Development and Evaluation of the Lifestyle History Questionnaire (LHQ) for People Entering Treatment for Substance Addictions.

OBJECTIVE: We developed and investigated the psychometric properties of the Lifestyle History Questionnaire (LHQ), a self-report instrument designed to measure the extent of occupational dysfunction attributable to substance abuse. METHOD: The instrument was developed using concepts in the ecological models of occupational therapy and in the work of William L. White, who defined addiction culture in terms of the patterns of life in context. We analyzed data from two field tests using both classical test theory and item response theory. RESULTS: The final version of the instrument has 70 items, 1 unifying construct, and 8 subscales. We found it to be valid and reliable (α=.93) for measuring the extent of occupational dysfunction and specific areas of strengths and weaknesses. CONCLUSION: The LHQ is a promising new instrument, the first of its kind to measure occupational dysfunction in context for people with substance addictions.

Effectiveness of a peer-support community in addiction recovery: participation as intervention.

The main purpose of the study was to determine whether a peer-support community programme would reduce relapse rates among clients recovering from substance addictions and homelessness and result in increased perceived community affiliation, supportive behaviours, self-determination and quality of life. Mixed methods were utilized including semi-structured interviews, participant observation and a pretest/post-test to evaluate changes on the quality of life rating, the Medical Outcomes Study-Social Support Survey, and the Volitional Questionnaire. Data from the prior year's permanent supportive housing programme were used for comparison of relapse rates. Significant reduction of risk of relapse was found in clients who participated in the programme. Significant differences were found on three subscales of the Medical Outcomes Study-Social Support Survey. Improvement that did not reach statistical significance was seen on the quality of life rating. Qualitative evidence supported improvements in perceived community affiliation and supportive behaviours.Evidence suggests that a peer-supported community programme focused on self-determination can have a significant positive impact on recovery from substance addictions and homelessness. Limitations include a small sample size and lack of a randomized control group.

Validity and reliability of self-reported arthritis: Georgia senior centers, 2000-2001.

BACKGROUND: Arthritis and other rheumatic conditions are a common cause of disability among adults in the United States. Telephone interviews of the state-based Behavioral Risk Factor Surveillance System (BRFSS) are used by states and territories to estimate the prevalence of arthritis. The purpose of this study was to assess the validity and reliability of the 1996-2001 BRFSS arthritis case definition in a senior center population. METHODS: A total of 487 respondents at selected senior centers in Georgia were surveyed by telephone, evaluated 3 to 4 weeks later by board-certified rheumatologists, and completed a written survey in 2000 to 2001. Using the rheumatologists' summary assessment "Does this person have arthritis or a related condition" as the standard, the sensitivity and specificity of the BRFSS arthritis case definitions were calculated. Reliability for the BRFSS arthritis case definition was also calculated by comparing responses to the telephone survey with responses to a written survey. RESULTS: Sensitivity was 70.8% (95% confidence interval [CI]=65.9-75.6), and the specificity was 70.3% (95% CI=62.9-77.8). The agreement between the telephone and written responses indicating self-reported arthritis was high (kappa=0.68). Analyses were conducted in 2002 to 2004. CONCLUSIONS: Self-reported arthritis in the 1996-2001 BRFSS was highly reliable, and moderately sensitive and specific among these senior center participants.

Mothers in recovery: an occupational perspective.

The purposes of this study were to discover the stories of mothers regarding their journeys to addiction and through recovery, to explore the impact of addiction on the occupational performance of mothers and to identify the factors perceived by these mothers as important in their treatment. A narrative inquiry with thematic analysis of data was utilized; semi-structured interviews were conducted with 10 women in treatment for alcohol or other drug addiction who were all mothers of minor children. Alterations in occupational identity, occupational performance patterns and performance capacity were revealed. Environmental elements contributing to addiction and those important in recovery were identified and included structure (or the lack of it) and the persons populating the social environment. This qualitative study is not generalizable and should be viewed as relevant to these informants in this context; participants had histories of chronic substance addiction and are not representative of all addictions patients. Findings can be viewed within the context of other research to help enrich the reader's understanding of the complexity of issues. Further research is recommended to test the efficacy of occupational therapy interventions for substance addictions. Possible intervention studies might include those focused on environmental structure, exploration of interests in treatment and co-occupations of mother and child.

Prevalence of epilepsy and health status of adults with epilepsy in Georgia and Tennessee: Behavioral Risk Factor Surveillance System, 2002.

Behavioral risk factors associated with comorbidity in people with epilepsy are largely unknown. We studied a population-based sample of 8057 adults through the 2002 Behavioral Risk Factor Surveillance System, in Georgia and Tennessee, ascertaining a lifetime epilepsy prevalence of 2.1% in this population. This structured interview revealed that those with epilepsy had significantly worse self-reported fair or poor health status (39% vs 17% in adults without epilepsy), significantly greater cigarette smoking (38.8% vs 24.9% in other adults), and high rates of obesity (34.1% vs 23.7% in adults without epilepsy). Large percentages of adults with epilepsy reported currently symptomatic asthma and recent joint pain. Adults with epilepsy had lower educational attainment and lower household incomes, but a higher rate of medical insurance coverage, than did other adults. This type of population-based survey can serve to identify health disparities, behavioral risk factors for other chronic diseases, and unmet health care needs in individuals with epilepsy, and to track changes in these measures over time.