Three-year trajectories of alcohol use among at-risk and among low-risk drinkers in a general population sample of adults: A latent class growth analysis of a brief intervention trial.

Background: Few studies have assessed trajectories of alcohol use in the general population, and even fewer studies have assessed the impact of brief intervention on the trajectories. Especially for low-risk drinkers, it is unclear what trajectories occur, whether they benefit from intervention, and if so, when and how long. The aims were first, to identify alcohol use trajectories among at-risk and among low-risk drinkers, second, to explore potential effects of brief alcohol intervention and, third, to identify predictors of trajectories. Methods: Adults aged 18-64 years were screened for alcohol use at a municipal registration office. Those with alcohol use in the past 12 months (N = 1646; participation rate: 67%) were randomized to assessment plus computer-generated individualized feedback letters or assessment only. Outcome was drinks/week assessed at months 3, 6, 12, and 36. Alcohol risk group (at-risk/low-risk) was determined using the Alcohol Use Disorders Identification Test-Consumption. Latent class growth models were estimated to identify alcohol use trajectories among each alcohol risk group. Sex, age, school education, employment status, self-reported health, and smoking status were tested as predictors. Results: For at-risk drinkers, a light-stable class (46%), a medium-stable class (46%), and a high-decreasing class (8%) emerged. The light-stable class tended to benefit from intervention after 3 years (Incidence Rate Ratio, IRR=1.96; 95% Confidence Interval, CI: 1.14-3.37). Male sex, higher age, more years of school, and current smoking decreased the probability of belonging to the light-stable class (p-values<0.05). For low-risk drinkers, a very light-slightly increasing class (72%) and a light-increasing class (28%) emerged. The very light-slightly increasing class tended to benefit from intervention after 6 months (IRR=1.60; 95% CI: 1.12-2.28). Male sex and more years of school increased the probability of belonging to the light-increasing class (p-value < 0.05). Conclusion: Most at-risk drinkers did not change, whereas the majority of low-risk drinkers increased alcohol use. There may be effects of alcohol feedback, with greater long-term benefits among persons with low drinking amounts. Our findings may help to identify refinements in the development of individualized interventions to reduce alcohol use.

[Experiences of Stigmatization Among Professional Caregivers in the Context of Covid-19 - a Qualitative Study]. / Stigmatisierungserfahrungen bei beruflich Pflegenden im Kontext von Covid-19 ­ eine Qualitative Studie.

OBJECTIVE: Healthcare workers seem to be more affected by stigma due to the Covid-19 pandemic compared to other occupational groups. However, there is very little research on this topic. The aims of the present study were to investigate pandemic-related stigmatization experiences among nursing and medical staff in Germany and determine the type and effects of stigmatization as well as appropriate prevention and intervention measures. METHODS: The interviews were conducted by a semi-structured interview guide and evaluated using qualitative content analysis. RESULTS: Sixteen nurses participated in the interviews. Sources of stigmatization were friends and acquaintances, family members, executives, colleagues, patients and their relatives, strangers and public media. Some of the interviewed persons reported self-stigmatization. A common cause of stigma in the private environment was the fear of infection. In the context of the work, illness-related absence was also named as one of the causes of stigma. The interviewees reported about distancing and avoiding contact, as well as allegations they were faced with. As a result, they suffered from negative feelings and partially from psychosomatic complaints. Some interviewees tried to avoid stigmatization by concealing their own profession or place of work. Help was offered in private and professional context in form of conversations and encouragement. CONCLUSION: Stigmatization of healthcare professionals during the pandemic has hardly been explored in Germany. There is a particular need for research to quantify the extent, manifestations and effects of work-related stigmatization and to develop suitable preventive measures at workplace and outside of work.