Introducing care management to Brazil's alcohol and substance use disorder population

Brazil has a sizable alcohol and substance use disorder (ASUD) population, yet there are considerable gaps in treatment access and retention. ASUD, a chronic medical condition, is highly comorbid with medical and behavioral health disorders. This indicates a need for more targeted interventions in order to achieve health care integration (a major goal of Brazil's health care system). Care management - that is, the organization of patient care by an institution - is a viable strategy to engage individuals with ASUD who might benefit from treatment but are not aware of or do not use the available resources, as well as to help maintain patients in treatment. Care management is considered an essential supplement to the treatment of chronic disease. The objective of this article is to discuss the applicability of care management for the treatment of ASUD within the public health care system in Brazil. We describe models of care management that have been adopted internationally and identify the feasibility and advantages for its adoption in Brazil.

Introducing care management to Brazil's alcohol and substance use disorder population.

Brazil has a sizable alcohol and substance use disorder (ASUD) population, yet there are considerable gaps in treatment access and retention. ASUD, a chronic medical condition, is highly comorbid with medical and behavioral health disorders. This indicates a need for more targeted interventions in order to achieve health care integration (a major goal of Brazil's health care system). Care management - that is, the organization of patient care by an institution - is a viable strategy to engage individuals with ASUD who might benefit from treatment but are not aware of or do not use the available resources, as well as to help maintain patients in treatment. Care management is considered an essential supplement to the treatment of chronic disease. The objective of this article is to discuss the applicability of care management for the treatment of ASUD within the public health care system in Brazil. We describe models of care management that have been adopted internationally and identify the feasibility and advantages for its adoption in Brazil.

Envolvimento religioso e fatores sociodemográficos: resultados de um levantamento nacional no Brasil / Religious involvement and sociodemographic factors: a Brazilian national survey

CONTEXTO: As relações entre envolvimento religioso e saúde têm sido objeto de crescente interesse, mas há carência de estudos fora dos Estados Unidos e da Europa. OBJETIVOS: O presente estudo descreve o envolvimento religioso na população brasileira e sua relação com variáveis sociodemográficas. MÉTODOS: Numa amostra probabilística da população brasileira (n = 3.007), variáveis sociodemográficas e de envolvimento religioso foram avaliadas. RESULTADOS: Cinco por cento dos brasileiros declararam não ter religião, 83 por cento consideraram religião muito importante para sua vida e 37 por cento frequentavam um serviço religioso pelo menos uma vez por semana. As filiações religiosas mais frequentes foram Catolicismo (68 por cento), Protestante/Evangélica (23 por cento) e Espiritismo Kardecista (2,5 por cento). Dez por cento referiram frequentar mais de uma religião. De modo semelhante a estudos em outros países, maior idade e sexo feminino se associaram a maiores níveis de religiosidade subjetiva e organizacional, mesmo após o controle para outras variáveis sociodemográficas. Entretanto, nível educacional, renda e raça negra não se associaram de modo independente a indicadores de religiosidade. CONCLUSÃO: Este estudo mostra altos níveis de religiosidade entre os brasileiros e sugere que religiosidade, em diferentes culturas, pode relacionar-se de modo diferente com outras variáveis. Para uma melhor compreensão da influência da religiosidade na saúde, é necessário expandir esse tipo de estudo para outras culturas.

BACKGROUND: The relationship between religious involvement and health has been subject to an increasing interest. However, studies investigating religious involvement are scarce outside United States and Europe. OBJECTIVES: This study describes religious involvement in the Brazilian population and its relationship with sociodemographic variables. METHODS: In a Brazilian nationally probabilistic sample (n = 3,007), religious involvement variables and sociodemographic factors were assessed. RESULTS: Five percent of Brazilians reported having no religion, 83 percent considered religion very important in their lives, and 37 percent attended religious services at least once a week. The most frequent affiliations were Catholicism (68 percent), Protestant/Evangelicals (23 percent), and Kardecist Spiritism (2.5 percent). Ten percent reported attending more than one religion. In line with studies in other countries, older age and female gender were independently associated with higher levels of subjective and organizational religiousness after controlling for other sociodemographic factors. However, educational level, income and black race were not independently associated with religious involvement variables. DISCUSSION: This study shows high levels of religious involvement among Brazilians and suggests that religiousness may have different associations with other variables across different cultures. To better understand the influence of religion on health, it is necessary to expand this kind of survey to other cultures.