Understanding culturally tailored approaches in males of punjabi ancestry with alcohol use disorder at Roshni Clinic.

Learning Objectives: 1. Identify and describe factors that are important to the care of patients of Punjabi ancestry suffering from AUD. 2. Explain the importance of culturally tailored approaches to primary care in the context of AUD. Context: Structural and institutional racism in the healthcare system, language barriers, and stigma have resulted in people of color (POC) facing increased barriers to healthcare access, even though POC are often experiencing greater severity with their substances use disorders. There is limited research on the evaluation or description of culturally tailored interventions and limited culturally tailored centers serving racialized populations struggling with AUD, especially for the Punjabi population. Therefore, it is crucial for primary care providers to understand the importance of culturally tailored approaches to this patient population, as they are often the first point of contact. Objective: To understand and describe what aspects of care provided at Roshni Clinic was beneficial to patients by conducting a qualitative analysis of interviews. Study Design: Qualitative study. Interviews translated from Punjabi to English. Responses transcribed and coded, occurrences of themes were tabulated. Setting: Study completed at Roshni Clinic, a culturally tailored center located in Surrey, Canada that addresses problems associated with alcohol and other substances for adults >18 years old in a holistic, culturally tailored approach. Population Studied: Eight participants recruited and consented. Inclusion criteria: cis-male of Punjabi ancestry, communicate in English/Punjabi, diagnosed with AUD, hospitalized for alcohol related harms, and presented for care at Roshni. No exclusion criteria. Results: Nearly half the responses identified culturally tailored approaches as most helpful. Over one third of the responses indicated structural factors intrinsically tied to Roshni such as counseling, and accountability, as helpful. Approximately 10% was attributable to medications and patient education. Conclusions: Culturally tailored approaches and providers fluent in the Punjabi language proved to be the most beneficial factors to patients at Roshni Clinic. There are limited culturally tailored, primary care addictions centers such as Roshni Clinic serving Punjabi males with AUD in BC's Lower Mainland. Thus, this study stresses the importance of investment in research and development of patient informed culturally tailored care centers.

Understanding culturally tailored approaches in males of punjabi ancestry with alcohol use disorder at roshni clinic.

Learning objectives: 1. Identify and describe factors that are important to the care of patients of Punjabi ancestry suffering from AUD. 2. Explain the importance of culturally tailored approaches to primary care in the context of AUD. Context: Structural and institutional racism in the healthcare system, language barriers, and stigma have resulted in people of color (POC) facing increased barriers to healthcare access, even though POC are often experiencing greater severity with their substances use disorders. There is limited research on the evaluation or description of culturally tailored interventions and limited culturally tailored centers serving racialized populations struggling with AUD, especially for the Punjabi population. Therefore, it is crucial for primary care providers to understand the importance of culturally tailored approaches to this patient population, as they are often the first point of contact. Objective: To understand and describe what aspects of care provided at Roshni Clinic was beneficial to patients by conducting a qualitative analysis of interviews. Study design: Qualitative study. Interviews translated from Punjabi to English. Responses transcribed and coded, occurrences of themes were tabulated. Setting: Study completed at Roshni Clinic, a culturally tailored center located in Surrey, Canada that addresses problems associated with alcohol and other substances for adults >18 years old in a holistic, culturally tailored approach. Population studied: Eight participants recruited and consented. Inclusion criteria: cis-male of Punjabi ancestry, communicate in English/Punjabi, diagnosed with AUD, hospitalized for alcohol related harms, and presented for care at Roshni. No exclusion criteria. Results: Nearly half the responses identified culturally tailored approaches as most helpful. Over one third of the responses indicated structural factors intrinsically tied to Roshni such as counseling, and accountability, as helpful. Approximately 10% was attributable to medications and patient education. Conclusions: Culturally tailored approaches and providers fluent in the Punjabi language proved to be the most beneficial factors to patients at Roshni Clinic. There are limited culturally tailored, primary care addictions centers such as Roshni Clinic serving Punjabi males with AUD in BC's Lower Mainland. Thus, this study stresses the importance of investment in research and development of patient informed culturally tailored care centers. Learning objectives: 1. Identify and describe factors that are important to the care of patients of Punjabi ancestry suffering from AUD. 2. Explain the importance of culturally tailored approaches to primary care in the context of AUD. Context: Structural and institutional racism in the healthcare system, language barriers, and stigma have resulted in people of color (POC) facing increased barriers to healthcare access, even though POC are often experiencing greater severity with their substances use disorders. There is limited research on the evaluation or description of culturally tailored interventions and limited culturally tailored centers serving racialized populations struggling with AUD, especially for the Punjabi population. Therefore, it is crucial for primary care providers to understand the importance of culturally tailored approaches to this patient population, as they are often the first point of contact. Objective: To understand and describe what aspects of care provided at Roshni Clinic was beneficial to patients by conducting a qualitative analysis of interviews. Study design: Qualitative study. Interviews translated from Punjabi to English. Responses transcribed and coded, occurrences of themes were tabulated. Setting: Study completed at Roshni Clinic, a culturally tailored center located in Surrey, Canada that addresses problems associated with alcohol and other substances for adults >18 years old in a holistic, culturally tailored approach. Population studied: Eight participants recruited and consented. Inclusion criteria: cis-male of Punjabi ancestry, communicate in English/Punjabi, diagnosed with AUD, hospitalized for alcohol related harms, and presented for care at Roshni. No exclusion criteria. Results: Nearly half the responses identified culturally tailored approaches as most helpful. Over one third of the responses indicated structural factors intrinsically tied to Roshni such as counseling, and accountability, as helpful. Approximately 10% was attributable to medications and patient education. Conclusions: Culturally tailored approaches and providers fluent in the Punjabi language proved to be the most beneficial factors to patients at Roshni Clinic. There are limited culturally tailored, primary care addictions centers such as Roshni Clinic serving Punjabi males with AUD in BC's Lower Mainland. Thus, this study stresses the importance of investment in research and development of patient informed culturally tailored care centers.

Treatment of alcohol use disorder among people of South Asian ancestry in Canada and the United States: A narrative review.

To explore access and treatment for alcohol use disorders (AUDs) among people of South Asian ancestry living in Canada or the United State, EQUATOR guidelines were applied to 34 manuscripts identified through an English language literature search (1946-2017) for this narrative review. The population studied has poor access to and engagement with treatment for AUD. Early evidence suggests benefit from adopting language-specific materials, offering South Asian-specific therapy groups, and incorporating traditional healers. Specific engagement and therapy considerations may increase AUD treatment access and effectiveness among South Asians living in Canada or the United States.

Burden and correlates of mental health diagnoses among sex workers in an urban setting.

BACKGROUND: Women involved in both street-level and off-street sex work face disproportionate health and social inequities compared to the general population. While much research has focused on HIV and sexually transmitted infections (STIs) among sex workers, there remains a gap in evidence regarding the broader health issues faced by this population, including mental health. Given limited evidence describing the mental health of women in sex work, our objective was to evaluate the burden and correlates of mental health diagnoses among this population in Vancouver, Canada. METHODS: An Evaluation of Sex Workers Health Access (AESHA) is a prospective, community-based cohort of on- and off-street women in sex work in Vancouver, Canada. Participants complete interviewer-administered questionnaires semi-annually. We analyzed the lifetime burden and correlates of self-reported mental health diagnoses using bivariate and multivariable logistic regression. RESULTS: Among 692 sex workers enrolled between January 2010 and February 2013, 338 (48.8%) reported ever being diagnosed with a mental health issue, with the most common diagnoses being depression (35.1%) and anxiety (19.9%). In multivariable analysis, women with mental health diagnoses were more likely to identify as a sexual/gender minority (LGBTQ) [AOR=2.56, 95% CI: 1.72-3.81], to use non-injection drugs [AOR=1.85, 95% CI: 1.12-3.08], to have experienced childhood physical/sexual trauma [AOR=2.90, 95% CI: 1.89-4.45], and work in informal indoor [AOR=1.94, 95% CI: 1.12 - 3.40] or street/public spaces [AOR=1.76, 95% CI: 1.03-2.99]. CONCLUSIONS: This analysis highlights the disproportionate mental health burden experienced by women in sex work, particularly among those identifying as a sexual/gender minority, those who use drugs, and those who work in informal indoor venues and street/public spaces. Evidence-informed interventions tailored to sex workers that address intersections between trauma and mental health should be further explored, alongside policies to foster access to safer workspaces and health services.

Gender influences on hepatitis C incidence among street youth in a Canadian setting.

PURPOSE: Few studies have examined gender-based differences in the risk of hepatitis C virus (HCV) infection among street-involved youth. We compared rates of HCV infection among male and female street-involved youth in a Canadian setting. METHODS: The At-Risk Youth Study is a prospective cohort of drug-using street-involved youth. Study recruitment and follow-up occurred in Vancouver, Canada, between September 2005 and November 2011. Eligible participants were illicit drug-using youth aged 14-26 years at enrollment, recruited by street-based outreach. We evaluated rates of HCV antibody seroconversion, measured every 6 months during study follow-up, and used Cox proportional hazards regression to compare risk factors for HCV incidence between male and female street youth. RESULTS: Among 512 HCV-seronegative youth contributing 836 person-years of follow-up, 56 (10.9%) seroconverted to HCV. Among female participants, the incidence density of HCV infection was 10.9 per 100 person-years, and in males, it was 5.1 per 100 person-years (p = .009). In multivariate analyses, female gender was independently associated with a higher rate of HCV seroconversion (adjusted hazard ratio, 2.01; 95% confidence interval, 1.18-3.44). Risk factors were similar in gender-stratified analyses and included heroin injection and crystal methamphetamine injection, although syringe sharing was only associated with HCV incidence among males. CONCLUSIONS: Among street-involved youth in this setting, females had double the incidence of HCV seroconversion demonstrating the need for gender-focused HCV prevention interventions for this population.