Community Support for Harm Reduction and Treatment of Opioid Use Disorder.

As the opioid epidemic continues, availability of evidence-based strategies for harm reduction and treatment in communities is critical to reduce overdose and other consequences of opioid use disorder. Community members' support of harm reduction and treatment services is needed for new programs and to maintain existent programs. This study sought to understand beliefs and attitudes associated with support for three community-based strategies to address opioid misuse and addiction: naloxone, needle exchange, and medication-assisted treatment. We conducted a cross-sectional online survey with 545 adults. Results of the survey showed that participants supported all three strategies, with the strongest support for medication-assisted treatment. Multiple regression showed that stigma and perceived stigma were significant predictors for all three strategies, with inverse relationships. Stigmatizing beliefs predicted less support while perceiving stigma among others was associated with greater support for the strategies. Normative beliefs also significantly predicted support for all three strategies, such that stronger belief that others were supportive of each strategy was associated with greater support for that strategy. Other predictors varied across the three strategies. Support for harm reduction and treatment programs in communities affected by the opioid epidemic may be bolstered by reducing stigma and increasing normative beliefs. Stronger support for medication-assisted treatment may be leveraged and extended to harm reduction strategies. Results of our study contribute insights for bolstering community support for harm reduction and treatment, which is vital for adoption and maintenance of these important programs.

Youth misperceptions of peer substance use norms: a hidden risk factor in state and community prevention.

Effective community prevention of substance abuse involves the integration of policies and programs to address many different risk and protective factors across the social ecology. This study sought to examine whether youth perceptions of peer substance use norms were operating as a risk factor at the same level as other known risk factors in a statewide community prevention effort. Several different analytical techniques were employed to examine the self-reported data from a sample of over 8,000 students in grades 6, 8, 10, and 12 from across Wyoming using a survey based on a risk and protective factor model. The findings of this study revealed that youth misperception of peer substance use norms operate at a level of significance similar to other known risk factors, and these misperceptions are a risk factor that should be measured in order to estimate its relationship with substance use. The measurement of this risk factor has important strategic implications for community prevention.

Role of Trusted Sources and Behavioral Beliefs in Promoting Mitigation Behaviors During the COVID-19 Pandemic: Survey Study.

BACKGROUND: During the ongoing COVID-19 pandemic and in preparation for future public health crises, it is important to understand the relationship between individuals' health beliefs, including their trust in various sources of health information, and their engagement in mitigation behaviors. OBJECTIVE: We sought to identify relationships between trust in various sources of health information and the behavioral beliefs related to vaccination and mask wearing as well as to understand how behavioral beliefs related to vaccination differ by willingness to be vaccinated. METHODS: We conducted an online survey of 1034 adults in the United States and assessed their trust in federal, local, and media sources of health information; their beliefs about vaccination; and their masking intention and vaccination willingness. RESULTS: Using regression, masking intention was predicted by trust in the World Health Organization (P<.05) and participants' state public health offices (P<.05), while vaccine willingness was predicted by trust in participants' own health care providers (P<.05) and pharmaceutical companies (P<.001). Compared to individuals with low willingness to be vaccinated, individuals with high willingness indicated greater endorsement of beliefs that vaccines would support a return to normalcy, are safe, and are a social responsibility (P<.001 for all). CONCLUSIONS: Results can be used to inform ongoing public health messaging campaigns to manage the COVID-19 pandemic and increase readiness for the next pandemic. Additionally, results support the need to bolster the public's trust in health care agencies as well as to enhance trust and respect in health care providers to increase people's adoption of mitigation behaviors.

Modeling the system of beliefs that influence driving under the influence of cannabis (DUIC) in Washington State.

Cannabis use is increasing in the U.S. Driving under the influence of cannabis (DUIC) may be increasing as well potentially resulting in fatal and serious injury crashes. The purpose of this article is to explore the belief system associated with driving under the influence of cannabis (DUIC) using structural equation modeling (SEM). A sample (n = 2,084) of surveys collected from adults in the U.S. was analyzed using SEM to reveal the latent structure of the belief system associated with DUIC. The results of this analysis indicated that reported DUIC behavior (frequency and recency) was predicted by willingness that influenced intention. Willingness and intention were directly influenced by control beliefs, attitudes, norms, and attitudes (prototype image) toward people who never DUIC. Intention was also influenced by attitudes toward people who do DUIC. Intention had a stronger influence on DUIC than willingness alone. These components were influenced by underlying behavioral, normative, and control beliefs. Thus, strategies that can change these beliefs may also reduce DUIC.

Traffic safety culture and prosocial driver behavior for safer vehicle-bicyclist interactions.

INTRODUCTION: Bicyclist safety is a growing concern as more adults use this form of transportation for recreation, exercise, and mobility. Most bicyclist fatalities result from a crash with a vehicle. Often, the behaviors of the driver are responsible for the crash. METHOD: This survey study of Montana and North Dakota residents (n = 938) examined the influence of traffic safety culture on driver behaviors that affect safe interactions with bicyclists. RESULTS: Prosocial driver behavior was most common and appeared to be intentional. Intention was increased by positive attitudes, normative perceptions, and perceived control. However, normative perceptions appear to offer the most opportunity for change. Practical Application: Strategies that increase perceptions that prosocial driver behavior is normal may increase prosocial intentions, thereby increasing bicyclist safety.

Developing a theoretical foundation to change road user behavior and improve traffic safety: Driving under the influence of cannabis (DUIC).

OBJECTIVES: This study explored a theoretical model to assess the influence of culture on willingness and intention to drive under the influence of cannabis (DUIC). This model is expected to guide the design of strategies to change future DUIC behavior in road users. METHODS: This study used a survey methodology to obtain a nationally representative sample (n = 941) from the AmeriSpeak Panel. Survey items were designed to measure aspects of a proposed definition of traffic safety culture and a predictive model of its relationship to DUIC. RESULTS: Although the percentage of reported past DUIC behaviors was relatively low (8.5%), this behavior is still a significant public health issue-especially for younger drivers (18-29 years), who reported more DUIC than expected. Findings suggest that specific cultural components (attitudes, norms) reliably predict past DUIC behavior, general DUIC willingness, and future DUIC intention. Most DUIC behavior appears to be deliberate, related significantly to willingness and intention. Intention and willingness both appear to fully moderate the relationship between traffic safety culture and DUIC behavior. CONCLUSIONS: This study explored a theoretical model to understand road user behavior involving drug (cannabis)-impaired driving as a significant risk factor for traffic safety. By understanding the cultural factors that increase DUIC behavior, we can create strategies to transform this culture and sustain safer road user behavior.