Screening, Brief Intervention and Referral to Treatment (SBIRT): An examination of health disparities.

Risky substance use can lead to a variety of negative health outcomes, yet treatment is often underutilized by historically minoritized racial/ethnic groups. Screening, Brief Intervention and Referral to Treatment (SBIRT) is effective in changing substance use patterns across diverse settings and for diverse demographic groups. However, few studies have focused on whether individuals receive the appropriate level of care based on screening criteria. The purpose of this study was to investigate intervention match/mismatch and factors (e.g., service site, gender, race, ethnicity, age, socio-economic status) that predicted the likelihood of being matched/mismatched to an intervention. A sample of N = 3412 were available for analyses and logistic regressions were performed to examine the relationship between matching/mismatching to an intervention and other factors. Of participants, 2222 (65%) were matched to an intervention and 1190 (35%) were mismatched to an intervention. Being older, Hispanic, and receiving SBIRT by health-teams designed to reduce health disparities was related to increased odds of being mismatched. Exploratory results suggested that across predictors, individuals were more likely to receive a lesser intervention than their screening score indicated. Most clients were matched well to intervention as based on screening score. When mismatch occurred, a lower level of care was given. Staff may benefit from attending to more client engagement so that clients return for more intensive interventions; and agencies may need more resources to facilitate client access to services.

Motivational interviewing for family planning and reducing risky sexual behavior among incarcerated men nearing release: A randomized controlled pilot study.

Incarcerated men are at high risk for sexually transmitted infections (STIs) and unintended partner pregnancy postrelease. Limited research has been invested in developing and testing treatments targeting risky sexual behavior and unwanted pregnancy for this at-risk population. Motivational interviewing (MI) is a promising behavioral intervention for decreasing risky sexual behaviors. This study assessed the feasibility and acceptability of MI for family planning and risky sexual behaviors with incarcerated men nearing release. Preliminary efficacy of the MI intervention was also compared to an educational control group. Thirty-two men were assessed at baseline and randomized to one 90-min session. Assessment occurred 2 months after release. MI was feasibly administered, and participants were highly satisfied with both treatments. In addition, those who received MI reported higher rates of condom use with casual partners, higher rates of partner use of hormonal contraceptives, and slightly higher rates of sex that was protected against pregnancy. Increases are readiness to discuss family planning with sexual partners, as well as reported frequency of these discussions, and increases in family planning knowledge were also found in those randomized to MI. The findings from this study indicate the need to further assess MI with this population with a full-scale clinical trial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Motivational interviewing to reduce risky sexual behaviors among at-risk male youth: A randomized controlled pilot study.

BACKGROUND: Despite male youth taking more sexual risks that lead to unwanted partner pregnancy and/or sexually transmitted infections (STIs), research evaluating interventions for risky sex has focused almost exclusively on adolescent and adult females. With STIs among male youth on the rise, behavioral interventions that target risky sex among male youth are needed. PURPOSE: A randomized controlled pilot study was conducted to examine the feasibility and acceptability of two manualized behavioral interventions for sexually active male youth. METHODS: Sexually active at-risk male youth (N = 27) were recruited and randomized to receive one session of motivational interviewing (MI) or didactic educational counseling (DEC). Assessment interviews were conducted prior to and 3 months following the intervention session. RESULTS: Support for the feasibility and acceptability of delivering behavioral interventions to reduce risky sexual behaviors among at-risk male youth was found. Compared to participants in DEC at follow-up, participants in MI reported having significantly fewer sexual encounters with casual partners, used substances at the time of sex significantly less often with all partners and casual partners, and reported fewer incidents of using substances at the time of sex without a condom with all partners. Conversely, participants who received MI used substances at the time of sex with main partners and used substances at the time of sex without a condom more often with main partners at follow-up compared to participants who received DEC. CONCLUSIONS: Results of the pilot study support conducting a larger randomized controlled trial to examine treatment effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A psychometric assessment of the Brief Situational Confidence Questionnaire for Marijuana (BSCQ-M) in juvenile justice-involved youth.

Cannabis refusal self-efficacy, defined as confidence in the ability to refuse cannabis or to avoid cannabis use, is associated with decreased cannabis use. Juvenile justice-involved youth are at high risk for cannabis use and may have lower refusal self-efficacy. While court-involved, non-incarcerated (CINI) and incarcerated youth are groups that are both at high-risk for cannabis use, the experience of incarceration may impact the measurement of refusal self-efficacy for cannabis. The factor structure, measurement invariance, and concurrent validity of the Brief Situational Confidence Questionnaire for Cannabis (BSCQ-M) was assessed among CINI (n = 148) and incarcerated (n = 199) youth (80.7% male, Mage = 16.3). Confirmatory factor analyses indicated that a correlated 3-factor model including positive/good times, negative internal, and negative external situational factors best fit the data. Multigroup measurement invariance testing revealed that the BSCQ-M demonstrated configural, metric, scalar, and residual invariance across CINI and incarcerated samples, indicating measurement invariance across the two groups. Negative binomial regressions revealed that BSCQ-M scores were significantly negatively associated with concurrent cannabis use. Results suggest that the BSCQ-M is a brief, psychometrically sound measure of refusal self-efficacy for cannabis among juvenile justice-involved youth that can be utilized with both CINI and incarcerated youth.

Intravenous Dexmedetomidine as an Adjunct to Neuraxial Anesthesia in Cesarean Delivery: A Retrospective Chart Review.

BACKGROUND: Dexmedetomidine is a selective α-2 agonist commonly used for sedation that has been used in obstetric anesthesia for multimodal labor analgesia, postcesarean delivery analgesia, and perioperative shivering. This study evaluated the role of intravenous dexmedetomidine to provide rescue analgesia and/or sedation during cesarean delivery under neuraxial anesthesia. METHODS: We conducted a single-center, retrospective cohort study of all parturients undergoing cesarean delivery under neuraxial anesthesia between December 1, 2018, and November 30, 2019, who required supplemental analgesia during the procedure. Patients were divided into two groups: patients who received intravenous dexmedetomidine (Dexmed group) and patients who received adjunct medications such as fentanyl, midazolam, ketamine, and nitrous oxide (Standard group). Primary outcome was incidence of conversion to general anesthesia. RESULTS: During the study period, 107 patients received adjunct medications. There was no difference in conversion to general anesthesia between the Dexmed group and the Standard group (6% (4/62) vs. 9% (4/45); p=0.718). In the Dexmed group, the mean dexmedetomidine dose received was 37 µg (range 10 to 140 µg). While the use of inotropic/vasopressor medications was common and similar in both groups, there was an increase in the incidence of bradycardia (Dexmed 15% vs. Standard 2%; p=0.042) but not hypotension (Dexmed 24% vs. Standard 24%; p=1.00) in the Dexmed group. CONCLUSION: In patients who required supplemental analgesia for cesarean delivery, those who received dexmedetomidine versus other medications had a similar rate of conversion to general anesthesia, a statistically significant increase in bradycardia, but no difference in the incidence of hypotension.

New Q Waves and T-Wave Inversions Following Endovascular Surgery Lead to Diagnosis of Clinically Silent Myocardial Infarction Despite Negative Preoperative Cardiovascular Risk Evaluation: A Case Report.

In this case, a 79-year-old male presented with new anteroseptal Q waves and T-wave inversions across the precordial leads following an otherwise uneventful endovascular repair of his thoracoabdominal aortic aneurysm. The patient had no history of cardiac disease and had undergone a dobutamine stress echocardiogram within the preceding 6 months that showed no evidence of inducible ischemia. Nevertheless, routine postoperative electrocardiogram (EKG) revealed new Q waves and T-wave inversions and transthoracic echocardiogram that demonstrated akinesis of the left ventricle (LV) apex with chronic-appearing apical thrombus. We will further discuss preoperative evaluation of cardiovascular risk along with postoperative interpretation of EKG abnormalities.

The Brief Situational Confidence Questionnaire for alcohol: A psychometric assessment with incarcerated youth.

The factor structure, measurement invariance, validity, reliability, and stability of scores on the Brief Situational Confidence Questionnaire (BSCQ) were evaluated for use with incarcerated youth. The BSCQ is an 8-item measure that assesses self-efficacy to resist alcohol use in tempting situations. The brevity of the measure may make it a useful tool for clinicians and researchers in a forensic setting. Analyses were conducted with 2 separate samples (N = 205 and N = 189) of incarcerated youth (M age = 16.90 and 17.12 years, respectively; 88% and 86% male). Based on prior theory and confirmatory factor analyses (CFAs), results indicated that a correlated 2-factor model best fit the data. Multisample CFAs suggested that BSCQ scores demonstrated configural and metric invariance across our 2 samples. Further, the BSCQ scores demonstrated sufficient test-retest stability in Samples 1 and 2 (Pearson's r = .66, .55) and internal consistency (Cronbach's α = .84 and .86, respectively). Negative binomial regressions showed that the overall BSCQ scores were significantly associated with concurrent alcohol use (number of drinking days, number of heavy drinking days, average drinks per week) and significantly predicted future alcohol use. Scores on the BSCQ demonstrated sufficient stability, internal consistency, and validity, and the 2-factor structure was largely invariant across 2 separate samples of incarcerated youth. Given its brevity, the BSCQ may provide valid and reliable scores to use with this population when time and resources are scarce. (PsycINFO Database Record (c) 2020 APA, all rights reserved).