(Articles listed are either accepted and published or in publication)
Bandiera, F. C., Vaeth, P. A. C., Caetano, R., Perez-Stable, E. J., 2018 The role of acculturation and binge drinking on smoking status among Mexican Americans: Comparison by border residence 183205-209.
doi: 10.1016/j.drugalcdep.2017.11.014 Impact Factor: 3.222 Abstract
BACKGROUND: Border Mexican Americans (MA) are exposed to poverty and under-education, all of which are predictors of cigarette smoking.
METHODS: This study analyzed two epidemiologic surveys among border and non-border MA. In the border sample, interviews were conducted in urban areas of U.S.-Mexico border counties of California, Arizona, New Mexico, and Texas. The non-border sample consisted of respondents interviewed in Los Angeles, Houston, New York, Philadelphia, and Miami. Analyses were stratified by gender, adjusted for age and education, and modeled the effects of acculturation and binge drinking on cigarette smoking behavior.
RESULTS: There were 2595 respondents, 1307 residing in border counties and 1288 from 5 other cities. There was no difference in cigarette smoking in the past 12 months between border and non-border MA among men (25.8% vs. 29.4%) or women (9.4% vs. 9.9%), respectively. Acculturation was not significantly related with cigarette smoking among men; however, women with high acculturation levels were more marginally likely to be past year smokers than those with low acculturation (RRR=2.06, 95% CI 0.97-4.78). Binge drinking was associated with being past year smoker in both men (RRR=3.54, 95% CI=2.31-5.42) and women (RRR=2.23, 95% CI 1.17-4.27), but not with being a former smoker.
CONCLUSIONS: Border residence did not influence cigarette smoking behavior among Mexican Americans and both groups had significant associations between smoking and binge drinking.
Braciszewski, J. M., Tran, T. B., Moore, R. S., Bock, B. C., Tzilos Wernette, G. K., Chamberlain, P., Stout, R. L., Vose-O'Neal, A., 2018 Feeling Heard and Not Judged: Perspectives on Substance Use Services Among Youth Formerly in Foster Care Child Maltreatment, 23
(1),
85-95.
doi: 10.1177/1077559517729486 Impact Factor: 2.278 Abstract
Youth in foster care have limited access to substance use services for a variety of reasons. Attempts to unpack this health disparity have focused on foster care systems, administrators, providers, and foster parents. This study seeks to understand the perspectives of youth themselves, with the hope of understanding their experiences with and preferences for such services. Analyses of focus groups with youth who had recently left foster care suggested concrete and perceptual facilitators/barriers to treatment. Concrete facilitators/barriers included the need for expanding social support, access to multiple service options, and tailored intervention approaches. Perceptual concerns revolved around understanding each individual's readiness to change, feeling judged by authority figures, and desiring help from people with lived experience. Participants also described novel intervention ideas, including a focus on technology-based approaches. By relying on youth voices, we can improve upon the current state of substance use interventions within foster care.
Braciszewski, J. M., Tzilos Wernette, G. K., Moore, R. S., Tran, T. B., Bock, B. C., Stout, R. L., Chamberlain, P., Vose-O'Neal, A., 2018 Developing a tailored substance use intervention for youth exiting foster care Child Abuse & Neglect, 77211-221.
doi: 10.1016/j.chiabu.2018.01.013 Impact Factor: 2.293 Abstract
Youth who are aging out of the foster care system face significant barriers to accessing substance use treatment. Mobile interventions have shown efficacy for several mental and physical health issues and may be helpful in overcoming barriers facing foster youth with substance use problems. A program (iHeLP) for substance use reduction was developed that used a computerized screening and brief intervention (SBI) followed by six months of dynamically-tailored text messages. The program was shown to focus groups of youth (N?=?24) ages 18-19 who recently left foster care and had moderate to severe substance use risk. Focus group feedback was used to modify iHeLP prior to delivery in an open trial (N?=?16). Both study phases included assessments of feasibility and acceptability; the open trial also included assessments of substance use outcomes at 3 and 6 months. Focus groups indicated a high level of acceptability for the proposed intervention components. Of those screened for the open trial, 43% were eligible and 74% of those eligible enrolled, indicating good feasibility. Retention through the final follow-up was 59%, and drop out was associated with involvement in the criminal justice system. Participant ratings for liking, ease of working with, interest in and respectfulness of the SBI were high. Satisfaction ratings for the texting component were also high. A computerized brief screening intervention for substance use risk reduction together with tailored text messaging is both feasible and highly acceptable among youth who have recently aged-out of foster care.
Byrnes, Hilary F., Miller, Brenda A., Morrison, Christopher N., Wiebe, Douglas J., Woychik, Marcie, Wiehe, Sarah E., 2017 Association of environmental indicators with teen alcohol use and problem behavior: Teens' observations vs. objectively-measured indicators Health & Place, 43151-157.
doi: 10.1016/j.healthplace.2016.12.004 Impact Factor: 2.541 Abstract
Most prior studies use objectively measured data (e.g., census-based indicators) to assess contextual risks. However, teens' observations might be more important for their risk behavior.
Objectives: 1) determine relationships between observed and objective indicators of contextual risks 2) determine relations of observed and objective indicators with teen alcohol use and problem behavior. Teens aged 14-16 (N=170) carried GPS-enabled smartphones for one month, with locations documented.
Ecological momentary assessment (EMA) measured teens' observations via texts regarding risk behaviors and environmental observations. Objective indicators of alcohol outlets and disorganization were spatially joined to EMAs based on teens' location at the time of the texts. Observed and objective disorganization, and objective indicators of alcohol outlets were related to alcohol use. Observed disorganization was related to problem behavior, while objective indicators were unrelated. Findings suggest the importance of considering teens' observations of contextual risk for understanding influences on risk behavior and suggest future directions for research and prevention strategies.
Caetano, R., Gruenewald, P., Vaeth, P. A. C., Canino, G., 2018 DSM-5 Alcohol Use Disorder Severity in Puerto Rico: Prevalence, Criteria Profile, and Correlates Alcohol Clin Exp Res, 42
(2),
378-386.
doi: 10.1111/acer.13572 Impact Factor: 2.275 Abstract
BACKGROUND: Our aim was to examine lifetime criteria profiles and correlates of severity (mild, moderate, severe) of DSM-5 alcohol use disorders (AUD) in Puerto Rico.
METHODS: Data are from a household random sample of individuals 18 to 64 years of age in San Juan, Puerto Rico. The survey response rate was 83%. DSM-5 AUD was identified with the Spanish version of the World Health Organization's Composite International Diagnostic Interview. The analyses also identify correlates of each severity level using an ordered logistic regression model.
RESULTS: The prevalence of lifetime DSM-5 AUD among men and women was 38 and 16%, respectively. Mild lifetime DSM-5 AUD was the most prevalent severity level among both men (18%) and women (9%). The most common criteria, independent of gender and severity level, were drinking larger quantities and for longer than planned (men range: 80 to 97%; women range: 78 to 91%) and hazardous use (men range: 56 to 91%; women range: 42 to 74%). Results from ordered logistic regression showed that the adjusted odds ratio for weekly drinking frequency, greater volume of alcohol consumed per drinking occasion, positive attitudes about drinking, drinking norms, and male gender invariantly increased risks across all DSM-5 AUD severity levels (mild, moderate, severe). Greater negative attitudes about drinking, low family cohesion, and Protestant religion were related to greater risks at higher AUD severity levels.
CONCLUSIONS: AUD prevalence is high in San Juan, Puerto Rico. Prevalence rates for some criteria are equally high across severity levels and poorly differentiate between mild, moderate, or severe DSM-5 AUD. The sociodemographic and alcohol-related risks vary across DSM-5 severity levels.
Caetano, R., Vaeth, P. A. C., Canino, G., 2018 Illegal drug use and its correlates in San Juan, Puerto Rico 185356-359.
doi: 10.1016/j.drugalcdep.2017.12.029 Impact Factor: 3.222 Abstract
BACKGROUND: Data on the prevalence and correlates of illegal drug use in Puerto Rico are now almost 20 years old.
OBJECTIVES: This study sought to estimate the 12-month prevalence of illegal and non-prescribed medical drug use in San Juan, Puerto Rico and identify sociodemographic correlates of use.
METHODS: Data are from a random household sample of 1510 individuals, 18-64 years of age in San Juan, Puerto Rico.
RESULTS: The 12-month prevalence of any illegal or non-prescribed drug use was 16.5%. Prevalence among men (20.7%) was higher than among women (12.9%; chi(2)=16.308; df=1; p<.01). Prevalence for specific drugs ranged from 11.2% for marijuana to 0.2% for methadone. RESULTS: of the multiple logistic regression analysis showed that male gender (OR=1.67, 95CI=1.21-2.3; p<.01), age 18-29 (OR=2.39; 95CI=1.35-4.23; p<.01), age 30-39 (OR=1.93; 95CI=1.01-3.69; p<.05), low (OR=2.03; 95CI=1.36-3.02; p<.001) and medium (OR=1.50; 95CL=1.01-2.23; p<.05) family cohesion/pride, and no religious preference (OR=1.99; 95CI=1.23-3.22; p<.01) increased the odds of drug use. Annual family income of $40,000-$60,000 (OR=0.45; 95CI=0.21-0.93; p<.05) and $60,001 and more (OR=0.35; 95CI=0.13-0.94; p>.05) were negatively associated with drug use compared to annual income up to $10,000.
CONCLUSIONS: As in many other places in the U.S., drug use in San Juan, Puerto Rico is high, affecting about 1 in 6 adults in the population. The highest prevalence is for marijuana use, which cannot be medically prescribed and of which recreational use is illegal on the island.
Caetano, Raul, Vaeth, Patrice A. C., Romano, Eduardo, Canino, Glorisa, 2018 Drinking and driving in Puerto Rico Substance Use & Misuse, 1-9.
doi: 10.1080/10826084.2017.1413394 Impact Factor: 1.15 Abstract
Background: Epidemiological information is lacking for driving under the influence of alcohol (DUI) in Puerto Rico.
Objectives: To examine the prevalence and correlates of DUI in Puerto Rico. Methods: Data are from a household sample of 1510 individuals, aged 18-64 years in San Juan, Puerto Rico. The response rate was 83%.
Results: The rate of 12 month self-reported DUI was 20% among men and 8% among women (p < 0.001). Twelve month DUI arrests were reported by 0.1% of men and 0.2% of women (p: ns) while lifetime arrests were reported by 6% of men and 0.7% of women (p < 0.001). Adjusted analyses showed that the number of hours of daily driving (OR = 1.08, 95% CI = 1.01-1.17; p < 0.05), male gender (OR = 1.66, 95% CI = 1.07-2.58; p < 0.01), having more liberal drinking norms (OR = 4.81; 95% CI = 2.61-8.84; p < 0.01) and more positive attitudes towards drinking (OR = 4.58; 95% CI = 1.28-16.31; p < 0.01), consuming a higher number of weekly drinks (OR = 1.05; 95% CI: 1.03-1.07; p < 0.001), and binge drinking (OR = 2.60; 95% CI = 1.62?4.16; p < 0.001) were factors of risk for self-reporting DUI. A lifetime arrest was associated with being separated or divorced (OR = 2.7; 95% CI = 1.04-7.36; p < 0.05), male gender (OR = 5.25; 95% CI = 1.93-14.26; p < 0.001), more liberal drinking norms (OR = 6.97; 95% CI = 2.37-20.48; p < 0.001), and illicit drug use (OR = 2.82; 95% CI = 1.25-6.35; p < 0.001).
Conclusions: The prevalence of self-reported DUI in San Juan, Puerto Rico was high, but the proportion of people arrested for DUI in a span of 12 months or during their lifetime was low. Stricter enforcement of DUI laws may be necessary to minimize DUI in urban Puerto Rico.
Chisolm-Straker, M., Willging, C., Daul, A. D., McNamara, S., Sante, S. C., Shattuck, D. G., Crandall, C. S., 2018 Transgender and Gender-Nonconforming Patients in the Emergency Department: What Physicians Know, Think, and Do Annals of Emergency Medicine, 71
(2),
183-188.e1.
doi: 10.1016/j.annemergmed.2017.09.042 Impact Factor: 4.784 Abstract
We explore self-reported knowledge, attitudes, and behaviors of emergency physicians in regard to the care of transgender and gender-nonconforming patients to identify opportunities to improve care of this population. From July to August 2016, we electronically surveyed the American College of Emergency Physicians' Emergency Medicine Practice-Based Research Network of 654 active emergency physician participants. We performed frequency tabulations to analyze the closed-ended response items. Of the 399 respondents (61% response rate), 88.0% reported caring for transgender and gender-nonconforming patients in the emergency department (ED), although 82.5% had no formal training about this population. The majority of physicians (86.0%) were comfortable asking about personal pronouns. Only 26.1% of respondents knew the most common gender-affirming surgery for female-to-male patients; 9.8% knew the most common nonhormone gender-affirming medication that male-to-female patients use. Almost no respondents (<3%) were aware of emergency medicine practitioners' performing inappropriate examinations on transgender and gender-nonconforming patients. Although transgender and gender-nonconforming people represent a minority of ED patients nationwide, the majority of respondents reported personally providing care to members of this population. Most respondents lacked basic clinical knowledge about transgender and gender-nonconforming care.
The U. S. Burden of Disease Collaborators, Miller, Ted, 2018 The state of US health, 1990-2016: Burden of diseases, injuries, and risk factors among US states Journal of the American Medical Association, 319
(14),
1444-1472.
doi: 10.1001/jama.2018.0158 Impact Factor: 43.31 Abstract
Introduction: Several studies have measured health outcomes in the United States, but none have provided a comprehensive assessment of patterns of health by state.
Objective: To use the results of the Global Burden of Disease Study (GBD) to report trends in the burden of diseases, injuries, and risk factors at the state level from 1990 to 2016.
Design and Setting: A systematic analysis of published studies and available data sources estimates the burden of disease by age, sex, geography, and year.
Main Outcomes and Measures: Prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost (YLLs) due to premature mortality, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 333 causes and 84 risk factors with 95% uncertainty intervals (UIs) were computed.
Results Between 1990 and 2016, overall death rates in the United States declined from 745.2 (95% UI, 740.6 to 749.8) per 100?000 persons to 578.0 (95% UI, 569.4 to 587.1) per 100?000 persons. The probability of death among adults aged 20 to 55 years declined in 31 states and Washington, DC from 1990 to 2016. In 2016, Hawaii had the highest life expectancy at birth (81.3 years) and Mississippi had the lowest (74.7 years), a 6.6-year difference. Minnesota had the highest HALE at birth (70.3 years), and West Virginia had the lowest (63.8 years), a 6.5-year difference. The leading causes of DALYs in the United States for 1990 and 2016 were ischemic heart disease and lung cancer, while the third leading cause in 1990 was low back pain, and the third leading cause in 2016 was chronic obstructive pulmonary disease. Opioid use disorders moved from the 11th leading cause of DALYs in 1990 to the 7th leading cause in 2016, representing a 74.5% (95% UI, 42.8% to 93.9%) change. In 2016, each of the following 6 risks individually accounted for more than 5% of risk-attributable DALYs: tobacco consumption, high body mass index (BMI), poor diet, alcohol and drug use, high fasting plasma glucose, and high blood pressure. Across all US states, the top risk factors in terms of attributable DALYs were due to 1 of the 3 following causes: tobacco consumption (32 states), high BMI (10 states), or alcohol and drug use (8 states).
Conclusions and Relevance: There are wide differences in the burden of disease at the state level. Specific diseases and risk factors, such as drug use disorders, high BMI, poor diet, high fasting plasma glucose level, and alcohol use disorders are increasing and warrant increased attention. These data can be used to inform national health priorities for research, clinical care, and policy.
Collins, D. A., Thompson, K., Atwood, K. A., Abadi, M. H., Rychener, D. L., Simmons, L. A., 2018 Integration of Health Coaching Concepts and Skills into Clinical Practice Among VHA Providers: A Qualitative Study. Global Advances in Health and Medicine, 72164957X18757463.
Impact Factor: N/A Abstract
Background: Although studies of health coaching for behavior change in chronic disease prevention and management are increasing, to date no studies have reported on what concepts and skills providers integrate into their clinical practice following participation in health coaching courses. The purpose of this qualitative study was to assess Veterans Health Administration (VHA) providers’ perceptions of the individual-level and system-level changes they observed after participating with colleagues in a 6-day Whole Health Coaching course held in 8 VHA medical centers nationwide.
Methods: Data for this study were from the follow-up survey conducted with participants 2 to 3 months after completing the training. A total of 142 responses about individual-level changes and 99 responses about system-level changes were analyzed using content analysis.
Results: Eight primary themes emerged regarding individual changes, including increased emphasis on Veterans’ values, increased use of listening and other specific health coaching skills in their clinical role, and adding health coaching to their clinical practice.Four primary themes emerged regarding system-level changes, including leadership support, increased staff awareness/support/learning and sharing, increased use of health coaching skills or tools within the facility, and organizational changes demonstrating a more engaged workforce, such as new work groups being formed or existing groups becoming more active.
Conclusions Findings suggest that VHA providers who participate in health coaching trainings do perceive positive changes within themselves and their organizations. Health coaching courses that emphasize patient-centered care and promote patient–provider partnerships likely have positive effects beyond the individual participants that can be used to promote desired organizational change.
Ehrhart, M. G., Torres, E. M., Green, A. E., Trott, E. M., Willging, C. E., Moullin, J. C., Aarons, G. A., 2018 Leading for the long haul: a mixed-method evaluation of the Sustainment Leadership Scale (SLS) Implementation Science, 13
(1),
17.
doi: 10.1186/s13012-018-0710-4 Impact Factor: 3.354 Abstract
Despite our progress in understanding the organizational context for implementation and specifically the role of leadership in implementation, its role in sustainment has received little attention. This paper took a mixed-method approach to examine leadership during the sustainment phase of the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Utilizing the Implementation Leadership Scale as a foundation, we sought to develop a short, practical measure of sustainment leadership that can be used for both applied and research purposes. Data for this study were collected as a part of a larger mixed-method study of evidence-based intervention, SafeCare®, sustainment. Quantitative data were collected from 157 providers using web-based surveys. Confirmatory factor analysis was used to examine the factor structure of the Sustainment Leadership Scale (SLS). Qualitative data were collected from 95 providers who participated in one of 15 focus groups. A framework approach guided qualitative data analysis. Mixed-method integration was also utilized to examine convergence of quantitative and qualitative findings. Confirmatory factor analysis supported the a priori higher order factor structure of the SLS with subscales indicating a single higher order sustainment leadership factor. The SLS demonstrated excellent internal consistency reliability. Qualitative analyses offered support for the dimensions of sustainment leadership captured by the quantitative measure, in addition to uncovering a fifth possible factor, available leadership. This study found qualitative and quantitative support for the pragmatic SLS measure. The SLS can be used for assessing leadership of first-level leaders to understand how staff perceive leadership during sustainment and to suggest areas where leaders could direct more attention in order to increase the likelihood that EBIs are institutionalized into the normal functioning of the organization.
Finan, Laura J., Lipperman-Kreda, Sharon, Abadi, Melissa, Grube, Joel W., Kaner, Emily, Balassone, Anna, Gaidus, Andrew, 2018 Tobacco outlet density and adolescents' cigarette smoking: a meta-analysis Tobacco Control,
doi: 10.1136/tobaccocontrol-2017-054065 Impact Factor: 4.729 Abstract
Objective: We conducted meta-analyses of studies that investigated the associations between tobacco outlet density around homes and schools and adolescents' past-month cigarette smoking.
Data Sources: Systematic literature searches of eight databases were carried out in February 2017. Searches were not limited by date, language, country or peer-reviewed status.
Study Selection: After screening for quality, studies that examined the relationship between tobacco outlet density and adolescents' past-month smoking were selected for inclusion.
Data Extraction: Two investigators screened study abstracts and full texts and independently extracted data. Consensus was reached at each stage.
Data Synthesis: Random-effects meta-analyses were conducted on 11 studies that provided 13 effect sizes. Results showed that there was a significant association between tobacco outlet density around homes and adolescents' past-month smoking behaviour, with an overall effect size of OR=1.08 (95% CI 1.04 to 1.13; P<0.001; I2=0%). For density around schools, the association was not statistically significant (OR=1.01, 95% CI 0.98 to 1.03; P=0.53; I2=39%).
Conclusions: These findings suggest that exposure to tobacco outlets near home environments may be important for understanding adolescents' past-month smoking. Restricting access to tobacco outlets and controlling the number of outlets in residential areas may be an effective preventive strategy to help reduce adolescents' smoking.
George, Michael D., 2016 A study of collaborative leadership in South Carolina Alcohol Enforcement Teams Public Policy and AdministrationAbstract
In 2007 South Carolina funded 15 regional coordinators to work with local law enforcement agencies and alcohol and drug commissions to create 16 community
alcohol enforcement teams to improve enforcement of underage drinking laws. Previous researchers have suggested that collaborative leadership is needed for
effective teams, yet little is known about the factors that serve as barriers to and facilitators of, collaborative leadership in alcohol enforcement teams. The purpose of
this phenomenological study was to explore the lived experiences of coordinators involved in leading the alcohol enforcement teams in South Carolina. The theoretical framework used was Cameron, Quinn, DeGraff, and Thankor’s conceptualization of the competing values framework. Data were collected through in-depth interviews with a purposive sample of 12 alcohol team coordinators. These data were inductively coded and then subjected to a modified Van Manen and Vagle analysis. Key findings indicate strong support for the idea that existence of positive community relationships and supportive champions from community partners were crucial to building and maintaining successful teams. These findings were consistent with the theoretical framework. Recommendations include implementing leadership and collaboration training for the coordinators and team members. These findings have implications for positive social change by increasing awareness among policy makers about collaborative leadership factors, which in turn could lead to policies that generate more effectual teams, improve enforcement of underage drinking laws, and consequently, result in safer communities.
George, M.D., Holder, H.D., Mckenzie, P.N., Mueller, H.R.,, Herchek, D.C., Faile, B.S., 2018 Replication of a controlled community prevention trial: Results from a local implementation of science-based intervention to reduce impaired driving The Journal of Primary Prevention, 39
(1),
47-58.
doi: 10.1007/s10935-017-0499-y Impact Factor: 1.597 Abstract
We tested the generalizability of a science-based community prevention design to reduce DUI crashes. Previous researcher-led studies have confirmed the effects of an intervention design of visible enforcement coupled with heightened public awareness of enforcement to increase driver perception of likely detection for drinking and driving. A community coalition based the project on a prevention intervention model that included two key intermediate variables: levels of visible enforcement and of public awareness of enforcement. We evaluated the project using community-specific monthly time-series measures of DUI crashes and state level trends in DUI crashes, indicators of enforcement, and public attention to enforcement. We devised the evaluation design to determine if an observed trend in DUI crashes declined and to verify if key intermediate variables increased, as stimulated by local efforts. DUI crash analysis documented an upward trend during a pre-trial period from July 2010-December 2011, which matched the upward trend in state DUI crashes. After the local intervention began in January 2012, local DUI crashes began a clear downward trend (average 2013 crashes were 23% lower than in 2012 and a 5-month post-intervention average from 2013 was lower than the equivalent 5-month pre-intervention average). This contrasted with the continued upward state DUI crash trend, with a 2-year increase of 16%. The downward trend in local crashes was associated with an increase in DUI enforcement as well as news stories concerning DUI enforcement that were stimulated by the efforts of the community prevention project. These results confirm the generalizability of two previous community research trials that were conducted with limited or no research resources or leadership. We discuss the importance of controlling for external factors in attributing causation in a local prevention evaluation by confirming both sufficient local prevention efforts and a decline in DUI crashes.
Hallfors, D.D., Cho, H., Hartman, S., Mbai, I.,, Ouma, C.A., Halpern, C.T., 2017 Process evaluation of a clinical trial to test school support as HIV prevention among orphaned adolescents in Western Kenya Prevention Science, 18
(8),
955-963.
doi: 10.1007/s11121-017-0827-8 Impact Factor: 2.570 Abstract
Orphaned adolescents are a large and vulnerable population in sub-Saharan Africa, at higher risk for HIV than non-orphans. Yet prevention of new infection is critical for adolescents since they are less likely than adults to enter and remain in treatment and are the only age group with rising AIDS death rates. We report process evaluation for a randomized controlled trial (RCT) testing support to stay in school (tuition, uniform, nurse visits) as an HIV prevention strategy for orphaned Kenyan adolescents. The RCT found no intervention effect on HIV/HSV-2 biomarker outcomes. With process evaluation, we examined the extent to which intervention elements were implemented as intended among the intervention group (N = 412) over the 3-year study period (2012-2014), the implementation effects on school enrollment (0-9 terms), and whether more time in school impacted HIV/HSV-2. All analyses examined differences as a whole, and by gender. Findings indicate that school fees and uniforms were fully implemented in 94 and 96% of cases, respectively. On average, participants received 79% of the required nurse visits. Although better implementation of nurse visits predicted more terms in school, a number of terms did not predict the likelihood of HIV/HSV-2 infection. Attending boarding school also increased number of school terms, but reduced the odds of infection for boys only. Four previous RCTs have been conducted in sub-Saharan Africa, and only one found limited evidence of school impact on adolescent HIV/HSV-2 infection. Our findings add further indication that the association between school support and HIV/HSV-2 prevention appears to be weak or under-specified.
Kostyniuk, Lidia P., Eby, David W., Molnar, Lisa J., St. Louis, Renée M., Zanier, Nicole, Miller, Ted R., 2018 Potential effects of lowering the BAC limit on injuries, fatalities, and costs Journal of Safety Research, 6449-54.
doi: https://doi.org/10.1016/j.jsr.2017.12.005 Impact Factor: 1.841 Abstract
Introduction: Potential health and cost impacts of lowering the BAC limit for U.S. drivers below .08% were explored through analyses of reductions in crash incidence, injury severity, and costs based on five scenarios with varying assumptions about how the change to a .05% BAC limit might affect alcohol-impaired driving.
Methods: Distribution of crashes by injury level and highest driver or non-occupant BAC levels for 2010, together with unit crash costs provided a base for comparison. Scenario 1 assumed all alcohol-impaired driving ceased; scenario 2 assumed all drivers obeyed the law, and scenario 3 assumed decreases in driver BAC levels would be limited to those who had been driving near the legal limit before the change. Scenario 4 was based on changes in driver BAC levels associated with a 08% to .05% BAC limit change in Australia, and scenario 5 was based on changes in alcohol-related crashes associated with the change to the .08% BAC limit in the United States. The number of casualties prevented in each scenario was estimated using relative risks of crash involvement, and changes in societal costs were estimated using the unit costs.
Results: Reductions ranging from 71% to 99% in fatalities, injuries, and costs related to alcohol-impaired driving were estimated in scenarios 1 and 2. Scenarios 3–5 produced smaller reductions ranging from 4% to 16% for alcohol-impaired fatalities, injuries, and costs.
Conclusion: The wide difference between the outcomes of the two sets of scenarios reflects the sensitivity of BAC policy benefits to driver compliance behavior. Practical application The quantification of the reduction in the number and costs of traffic crash casualties in the set of behavioral scenarios explored in this research can inform policymakers about the extent and limits of benefits achievable by lowering the BAC limits as they consider strategies to reduce alcohol-impaired driving.
Lipperman-Kreda, Sharon, Finan, Laura J., Grube, Joel W., 2018 Social and situational characteristics associated with adolescents' drinking at party and non-party events Addictive Behaviors, 83148-153.
doi: 10.1016/j.addbeh.2017.12.001 Impact Factor: 2.944 Abstract
We investigated social and situational characteristics associated with adolescents' drinking at party and non-party events and whether these associations vary by party location (homes versus other locations). Ecological momentary assessment data were obtained over two weekends from 149 adolescents in California (46% female, M age=16.4years), using smartphone surveys administered early and late in the evening and the following morning. We assessed whether, where, and with whom adolescents drank alcohol. Social contexts with more people (RRR=1.05, p=0.005) and with mixed gender composition (RRR=3.15, p=0.05) were positively associated with increased risks of alcohol use at parties, but not at non-party events. Conversely, social contexts with friends were positively associated with alcohol use at non-party events (RRR=4.32, p=0.005), but not at parties. Perceived access to alcohol was associated with increased risks for alcohol use at both party and non-party events, but the association was stronger for alcohol use at parties than non-parties (RRR=1.85, p<0.005 versus 4.01, p=0.005). Additional analyses showed that contexts with mixed gender composition were positively associated with alcohol use at parties not in homes (RRR=11.29, p=0.05), and perceptions of getting caught by parents or police were negatively associated with non-party alcohol use in homes (RRR=0.57, p=0.005). This study identified social-ecological contexts of underage drinking parties, which are high risk settings for heavier drinking and other alcohol-related problems. Findings can inform context-based interventions to target these high-risk settings, whether at homes or other locations.
Lyle, Greg, Hendrie, Delia, Miller, Ted R., Randall, Sean, Davison, Erica, 2018 Linked data systems for injury surveillance and targeted prevention planning: Identifying geographical differences in injury in Western Australia, 2009-2012 Health Promotion Journal of Australia, 001-12.
doi: https://doi.org/10.1002/hpja.26 Impact Factor: 1.097 Abstract
Issue addressed: Injuries are a leading preventable cause of disease burden in Australia. Understanding how injuries vary by geographical location is important to guide health promotion planning. Therefore, the geographical and temporal distribution of injury across Western Australia from 2009 to 2012 is explored.
Methods: Three Western Australian health datasets were linked and the expected number of injury cases per postcode calculated. A Standardised Injury Ratio was calculated by comparing the observed and expected number of injury cases. Priority areas and associated injury mechanisms were identified by postcode based on injury rates and temporal trends.
Results: Injury levels varied across health region, health district and postcode. All non-metropolitan regions had at least one health district classified as High or Medium-High priority. In contrast, neither metropolitan health region had health districts in these categories. Adopting the finer postcode level of analysis showed localised injury priority areas, even within health districts not classified as High or Medium-High injury areas. Postcodes classified as High or Medium-High injury priority were located alongside those with lower priority categories.
Conclusion: Injury prevention priority areas had consistent trends both geographically and over time. Finer scale analysis can provide public health policy makers with more robust information to plan, evaluate and support a range of injury prevention programs. So what?: The use of linked data systems and spatial analysis can assist health promotion decision-makers and practitioners by demonstrating area-based differences in injury prevention allowing effective targeting of limited resources to populations at the highest risk of injury.
Miller, Ted R., Levy, David T., Swedler, David I., 2018 Lives saved by laws and regulations that resulted from the Bloomberg road safety program Accident Analysis & Prevention, 113131-136.
doi: https://doi.org/10.1016/j.aap.2018.01.014 Impact Factor: 2.685 Abstract
Objective: To estimate lives saved during 2008–2023 by traffic safety laws passed in six developing countries while participating in the Bloomberg Road Safety Program (BRSP).
Methods: BRSP-funded local staff identified relevant laws and described enforcement to the study team. We analyzed road crash death estimates for 2004–2013 from the Global Burden of Disease and projected estimates absent intervention forward to 2023. We amalgamated developing country and US literature to estimate crash death reductions by country resulting from laws governing drink driving, motorcycle helmets, safety belt use, and traffic fines.
Results: BRSP helped win approval of traffic safety laws in Brazil, China, Kenya, Mexico, Turkey, and Vietnam. In 2008–2013, those laws saved an estimated 19,000 lives. Many laws only took effect in 2014. The laws will save an estimated 90,000 lives in 2014–2023. Of the 109,000 lives saved, drink driving laws will account for 84%, increased motorcyclist protection for 13%, increased fines and penalty points for 2%, and safety belt usage mandates for 1%. Drink driving reductions in China will account for 56% of the savings and reduced drink driving and motorcycling deaths in Vietnam for 35%. The savings in China will result from a narrow intervention with just 4% estimated effectiveness against drink driving deaths. As a percentage of deaths anticipated without BRSP effort, the largest reductions will be 11% in Vietnam and 5% in Kenya.
Conclusions: Viewed as a public health measure, improving traffic safety provided large health gains in developing nations.
Rockett, Ian R. H., Caine, Eric D., Connery, Hilary S., D’Onofrio, Gail, Gunnell, David J., Miller, Ted R., Nolte, Kurt B., Kaplan, Mark S., Kapusta, Nestor D., Lilly, Christa L., Nelson, Lewis S., Putnam, Sandra L., Stack, Steven, Värnik, Peeter, Webster, Lynn R., Jia, Haomiao, 2018 Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history PLoS One, 13
(1),
e0190200.
doi: 10.1371/journal.pone.0190200 Impact Factor: N/A Abstract
Objective: A paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods.
Methods: This observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011–2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics.
Results: A suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43–49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11–44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11–2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10–1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06–66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19–3.18) and depression (OR, 1.48; 95% CI, 1.17–1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases.
Conclusions: Without psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths.
Shamblen, S. R., Kokoski, C., Collins, D. A., Strader, T. N., McKiernan, P., 2017 Implementing Creating Lasting Family Connections with reentry fathers: A partial replication during a period of policy change. 56
(5),
295-307.
doi: https://doi.org/10.1080/10509674.2017.1327917 Impact Factor: N/A Abstract
The present study is a replication of the Creating Lasting Family Connections Fatherhood Program (CLFCFP) using a randomized controlled trial (RCT). CLFCFP has been shown in prior studies to have a positive impact on relationship skills and recidivism using weaker quasi-experimental designs (McKiernan et al., 2013). Survey data on relationship skills and recidivism data came from 280 men in prison reentry. Findings for relationship skills were replicated in this RCT, suggesting CLFCFP participants had larger sustained improvements in relationship skills. Policy changes occurring shortly before the study possibly serve as an explanation for our inability to replicate recidivism findings.
Thrul, Johannes, Lipperman-Kreda, Sharon, Grube, Joel W., 2018 Do Associations Between Drinking Event Characteristics and Underage Drinking Differ by Drinking Location? Journal of Studies on Alcohol and Drugs, 79
(3),
417-422.
doi: https://doi.org/10.15288/jsad.2018.79.417 Impact Factor: 2.50 Abstract
Objective: We investigated how associations between social and situational characteristics (number of people, adult supervision, group gender composition, group age composition, ease of alcohol access, and weekend) and underage drinking are moderated by the specific locations in which drinking occurs
Method: Using a case-crossover design and retrospective surveys, a sample of 385 adolescents (mean age = 16.5 years; 47.3% female) from 24 mid-size California cities reported the last time they drank alcohol in a specific location (restaurant, outdoors, home) and the last time they were at the same type of location without drinking, as well as characteristics of each drinking and nondrinking event (N = 1,096 events).
Results: Results of multilevel regression models indicated that perceived ease of alcohol access was associated with drinking across all locations (adjusted odds ratios [aORs] = 2.11-2.75, all p < .01). Weekend (vs. weekday) increased the odds of drinking outdoors (aOR = 3.75, p < .001) and in the home (aOR = 4.37, p < .001), as did a lack of adult supervision (aOR = 1.70, p < .05 for outdoors; aOR = 1.64, p < .01 for home). Larger groups (aOR = 1.06, p < .001) and being with older people (aOR = 2.28, p < .001) increased the odds of drinking in the home only. Significant cross-level interaction effects between location and group size (aOR = 0.96; p < .001), group gender composition (aOR = 0.78, p < .05), group age composition (aOR = 0.70, p < .01), ease of alcohol access (aOR = 0.88, p < .05), and weekend (aOR = 0.66, p < .05) suggested that these predictors were less significant in outdoor locations compared with the home.
Conclusions: Locations moderate the social and situational characteristics of events and are important for underage drinking. Results can inform targeted prevention efforts.
Yao, Jie, Voas, Robert B., Lacey, John H., 2018 Drivers with alcohol use disorders and their risks of crash involvement Drug and Alcohol Dependence, 183210-216.
doi: https://doi.org/10.1016/j.drugalcdep.2017.10.040 Impact Factor: 3.222 Abstract
Background: The relationship between driver blood alcohol concentration (BAC) and crash involvement is well understood. However, the role of alcohol use disorders (AUDs) (i.e., dependence or abuse) in crash occurrence, as distinguished from non-clinical heavy alcohol consumption, has not been adequately explored.
Methods: Data from the 2010–2011 Crash Risk Study conducted in Virginia Beach, VA, were used in this study. Drivers involved in crashes were compared with control drivers, and four drinker groups were examined: alcohol dependent, alcohol abusers, heavy drinkers, and all other current (i.e., normative) drinkers. Logistic regression analyses were conducted on two outcomes: having a moderate BAC (=0.05?g/dl), and crash involvement.
Results: Overall, 2411 crash-involved and 5514 control drivers provided useable data, 52.4% of which were men and 70.8% Whites. The prevalence of drivers with AUDs was lower for the crash-involved drivers (8.7%) than for the control drivers (12.7%). Only heavy drinkers, but not abusive or dependent drinkers, were over four times more likely to drive with moderate BACs at nighttime. More important, at nighttime, the odds of crash involvement for dependent drinkers were only one third of those for normative drinkers. Daytime crashes, however, were more likely to involve normative drinkers than any of the other three drinker types.
Conclusions: Drivers with AUDs are not more likely than normative drinkers to drive with moderate BACs at night. After accounting for the influence of BAC, dependent drinkers have a lower risk of being involved in a crash, at any time of the day. |
