常满意,并且参与度很高,在干预后和 2 个月的随访中,他们表示改变大麻使用方式的动力更强,使用次数更少。
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引用次数: 0
Dissemination of health content through social networks: YouTube and opioid use disorders 通过社交网络传播健康内容:YouTube 与阿片类药物使用障碍。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-08-05 DOI: 10.1016/j.josat.2024.209475

Introduction

Most Americans now access social media platforms, including YouTube, to obtain health information. However, few studies have evaluated the quality of YouTube content related to opioid use disorder (OUD), including medications for OUD (MOUD; buprenorphine) and harm reduction resources (e.g., naloxone). The purpose of this cross-sectional analysis was to assess the quality, accuracy, and reliability of MOUD and harm reduction-related video content available on YouTube.

Methods

The study team conducted a YouTube search between June 2022 and July 2022 using key words related to MOUD and harm reduction content (e.g., “suboxone,” “methadone,” “Narcan”). The 5 most viewed videos from each search term were analyzed for quality (i.e., Global Quality Scale; GQS), accuracy (i.e., JAMA Benchmark Criteria), and reliability (i.e., DISCERN). Videos that were non-English, duplicate, or that did not directly mention OUD, MOUD, or harm reduction were excluded from the review (N = 6).

Results

YouTube videos (N = 70) were mostly produced by medical professionals (27.1 %), independent nonmedical users (21.4 %; e.g., vloggers, individuals documenting their experiences), medical organizations (17.1 %; e.g., hospitals, treatment programs), and/or media (14.3 %; e.g., news agencies). The target audience was primarily the general public (65.7 %), people who use opioids (20.0 %), and healthcare providers (10.0 %). Videos containing MOUD content (N = 64, 61.4 %) mostly focused on suboxone (25.0 %), methadone (23.4 %), Sublocade (14.1 %), and subutex/buprenorphine (14.1 %). The median quality score was 2 based on the GQS with 3 videos receiving the highest quality rating (5). Two videos were highly rated for accuracy per all three JAMA Benchmark criteria. Videos produced by nonmedical educational channels had the highest overall reliability scores on the DISCERN criteria (median 4), followed by medical professionals (median 3), and medical organizations (median 2.5).

Conclusion

The overall quality, accuracy, and reliability of MOUD and harm reduction related content posted on YouTube is poor. The lack of evidence-based content posted on YouTube reinforces the need for public health expert involvement in disseminating guideline-based content on social media.

导言:现在,大多数美国人都会访问包括 YouTube 在内的社交媒体平台来获取健康信息。然而,很少有研究对YouTube上与阿片类药物使用障碍(OUD)相关内容的质量进行评估,包括治疗OUD的药物(MOUD;丁丙诺啡)和减低伤害资源(如纳洛酮)。这项横向分析的目的是评估 YouTube 上与 MOUD 和减低伤害相关的视频内容的质量、准确性和可靠性:研究小组在 2022 年 6 月至 2022 年 7 月期间使用与 MOUD 和减低伤害内容相关的关键词(如 "suboxone"、"methadone"、"Narcan")在 YouTube 上进行了搜索。对每个搜索词中浏览量最高的 5 个视频进行了质量(即全球质量量表;GQS)、准确性(即 JAMA 基准标准)和可靠性(即 DISCERN)分析。非英语、重复或未直接提及 OUD、MOUD 或减低伤害的视频被排除在审查范围之外(N = 6):YouTube视频(N = 70)大多由医疗专业人士(27.1%)、独立的非医疗用户(21.4%;如vlogger、记录自己经历的个人)、医疗机构(17.1%;如医院、治疗项目)和/或媒体(14.3%;如新闻机构)制作。目标受众主要是普通公众(65.7%)、阿片类药物使用者(20.0%)和医疗服务提供者(10.0%)。包含 MOUD 内容的视频(N = 64,61.4%)主要集中在亚酮(25.0%)、美沙酮(23.4%)、Sublocade(14.1%)和亚丁酸/丁丙诺啡(14.1%)。根据 GQS,质量评分的中位数为 2 分,其中 3 个视频的质量评分最高(5 分)。根据《美国医学会杂志》的三项基准标准,有两部视频的准确性得到了高度评价。非医学教育频道制作的视频在 DISCERN 标准上的总体可靠性得分最高(中位数为 4 分),其次是医学专业人员(中位数为 3 分)和医疗机构(中位数为 2.5 分):YouTube上发布的MOUD和减低伤害相关内容的总体质量、准确性和可靠性较差。YouTube上发布的内容缺乏循证医学证据,这说明在社交媒体上传播基于指南的内容需要公共卫生专家的参与。
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引用次数: 0
“A lot of moving parts”: Recovery home challenges linking and housing individuals with criminal legal system involvement "许多移动部件":康复之家在联系和安置涉及刑事法律系统的个人方面面临挑战。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-08-04 DOI: 10.1016/j.josat.2024.209473

Introduction

There are high rates of substance use disorder (SUD) among people released from carceral settings and, upon release, many of these people also face unstable housing situations, posing challenges to connecting with resources to facilitate SUD recovery. Recovery homes provide a temporary sober living environment for those seeking both SUD recovery and transition back to the community after carceral release. However, successful recovery home placement for this population can prove difficult, and there is a need for research to identify ways to overcome them.

Methods

The current qualitative study seeks to understand barriers to recovery home access for people leaving carceral settings and identify potential best practices for overcoming these barriers from the perspective of recovery home directors. The study conducted semi-structured interviews at two data collection points with eight recovery home directors from sites participating in a housing linkage and placement intervention pilot. The research team used qualitative software to identify and organize directors' experiences and practices in housing and supporting this population.

Results

Recovery home directors identified significant barriers to linkage from carceral settings, including difficulties communicating and coordinating placement with potential residents while still incarcerated. Interviews also revealed approaches recovery home directors take to improve recovery home placement, such as sharing information and resources with carceral settings prior to release and helping residents avoid reincarceration by managing relationships with court agents and parole.

Conclusion

Recovery resident directors have considerable insight into the most significant placement challenges faced by recovery homes upon carceral release as well as experience with potential solutions for overcoming them. Directors can be the key to direct seamless support and continuity of care for criminal legal system involved individuals through coordination with jails, prisons, and other community resources. Directors can also play a significant role in the successful completion of probation and parole by helping residents avoid further issues with the legal system. These directors view working cooperatively with residents as an effective approach to ensuring clients adhere to court orders and are successful in recovery and reentry.

导言:从监禁场所释放出来的人中,药物使用失调症(SUD)的发病率很高,而且这些人中的许多人在获释后还面临着不稳定的住房状况,这给他们与促进药物使用失调症康复的资源建立联系带来了挑战。康复之家为那些寻求药物滥用康复和刑满释放后重返社区的人提供了一个临时的清醒生活环境。然而,要成功安置这些人群入住康复之家却很困难,因此有必要开展研究,找出克服这些困难的方法:本定性研究旨在了解离开监禁环境的人进入康复之家的障碍,并从康复之家主任的角度找出克服这些障碍的潜在最佳做法。本研究在两个数据收集点对参与住房联系和安置干预试点项目的八个康复之家的负责人进行了半结构化访谈。研究小组使用定性软件来识别和整理主任们在安置和支持该人群方面的经验和做法:结果:康复之家负责人发现了从监禁环境中进行联系的重大障碍,包括与仍被监禁的潜在居民进行沟通和协调安置的困难。访谈还揭示了康复之家主任为改善康复之家安置所采取的方法,例如在释放前与监禁机构共享信息和资源,以及通过处理与法院代理人和假释的关系来帮助居民避免再次被监禁:康复院院长对康复院在犯人获释后所面临的最重要的安置挑战有相当深入的了解,对克服这些挑战的潜在解决方案也有丰富的经验。通过与监狱、牢房和其他社区资源的协调,院长可以成为为涉及刑事法律系统的个人提供直接无缝支持和持续关怀的关键。主任还可以通过帮助居民避免与法律系统发生进一步的问题,在成功完成缓刑和假释方面发挥重要作用。这些负责人认为,与居民合作是确保客户遵守法庭命令并成功康复和重返社会的有效方法。
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引用次数: 0
C2: editorial board C2:编辑委员会
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-08-03 DOI: 10.1016/S2949-8759(24)00176-0
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引用次数: 0
TOC (update) 技术选择委员会(更新)
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-08-03 DOI: 10.1016/S2949-8759(24)00177-2
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引用次数: 0
Wiidookaage'win: Beta-test of a Facebook group intervention for Native women to support opioid use recovery. Wiidookaage'win:对针对土著妇女的 Facebook 小组干预进行 Beta 测试,以支持阿片类药物的使用康复。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-08-01 Epub Date: 2024-05-15 DOI: 10.1016/j.josat.2024.209396
Anne I Roche, Antonia Young, Corinna Sabaque, Sydney S Kelpin, Pamela Sinicrope, Cuong Pham, Lisa A Marsch, Aimee N C Campbell, Kamilla Venner, Laiel Baker-DeKrey, Thomas Wyatt, Sharyl WhiteHawk, Teresa Nord, Kenneth Resnicow, Colleen Young, Ashley Brown, Gavin Bart, Christi Patten

Introduction: The ongoing opioid misuse epidemic has had a marked impact on American Indian/Alaska Native (AI/AN) communities. Culture- and gender-specific barriers to medically assisted recovery from opioid use disorder (OUD) have been identified, exacerbating its impact for AI/AN women. Wiidookaage'win is a community-based participatory research study that aims to develop a culturally tailored, moderated, private Facebook group intervention to support Minnesotan AI/AN women in medically assisted recovery from OUD. The current study assessed the preliminary feasibility and acceptability of the intervention in a beta-test to inform refinements before conducting a pilot randomized controlled trial (RCT).

Methods: The intervention was beta-tested for 30 days. Moderators were trained prior to delivering the intervention. Study assessments were conducted at baseline and post-intervention. The post-intervention assessments included substance use (self-report and urine drug screen), treatment acceptability, mental health, and spirituality outcomes. We examined intervention engagement patterns using Facebook metrics and qualitatively explored common topics that emerged in participant posts and comments.

Results: Ten AI/AN women taking medication for OUD (MOUD) were accrued (age range 25-62 years). Participants had been in opioid recovery a mean of 15.2 months (SD = 16.1; range = 3-60). The study participation rate (accrued/eligible) was 91 %. Nine participants completed the post-intervention survey assessment and eight completed a UDS. Acceptability was high based on the mean treatment satisfaction score (M = 4.8, SD = 0.2 out of a possible 5.0), Facebook group engagement, and positive qualitative feedback. All participants retained at post-intervention continued their MOUD treatment, and none had returned to opioid use.

Conclusions: The beta-test indicated that the Facebook platform and study procedures generally worked as intended and that the intervention was largely acceptable to study participants. The results of this study phase provided valuable insights to inform refinements prior to conducting a pilot RCT to further assess the feasibility, acceptability, and potential efficacy of the intervention.

导言:阿片类药物滥用的持续流行对美国印第安人/阿拉斯加原住民(AI/AN)社区产生了显著影响。在阿片类药物使用障碍(OUD)的医疗辅助康复过程中,文化和性别方面的障碍已被确认,这加剧了阿片类药物使用障碍对印第安/原住民妇女的影响。Wiidookaage'win 是一项以社区为基础的参与式研究,旨在开发一种符合当地文化的、有节制的私人 Facebook 小组干预措施,以支持明尼苏达州的亚裔/印第安人妇女从阿片类药物滥用症中进行医学辅助康复。目前的研究通过 beta 测试评估了干预措施的初步可行性和可接受性,以便在开展试点随机对照试验 (RCT) 之前对干预措施进行改进:方法:对干预措施进行了为期 30 天的测试。主持人在实施干预前接受了培训。在基线和干预后进行了研究评估。干预后评估包括药物使用(自我报告和尿液药物筛查)、治疗可接受性、心理健康和精神成果。我们使用 Facebook 指标检查了干预参与模式,并对参与者帖子和评论中出现的共同话题进行了定性探讨:共有 10 名正在服用药物治疗 OUD(MOUD)的亚裔美国人/印第安人妇女(年龄在 25-62 岁之间)。参与者的阿片类药物康复期平均为 15.2 个月(SD = 16.1;范围 = 3-60)。研究参与率(累计/合格)为 91%。九名参与者完成了干预后调查评估,八名参与者完成了 UDS。根据平均治疗满意度得分(中=4.8,标度=0.2,满分为 5.0)、Facebook 小组参与度和积极的定性反馈,可接受性较高。所有在干预后继续接受 MOUD 治疗的参与者都没有重新使用阿片类药物:测试结果表明,Facebook 平台和研究程序总体上达到了预期效果,研究参与者基本接受了干预措施。该研究阶段的结果提供了宝贵的见解,有助于在开展试点 RCT 之前对其进行改进,以进一步评估干预措施的可行性、可接受性和潜在疗效。
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引用次数: 0
Implementation of medication for opioid use disorder treatment during a natural disaster: The PROUD-LA study 在自然灾害期间实施阿片类药物使用障碍治疗:PROUD-LA 研究。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-07-31 DOI: 10.1016/j.josat.2024.209469

Background

The impacts of climate change-related extreme weather events (EWEs) on Medication for Opioid Use Disorders (MOUD) implementation for Medicaid beneficiaries are relatively unknown. Such information is critical to disaster planning and other implementation strategies. In this study we examined implementation determinants and strategies for MOUD during EWEs.

Methods

The Louisiana-based Community Resilience Learning Collaborative and Research Network (C-LEARN) utilized Rapid Assessment Procedures-Informed Community Ethnography (RAPICE), involving community leaders in study design, execution, and data analysis. We conducted qualitative semi-structured interviews with 42 individuals, including MOUD Medicaid member patients and their caregivers, healthcare providers and administrators, and public health officials with experience with climate-related disasters. We mapped key themes onto updated Consolidated Framework for Implementation Research domains.

Results

MOUD use is limited during EWEs by pharmacy closures, challenges to medication prescription and access across state lines, hospital and clinic service limits, overcrowded emergency departments, and disrupted communications with providers. MOUD demand simultaneously increases due to the stress associated with displacement, resource loss, the COVID-19 pandemic, and social determinants of health. Effective implementation strategies include healthcare system disaster plans with protocols for clear and regular patient-provider communication, community outreach, additional staffing, and virtual delivery of services. Providers can also increase MOUD access by having remote access to EHRs, laptops and contact information, resource lists, collaborative networks, and contact with patients via call centers and social media. Patients can retain access to MOUD via online patient portals, health apps, call centers, and provider calls and texts. The impact of EWEs on MOUD access and use is also influenced by individual characteristics of both patients and providers.

Conclusions

The increasing frequency and severity of climate-related EWEs poses a serious threat to MOUD for Medicaid beneficiaries. MOUD-specific disaster planning and use of telehealth for maintaining contact and providing care are effective strategies for MOUD implementation during EWEs. Potential considerations for policies and practices of Medicaid, providers, and others to benefit members during hurricanes or major community stressors, include changes in Medicaid policies to enable access to MOUD by interstate evacuees, improvement of medication refill flexibilities, and incentivization of telehealth services for more systematic use.

背景:与气候变化相关的极端天气事件(EWEs)对医疗补助受益人阿片类药物使用障碍(MOUD)实施的影响相对未知。这些信息对于灾害规划和其他实施策略至关重要。在这项研究中,我们探讨了在 EWE 期间实施 MOUD 的决定因素和策略:方法:路易斯安那州的社区抗灾学习合作与研究网络(C-LEARN)采用了快速评估程序--知情社区人种学(RAPICE),让社区领袖参与研究设计、执行和数据分析。我们对 42 人进行了半结构化定性访谈,其中包括医疗补助计划(MOUD Medicaid)成员患者及其护理人员、医疗服务提供者和管理者,以及具有应对气候相关灾害经验的公共卫生官员。我们将关键主题映射到更新的实施研究综合框架领域中:结果:由于药房关闭、跨州药物处方和获取面临挑战、医院和诊所服务限制、急诊室人满为患以及与医疗服务提供者的通信中断等原因,MOUD 的使用在 EWE 期间受到限制。由于流离失所、资源损失、COVID-19 大流行病和健康的社会决定因素带来的压力,对 MOUD 的需求也同时增加。有效的实施策略包括医疗保健系统灾难计划,其中包括明确和定期的患者-医疗服务提供者沟通协议、社区外联、额外的人员配备和虚拟服务提供。医疗服务提供者还可以通过远程访问电子病历、笔记本电脑和联系信息、资源清单、协作网络,以及通过呼叫中心和社交媒体与患者联系,增加对 MOUD 的访问。患者可以通过在线患者门户网站、健康应用程序、呼叫中心以及医疗服务提供者的电话和短信,继续使用 MOUD。EWE对MOUD获取和使用的影响还受到患者和医疗服务提供者个人特征的影响:结论:与气候相关的极端恶劣天气日益频繁和严重,对医疗补助受益人的 MOUD 构成了严重威胁。针对 MOUD 的灾难规划以及使用远程医疗来保持联系和提供护理是在 EWE 期间实施 MOUD 的有效策略。在飓风或重大社区压力期间,医疗补助计划、医疗服务提供者和其他机构为使成员受益而可能考虑的政策和做法包括改变医疗补助计划的政策,使州际疏散人员能够获得 MOUD,提高药物补充的灵活性,以及激励远程医疗服务更系统地使用。
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引用次数: 0
Tailoring opioid use prevention content for juvenile diversion programs with adolescents and their caregivers 为青少年及其看护人的青少年转送计划量身定制阿片类药物使用预防内容。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-07-31 DOI: 10.1016/j.josat.2024.209470

Introduction

Opioid use (OU) skyrockets as youth transition into young adulthood, indicating adolescence is a critical time for prevention. The juvenile legal system (JLS) presents an ideal setting for OU prevention, as it is the single largest referral source for youth outpatient OU treatment, after self-referral. However, no OU prevention programs have been developed for youth in JLS diversion programs or their families. The current formative study established specific OU prevention needs and preferences of families in JLS programs, to guide future tailored prevention efforts.

Methods

We interviewed 21 adolescents with substance use and 20 of their caregivers referred by a JLS diversion program in the northeastern United States to explore their OU-related knowledge, personal experiences, motivations, and behavioral skills. We used a deductive qualitative analysis approach wherein data were analyzed using an a priori coding framework based on the Information Motivation Behavioral Skills model.

Results

Caregivers knew more about OU than youth, several of whom misidentified both opiates and non-opiates. Few participants reported a history of personal OU, though many knew of others' OU. Participants perceived several potential motivations for OU: mental health problems, relationships, life stressors, difficulty accessing preferred substances, and experimentation. Though often unfamiliar with the symptoms, participants were eager to learn skills to identify and manage a suspected overdose.

Conclusions

Youth involved in a JLS diversion program and their caregivers were open to and eager for tailored opioid use prevention content to help them reduce risks. We discuss implications for OU prevention and intervention program development.

简介当青少年步入青年期时,阿片类药物的使用(OU)会激增,这表明青春期是预防的关键时期。青少年司法系统(JLS)是预防阿片类药物滥用的理想场所,因为它是继自我转介之后青少年阿片类药物滥用门诊治疗的最大转介来源。然而,目前还没有针对青少年司法系统分流项目中的青少年或其家庭制定出任何预防开放性有机会谈的计划。当前的形成性研究确定了青少年司法分流项目中家庭的具体 "开放性治疗 "预防需求和偏好,以指导未来有针对性的预防工作:我们采访了由美国东北部的一个青少年分流项目转介的 21 名使用药物的青少年和他们的 20 名照顾者,以探究他们与 OU 相关的知识、个人经历、动机和行为技能。我们采用了演绎定性分析方法,根据信息动机行为技能模型,使用先验编码框架对数据进行分析:结果:护理人员比青少年更了解鸦片类药物,其中一些护理人员对鸦片类药物和非鸦片类药物的识别都有误。很少有参与者报告自己曾服用过阿片类药物,但许多人知道其他人服用过阿片类药物。参试者认为使用鸦片的几种潜在动机是:心理健康问题、人际关系、生活压力、难以获得喜欢的药物以及尝试。尽管参与者往往不熟悉这些症状,但他们渴望学习识别和处理疑似用药过量的技能:结论:参与 JLS 分流计划的青少年及其照顾者愿意并渴望接受量身定制的阿片类药物使用预防内容,以帮助他们降低风险。我们讨论了 OU 预防和干预项目开发的意义。
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引用次数: 0
Law enforcement-led, pre-arrest diversion-to-treatment may reduce crime recidivism, incarceration, and overdose deaths: Program evaluation outcomes 执法部门主导的逮捕前转送治疗可减少犯罪累犯、监禁和用药过量死亡:项目评估结果。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-07-25 DOI: 10.1016/j.josat.2024.209458

Introduction

Substance use disorder (SUD), overdose, and drug use-related crime continue to increase in the U.S. Pre-arrest diversion-to-treatment programs may decrease crime recidivism and overdose deaths. We assessed the impact of a community-wide diversion-to-treatment initiative on crime, incarceration, and overdose.

Methods

This article reports on the prospective evaluation of a law enforcement-led, pre-arrest diversion-to-treatment program on crime, incarceration, and overdose deaths compared between participants who did not engage (non-engaged; n = 103), engaged but did not complete (non-completers; n = 60) and completed (completers; n = 100) the program. Participants included 263 adults apprehended by police officers for low-level, drug use-related crimes between September 1, 2017 and August 31, 2020. The program offered eligible persons participation in a six-month program consisting of a clinical assessment, referral to addiction treatment services based on each individual's needs, connection to recovery peer support, and treatment engagement monitoring. Completers had their initial criminal charges ‘voided,’ while non-engaged and non-Completer participants had their original charges filed with local prosecutors. The project collected participant-level data on arrests and incarceration within 12 months before and 12 months after program enrollment and data on fatal overdose within 12 months after program enrollment. Logistic regression predicted outcomes using baseline demographics (sex, age, race, housing status) and pre-index crime arrest and incarceration indices as covariates.

Results

After accounting for baseline demographics and pre-enrollment arrest/incarceration history, logistic regression models found that the non-engaged and the non-Completer groups were more likely than completers to be arrested (odds ratios [ORs]: 3.9 [95 % CI, 2.0–7.7] and 3.6 [95 % CI, 1.7–7.5], respectively) and incarcerated (ORs: 10.3 [95 % CI, 5.0–20.8] and 21.0 [95 % CI, 7.9–55.7], respectively) during the 12-month follow-up. Rates of overdose deaths during the 12-month follow-up were greatest in non-engaged (6/103, 5.8 %) and non-Completer (2/60, 3.3 %) groups; completers had the lowest rate (2/100, 2.0 %), with all deaths occurring after completion of the six-month treatment/monitoring program.

Conclusions

Collaboration between law enforcement, clinicians, researchers, and the broader community to divert adults who commit a low-level, drug use-related crime from criminal prosecution to addiction treatment may effectively reduce crime recidivism, incarceration, and overdose deaths.

导言:在美国,药物使用障碍(SUD)、用药过量和与药物使用相关的犯罪持续增加。我们评估了社区范围内的转送治疗计划对犯罪、监禁和用药过量的影响:本文报告了由执法部门主导的逮捕前转送治疗计划对犯罪、监禁和用药过量死亡的前瞻性评估,并对未参与计划(未参与;人数=103)、参与但未完成计划(未完成;人数=60)和完成计划(完成;人数=100)的参与者进行了比较。参与者包括在 2017 年 9 月 1 日至 2020 年 8 月 31 日期间因与毒品使用有关的低级犯罪而被警察逮捕的 263 名成年人。该计划让符合条件的人参加为期 6 个月的项目,包括临床评估、根据每个人的需求转介到戒毒治疗服务机构、与康复同伴支持建立联系以及治疗参与监测。完成计划者的初始刑事指控将被 "撤销",而未参与计划者和未完成计划者将向当地检察官提交其原始指控。该项目收集了参与者在加入项目前 12 个月和加入项目后 12 个月内的逮捕和监禁数据,以及加入项目后 12 个月内的致命用药过量数据。使用基线人口统计学数据(性别、年龄、种族、住房状况)和指数前犯罪逮捕和监禁指数作为协变量,对结果进行逻辑回归预测:结果: 在考虑了基线人口统计学特征和参与计划前的被捕/入狱史后,逻辑回归模型发现,未参与计划组和未完成计划组比完成计划组更有可能被捕(几率比 [ORs]:在 12 个月的随访期间,未参与组和未完成组比完成组更有可能被捕(几率比 [ORs]:分别为 3.9 [95 % CI,2.0-7.7] 和 3.6 [95 % CI,1.7-7.5])和入狱(ORs:分别为 10.3 [95 % CI,5.0-20.8] 和 21.0 [95 % CI,7.9-55.7])。在 12 个月的随访期间,未参与组(6/103,5.8%)和未完成组(2/60,3.3%)的用药过量死亡率最高;完成组的用药过量死亡率最低(2/100,2.0%),所有死亡病例均发生在完成为期 6 个月的治疗/监测计划之后:执法部门、临床医生、研究人员和更广泛的社区合作,将犯有低级毒品相关罪行的成年人从刑事起诉转到戒毒治疗,可有效减少犯罪累犯、监禁和吸毒过量死亡。
{"title":"Law enforcement-led, pre-arrest diversion-to-treatment may reduce crime recidivism, incarceration, and overdose deaths: Program evaluation outcomes","authors":"","doi":"10.1016/j.josat.2024.209458","DOIUrl":"10.1016/j.josat.2024.209458","url":null,"abstract":"<div><h3>Introduction</h3><p>Substance use disorder (SUD), overdose, and drug use-related crime continue to increase in the U.S. Pre-arrest diversion-to-treatment programs may decrease crime recidivism and overdose deaths. We assessed the impact of a community-wide diversion-to-treatment initiative on crime, incarceration, and overdose.</p></div><div><h3>Methods</h3><p>This article reports on the prospective evaluation of a law enforcement-led, pre-arrest diversion-to-treatment program on crime, incarceration, and overdose deaths compared between participants who did not engage (non-engaged; n = 103), engaged but did not complete (non-completers; n = 60) and completed (completers; n = 100) the program. Participants included 263 adults apprehended by police officers for low-level, drug use-related crimes between September 1, 2017 and August 31, 2020. The program offered eligible persons participation in a six-month program consisting of a clinical assessment, referral to addiction treatment services based on each individual's needs, connection to recovery peer support, and treatment engagement monitoring. Completers had their initial criminal charges ‘voided,’ while non-engaged and non-Completer participants had their original charges filed with local prosecutors. The project collected participant-level data on arrests and incarceration within 12 months before and 12 months after program enrollment and data on fatal overdose within 12 months after program enrollment. Logistic regression predicted outcomes using baseline demographics (sex, age, race, housing status) and pre-index crime arrest and incarceration indices as covariates.</p></div><div><h3>Results</h3><p>After accounting for baseline demographics and pre-enrollment arrest/incarceration history, logistic regression models found that the non-engaged and the non-Completer groups were more likely than completers to be arrested (odds ratios [ORs]: 3.9 [95 % CI, 2.0–7.7] and 3.6 [95 % CI, 1.7–7.5], respectively) and incarcerated (ORs: 10.3 [95 % CI, 5.0–20.8] and 21.0 [95 % CI, 7.9–55.7], respectively) during the 12-month follow-up. Rates of overdose deaths during the 12-month follow-up were greatest in non-engaged (6/103, 5.8 %) and non-Completer (2/60, 3.3 %) groups; completers had the lowest rate (2/100, 2.0 %), with all deaths occurring after completion of the six-month treatment/monitoring program.</p></div><div><h3>Conclusions</h3><p>Collaboration between law enforcement, clinicians, researchers, and the broader community to divert adults who commit a low-level, drug use-related crime from criminal prosecution to addiction treatment may effectively reduce crime recidivism, incarceration, and overdose deaths.</p></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Social support networks of incarcerated women with opioid use disorder: Differences associated with jail-based substance use treatment 患有阿片类药物使用障碍的被监禁妇女的社会支持网络:与监狱药物使用治疗相关的差异。
N/A PSYCHOLOGY, CLINICAL Pub Date : 2024-07-25 DOI: 10.1016/j.josat.2024.209457

Introduction

Social support is a critical factor for women's engagement with substance use treatment and recovery, particularly for women with criminal-legal system involvement. However, less is known about the social support networks of incarcerated women, particularly as a function of service engagement. Thus, this paper aims to describe the structure, composition, and function of social support networks of women with opioid use disorder (OUD) incarcerated in jails; and compare network differences between women receiving jail-based substance use treatment and non-treatment participants.

Methods

As part of a larger clinical trial under the NIDA-funded Justice Community Opioid Innovation Network (JCOIN), staff conducted an egocentric social network inventory with women who were randomly selected from eight jails in Kentucky, screened for OUD, and consented (N = 445). Women were asked to name people (alters) who provided them with support in the past 90 days and respond to questions about alters who were named. Bivariate comparisons examined differences in social networks among women who were currently receiving jail-based treatment (29.9 %, n = 133) and those who were incarcerated, but not receiving treatment (70.1 %, n = 312).

Results

On average, women's social support networks consisted of 2.4 alters (range 1–9). Compared to women with OUD who were not receiving treatment, those in treatment were significantly more likely to name at least one alter who was in recovery (57.9 % vs. 43.9 %, p = .007) and less likely to name a partner (21.8 % vs. 37.8 %, p = .001) or someone who had recently used opioids (9.8 % vs. 24.7 %, p < .001). On average, women in treatment also felt significantly closer to their alters (4.70 vs. 4.55 out of 5, p = .021) and rated alters as fulfilling more types of social support functions (5.54 vs. 5.18 out of 6, p < .001) and recovery support functions (2.83 vs. 2.70 out of 3, p = .016).

Conclusion

Results suggest that women participating in jail-based substance use treatment reported more positive social support network attributes, including network function and composition. Future research should assess longitudinal changes in networks and associated differences in recovery outcomes as women are released to the community.

导言:社会支持是女性参与药物使用治疗和康复的关键因素,尤其是对于涉及刑事法律系统的女性而言。然而,人们对被监禁妇女的社会支持网络知之甚少,特别是作为参与服务的功能。因此,本文旨在描述被监禁在监狱中的阿片类药物使用障碍(OUD)女性的社会支持网络的结构、组成和功能;并比较接受监狱药物使用治疗的女性与未接受治疗的女性之间的网络差异:作为由美国国家药品管理局(NIDA)资助的司法社区阿片类药物创新网络(JCOIN)大型临床试验的一部分,工作人员对从肯塔基州八所监狱中随机抽取、筛查出患有 OUD 并同意接受治疗的女性(N = 445)进行了以自我为中心的社交网络调查。妇女们被要求说出在过去 90 天内为她们提供支持的人(分身)的名字,并回答有关被点名的分身的问题。双变量比较研究了目前正在接受监狱治疗的女性(29.9%,n = 133)与那些被监禁但未接受治疗的女性(70.1%,n = 312)在社交网络方面的差异:妇女的社会支持网络平均由 2.4 个替代者组成(1-9 个不等)。与未接受治疗的 OUD 妇女相比,接受治疗的妇女更有可能说出至少一名正在康复中的替代者(57.9% vs. 43.9%,p = .007),而说出伴侣(21.8% vs. 37.8%,p = .001)或最近使用过阿片类药物的人的可能性较小(9.8% vs. 24.7%,p 结论:结果表明,接受治疗的妇女更有可能说出至少一名正在康复中的替代者(57.9% vs. 43.9%,p = .007):结果表明,参与监狱药物使用治疗的女性报告了更多积极的社会支持网络属性,包括网络功能和组成。未来的研究应评估网络的纵向变化以及女性被释放到社区后康复结果的相关差异。
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引用次数: 0
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Journal of substance use and addiction treatment
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