A systematic scoping study exploring opioid use across a variety of disability conditions.

BACKGROUND: Opioid use experiences among people with disability (PWD) as a group has not been clearly articulated in the current literature, despite links between pain and measures of disability. OBJECTIVE: To conduct a systematic search and scoping study examining the characteristics of current literature focused on opioid use among PWD. METHODS: Four databases were queried (i.e., Medline, PsycINFO, Embase, and CINAHL) for peer-reviewed, empirical, English-language, journal articles focused on long-term opioid use among PWD. Collected data points included: disability details (specific condition, onset of disability), opioid details (category of opioid use, and specified substance), study details, and design. RESULTS: A total of 196 articles were included, with 83.7% published since 2000 largely from the US. The majority of articles (70.4%) focused on the use of opioids as medical treatment, with fewer articles focusing on recreational opioid use or substance use disorders. The majority of included sources (73%) focused on opioid use in acquired conditions; neuropathic pain (21.9%) and attention deficit hyperactivity disorder (20.4%) were the most commonly studied. Differences were observed in the distribution of disability conditions across category of opioid use and study design classification; 73.5% were considered observational in design. CONCLUSIONS: The varied representation of disability conditions, and differences across opioid use category and study design classification point to a complicated relationship between opioid use and disability. The present research portfolio would benefit from research matching informational needs of a specific disability area or opioid use category to provide the evidence necessary to advance current knowledge and promote inclusion in national agendas.

Health information seeking and people with disability: A systematic search and scoping review.

BACKGROUND: Health information and access to it are important aspects of maintaining health. There are 61 million people with disability in the U.S., many of whom experience health disparities. However, it may not be clear to health professionals how people with disability seek health information. OBJECTIVE: Assess the breadth, examine the characteristics, and evaluate the risk of bias in the existing literature related to health information seeking and people with disability. METHODS: The authors conducted a systematic search across five databases (Pubmed, Scopus, PsycINFO, HealthSTAR, and CINAHL) to identify empirical journal articles related to health information seeking among people with disability. Analysis of data items and a quality assessment were completed. RESULTS: Forty-two articles met the criteria for inclusion and were assessed. The articles primarily used survey methodology (50%), and primarily focused on ten disability types, including MS (19%), CP (17%) and general disability (17%). The articles primarily investigated the internet (88%), and healthcare providers (71%) as sources of health information. Trustworthiness (31%), accuracy (29%), and accessibility (29%) were also commonly assessed. The overall quality was high, with room for improvement in minimizing bias. CONCLUSIONS: The literature addressing health information seeking among people with disability is heterogeneous, but generally of high quality. Future research may benefit from an inclusive definition of disability and a more consistent definition of health information. Focused research on best practices and interactions among sources of health information would be valuable additions.

A systematic search and technical review of online information pertaining to medical care for people with disability.

BACKGROUND: Little is known about the availability and technical quality of online information related to the medical care of people with disability, despite the potential of this information to alter clinical interactions and treatment decisions. OBJECTIVES: This review examines the utility of internet search engines for finding information related to medical care for people with disability, identifies common sources of this online information, and assesses the presence of technical attributes which allow for its critical evaluation. METHODS: Exhaustive systematic searches were conducted on two popular search engines (Google and Yahoo) using six search phrases. Resources were coded to categorize presenting organization, format, and technical quality. RESULTS: Only 8.9% of results included information related to medical care for people with disability. Analyzed resources were most often from non-profit organizations (31.7%) in website format (60.2%). The composite technical quality score for all included resources had a median and mode of three on a scale of six. CONCLUSIONS: Online information related to medical care for people with disability is not only difficult to locate, but has generally low technical quality. These findings have implications for health information professionals, patients, care providers, and information developers.

Self-other overlap: A unique predictor of willingness to work with people with disability as part of one's career.

BACKGROUND: People with disability (PWD) often rely on others, both for direct support and for the creation of enabling environments to meet their needs. This need makes it crucial for professionals to be willing to work with PWD, and for people to pursue careers that focus on supporting PWD. OBJECTIVES: To explore self-other overlap as a unique predictor of willingness to work with PWD as part of one's career, using three studies. METHODS: Studies 1 and 2 used cross-sectional surveys of college undergraduates to explore: 1. whether an association between self-other overlap and willingness to work with PWD exists, and 2. whether self-other overlap is a unique predictor, controlling for attitudes and empathy. Study 3 investigated whether self-other overlap is associated with the groups with whom the students indicated they want (and do not want) to work as part of their career. RESULTS: Across the three studies, self-other overlap was uniquely associated with students' willingness to work with PWD as part of one's profession, even when controlling for attitudes and empathy. CONCLUSIONS: Self-other overlap may be an important additional factor to take into consideration when developing interventions targeted toward promoting working with PWD.

Interventions to Teach Medical Students About Disability: A Systematic Search and Review.

Historically, medical students have received little training about working with patients with disability, but there is now a greater recognition of the need to educate medical students in this domain. The aims of this review were to define the body of literature and to determine effective strategies for teaching medical students about disability. A systematic search protocol executed across six databases identified journal articles reporting interventions implemented to teach disability to medical students. Seventy-seven articles spanning 1960-2018 met inclusion criteria. Most articles reported objectives related to increasing knowledge and skills or changing attitudes. However, only half included evaluations for all of their stated objectives in those domains. In addition, few articles used longitudinal evaluations, resulting in most articles basing conclusions on immediate posttest evaluations. Overall, the reported interventions exhibit a high risk of potential bias, with only 10% of the articles receiving a global quality rating of "good." Thus, although several articles have reported educational interventions to teach medical students about disability, the high risk of bias, incomplete reporting, and limitations of the evaluations prevent evidence-based determinations of effective strategies for teaching medical students about disability. The findings highlight ways to improve future studies in this domain.

Developing a systematic search strategy related to people with disability: A brief report testing the utility of proposed disability search terms in a search about opioid use.

BACKGROUND: The varied use of the term "disability" in the scientific literature makes it challenging to conduct systematic reviews of health issues among people with disability. Utilizing general disability search terms has been suggested as an efficient way to ensure a broad capture of the literature related to disability. OBJECTIVES: This study evaluates the utility of general disability terms versus condition-specific terms, in the context of systematically searching for articles related to disability and other conditions or issues, in this case, opioid use. METHODS: Systematic searches were conducted using three databases. An initial search of articles mentioning opioids and disability was conducted employing the general search terms recommended by Walsh et al.1 The results were then compared to 16 condition-specific searches. The proportion of unique articles from each condition-specific search that overlapped with the general search was assessed. RESULTS: There was very little overlap between the articles captured using condition-specific search terms and the articles captured utilizing the general search terms. The highest amount of overlap was for spinal muscular atrophy at 33.3%, with the overall median proportion of overlap being 13.4% (mean = 15.7%; SD = 11.7%). CONCLUSIONS: With a systematic search for articles about disability associated with opioid use as an example, condition-specific search terms capture a large proportion of articles not identified using general disability search terms. Disability researchers should be aware of pitfalls using general terminology and the importance of using disability-specific search terms.

The Effect of Partner Serostatus and Relationship Duration on HIV Medication Adherence.

High adherence rates to antiretroviral medications are necessary for people living with HIV/AIDS. The current study focuses on relationship-level predictors of HIV medication adherence by testing whether adherence rates differ by dyadic serostatus (seroconcordant vs. serodiscordant couples) among individuals with HIV in romantic relationships. Results showed a significant interaction between dyadic serostatus and relationship duration on adherence, such that individuals in long-term serodiscordant relationships reported better adherence than short-term serodiscordant relationships or seroconcordant partners in long-term relationships. Future research is needed to understand what relationship dynamics explain differences in adherence rates based on dyadic serostatus.

Partner Support, Willingness to Sacrifice, and HIV Medication Self-Efficacy.

When taken as prescribed, highly active anti-retroviral medications allow individuals with HIV to live long, healthy lives. Nevertheless, poor adherence is common. In the current study, we examined why some people fail to feel efficacious to adhere, focusing on their interpersonal relationships. Given past findings that some individuals with primary partners adhere better than those without, whereas others adhere worse, we examined whether relationship dynamics influence the association between support from a primary partner and adherence self-efficacy. Specifically, we hypothesized and found that relationship partners' support regarding medication adherence undermines self-efficacy when the partner is perceived as unwilling to sacrifice for the relationship. We discuss the implications of these results for intervention construction and for understanding the power of the relationship context on HIV medication adherence.

Beyond Same-Sex Attraction: Gender-Variant-Based Victimization Is Associated with Suicidal Behavior and Substance Use for Other-Sex Attracted Adolescents.

Gender-variant-based victimization is victimization based on the way others perceive an individual to convey masculine, feminine, and androgynous characteristics through their appearance, mannerisms, and behaviors. Previous work identifies gender-variant-based victimization as a risk factor for health-risking outcomes among same-sex attracted youths. The current study seeks to examine this relationship among other-sex attracted youths and same-sex attracted youth, and determine if gender-variant-based victimization is similarly or differentially associated with poor outcomes between these two groups. Anonymous data from a school-based survey of 2,438 racially diverse middle and high school students in the Eastern U.S. was examined. For other-sex attracted adolescents, gender-variant-based victimization was associated with a higher odds of suicidal thoughts and behaviors, regular use of cigarettes, and drug use. When compared to same-sex attracted adolescents, the harmful relationship between gender-variant-based victimization and each of these outcomes was similar in nature. These findings suggest that gender-variant-based victimization has potentially serious implications for the psychological wellbeing and substance use of other-sex attracted adolescents, not just same-sex attracted adolescents, supporting the need to address gender expression as a basis for victimization separate from sexuality- or gender-minority status. The impact that gender-variant-based victimization has on all adolescents should not be overlooked in research and interventions aimed at addressing sexual orientation-based and gender-variant-based victimization, substance use, and suicide prevention.

Nature, extent and implications of belief in Kikombe cha babu and other herbal HIV cures in Tanzania.

This study's objective was to describe awareness of, access to, belief in, and utilization of the healing tea Kikombe cha babu and other alternative treatments for HIV in Tanzania. Associations with HIV testing, treatment, and prevention behaviors are also explored. A survey with questions about alternative medicine was administered to a sample in Tanzania using a stratified, multistage random selection method. Adults were interviewed face-to-face. Items concerning alternative HIV treatments addressed awareness, access, beliefs, and treatment-seeking behaviors. Questions about HIV prevention and treatment were also asked. Results showed participants indicated a high awareness of alternative treatments available in Tanzania, with 95.3% of 2313 adults having heard of these treatments. Of those, 6.0% had actually sought the treatment, and 46.8% had an acquaintance seek it. However, 81.0% indicated these treatments were not easily accessible. There is a high level of belief in the ability of these alternative treatments to cure HIV, with 44.0% of people who had heard of these treatments indicating they believe such treatments can cure HIV. Additionally, many people indicated having these alternative treatments available would result in decreased condom use (15.6%), no need to use condoms (94.9%), and no need to take antiretroviral therapy (81.7%). However, 57.4% indicated they would be more likely to get tested for HIV if alternative treatments were available. Belief in the ability of alternative treatments to cure HIV in Tanzania is high and should be further explored due to its implications for potentially sidelining HIV prevention and treatment initiatives.

Social networking smartphone applications and sexual health outcomes among men who have sex with men.

Several smartphone applications (apps) designed to help men who have sex with men (MSM) find casual sexual partners have appeared on the market recently. Apps of this nature have the potential to impact sexual health and behavior by providing constant access to a large supply of available partners. In this study, the sexual health history, behavior, and personality of MSM who use these apps was compared to MSM who meet partners in other ways. A sample of 110 adult MSM was recruited online to complete a cross-sectional survey. All participants were either single or involved in a non-exclusive romantic relationship. There were no statistically significant differences between app users and non-users in frequency of insertive or receptive anal sex without a condom. However, app users reported significantly more sexual partners and had a higher prevalence of ever being diagnosed with an STI than did non-users. App users did not differ from non-users on any demographic or personality variables (including erotophilia, sensation seeking, and self-control); however, when adjusting lifetime total sex partners for those met specifically through apps, app users still had significantly more partners. This pattern of results suggests that app users may be more sexually active in general. More work is needed to fully understand the association between this emerging technology and potential sexual health risks.