Impact of Covid-19 on Caller Characteristics and Quit Rates: Experience of Regional Tobacco Quitline From India.

BACKGROUND: The tobacco epidemic is a major health concern amplified by Covid-19. We aimed to study differences in caller profiles to the regional tobacco quitline services of South India during the Covid-19 pandemic in comparison with the prepandemic. METHOD: Using a descriptive cross-sectional research design, we examined registered caller profiles to the quitline between March and July 2019 (Prepandemic N = 7845) and the same months in 2020 (Covid-19 pandemic phase N = 6447) phases. RESULTS: The proportion of registered callers with an expressed intent to quit tobacco increased by 1.73 times during pandemic (16.7% versus 9.6%). Health concerns were cited as the major reason (93.25%) to quit tobacco in 2020 as compared to 2019 (88.02%). Cough (28.50%) and psychological difficulties (14.20%) were reported significantly more by RCs in 2020. Self-reported quit rates were significantly higher among RCs in 2020 as compared to 2019 on the quit day (2019-47.37% & 2020-77.54%, p = .001), at one week (2019-25.17% and 2020-56.06%, p = .001) as was one-month continuous abstinence (2019-11.88% and 2020-39.60%, p = .001). CONCLUSION: The pandemic resulted in a greater intent to quit among registered callers to the quitline. However, awareness about the quitline services as well as other tobacco cessation services needs to be expanded to reach more tobacco users. IMPLICATIONS: Pandemics offer an opportunity to change health risk behaviors. During the Covid-19 pandemic, callers to the tobacco quitline were more motivated to quit tobacco and attributed it to concerns about the health risks from tobacco use, particularly during the pandemic. Quit rates also increased significantly during the pandemic as compared to before. These gains in encouraging tobacco cessation need to be maintained beyond the pandemic by strengthening existing quitlines and other supports for tobacco cessation.

Development and Testing of an Audio-Visual Self-Help Yoga Manual for Indian Caregivers of Persons with Schizophrenia Living in the Community: A Single-Blind Randomized Controlled Trial.

BACKGROUND: To test the feasibility and effectiveness of an audio-visual self-help audio-visual yoga manual on burden of Indian caregivers of persons with schizophrenia, living in the community. METHODS: An earlier developed yoga program for caregivers of schizophrenia was remodeled into an audio-visual self-help manual in three languages and validated by mental health and yoga experts. 48 consenting primary family caregivers of outpatients with schizophrenia were screened, recruited, and allotted randomly to Yoga or Care as Usual Group. Participants in Yoga group were taught yoga from the self-help manual (1 session of 1 h every month for 5 months). The caregivers were asked to follow the manual for the remaining month at home. Assessments of burden, perceived stress, quality of life, and anxiety-depression were conducted by a rater blind to the group status at baseline and at the end of every month. RESULTS: Post factoring for missing data, Repeatedmeasure ANOVA was conducted; which showed that there was no significant difference between the group that practiced the selfhelp yoga manual and the care as usual group. The caregivers who practiced yoga at home maintained an average of 50% attendance and "very well" level of yoga performance. CONCLUSION: The audio-visual self-help yoga manual was found to be feasible to use by the caregivers even though its effectiveness could not be ascertained due to high attrition.

Integrated Cognitive Behavioral Intervention Reduces Intimate Partner Violence Among Alcohol Dependent Men, and Improves Mental Health Outcomes in their Spouses: A Clinic Based Randomized Controlled Trial from South India.

BACKGROUND AND AIM: Alcohol abuse has been associated with intimate partner violence (IPV). The current study examined the effectiveness of an integrated cognitive-behavioral intervention (ICBI) in reducing intimate partner violence (IPV) perpetration among alcohol dependent men, and improving mental health outcomes among their wives and children. METHODS: One hundred seventy-seven alcohol dependent male inpatients who screened positive for IPV perpetration in the last 6 months were randomly assigned to receive ICBI which addressed both the alcohol use and IPV (n=88), or TAU (TAU: treatment as usual) (n=89). The ICBI sessions were attended by the patients alone. All patients and their spouses were followed up over 3 months following discharge from the treatment centre. RESULTS: Compared to TAU participants in the ICBI group reported significantly lower IPV perpetration, and their wives scored significantly lower on depression, anxiety, and stress levels at 3-month follow up. Alcohol consumption in the men and emotional and behavioral problems in their children were not significantly different between the groups, from baseline to follow up. CONCLUSIONS: Findings demonstrate the feasibility and effectiveness of an ICBI which addressed both the IPV and alcohol use in a coordinated manner in a vulnerable sample.

Two sides of a coin: Perpetrators and survivors perspectives on the triad of alcohol, intimate partner violence and mental health in South India.

The present study explored the intersection among alcohol consumption, gender roles, intimate partner violence (IPV) and mental health from the perspective of heavy drinking men who also perpetrate IPV (perpetrators) and their spouses (survivors). Interpretive phenomenological approach was used, and in-depth interviews were conducted with adult married heavy drinking men who reported to have perpetrated IPV (N=10) and their spouses (N=10). These interviews were audio-recorded, and salient themes were generated using the NVivo software. Findings indicated a deeply embedded association among alcohol consumption, IPV, and mental health, with culturally sanctioned gender norms strongly contributing to this association. There was evidence for anxiety and depression in the survivors and emotional-behavioural and academic difficulties in their children. The study provides valuable insight into the intersecting problems of alcohol and IPV, which independently and together signify an emergent public health problem that can have immense ramifications on mental health of individuals and families.