Patterns of Polydrug Use Classes Among a Subset of Latino Male Seasonal Workers in South Florida: A Latent Class Analysis.

BACKGROUND: Little is known about polydrug use among Latino seasonal farmworkers. This cross-sectional study with male Latino seasonal workers (LSWs) living in South Florida categorized distinct classes of drug use and then characterized each drug use typology by demographic, structural, and psychological factors. METHODS: One hundred and twenty-five male LSWs were recruited during community events using convenience sampling between July 2019-March 2020. Latent class analysis was conducted by leveraging measures of self-reported use of nine drugs in the past year (sedatives, cannabis, stimulants, heroin, opioids, cocaine, PCP, hallucinogens, and inhalants). Correlates of latent class membership were examined using 3-step categorical latent variable logistic regression. Analyses were performed using Mplus version 8 and SAS 9.4. RESULTS: Four drug use classes were identified, male LSWs who exhibited: 1) use of illegal opioids only (n = 32); 2) concurrent cannabis and cocaine use (n = 75); 3) concurrent sedative and cannabis use (n = 13); and 4) high concurrent drug use (n = 5). About 84.7% of the sample reported use of at least one drug in the past 12 months. LSWs who identified as White and were married or in a stable relationship were likely to only use illegal opioids. LSWs with less than high school education and self-reported good to excellent health were more likely to use cannabis and cocaine. Men with moderate to severe anxiety and self-reported bad health were classified as engaging in sedative and cannabis co-use. Survivors of physical abuse were more commonly classified as people using high concurrent substances relative to non-abused men among the four classes. CONCLUSIONS: This pilot study suggests the presence of heterogeneity in polydrug use classes among LSWs in South Florida.

Cultural adaptations of motivational interviewing: A systematic review.

Motivational interviewing (MI; Miller & Rollnick, 2012) has expanded from treating substance use disorders to other health concerns across a range of racial-ethnic groups and ages. The spirit of MI lends itself well to working with culturally diverse populations by eliciting the client's values and goals in a collaborative and client-centered approach in pursuit of behavior change. Additionally, MI has been further adapted for use with racial-ethnic minority groups to enhance its effectiveness with specific populations. The aim of this review was to investigate existing cultural adaptations of MI (CAMI), their effectiveness, and to provide directions for future cultural adaptations in both research and clinical settings. This systematic review identified studies of CAMI over the past 20 years using MEDLINE/Pubmed and Embase. The final dataset consisted of 25 peer review studies. In the randomized controlled trial (RCT) studies that utilized a control condition (n = 17), 10 studies showed that the CAMI condition performed significantly better on at least the primary outcome measure than the control condition. All 10 studies adapted Context, Content, and Concepts-three of the dimensions of cultural adaptation defined by the ecological validity framework used in this study (Bernal et al., 1995). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Investigating the Psychological Impact of COVID-19 on Healthcare Professionals: Implications and Recommendations.

Public health crises that increase the demand for healthcare professionals (HCPs) often result in increased mental distress in HCPs. The current study investigated the specific mental health ramifications of the COVID-19 pandemic on HCPs and perceived support from their places of work. Data was collected from US-based HCPs (N = 325) working as physicians (21.8%), nurses (26.8%), mental health professionals (MHPs; 30.5%), and allied healthcare professionals (AHPs; 20.9%) from April 2020 to April 2021 amidst the COVID-19 pandemic, using an online self-report survey. Descriptive and correlational statistical analyses assessed worry, stressors, psychological functioning, and perceived support. A majority of participants expressed worry about the pandemic broadly (93%), and approximately half (50.5%) indicated that their degree of worry was moderate to extreme. Respondents worried most about the risk of infection for family and relatives. HCPs reported not having been able to enjoy daily activities (66.9%), losing sleep (43.1%), and feeling constantly under strain (66.9%), compared to usual. Most HCPs indicated a strong desire for clear communication regarding the pandemic and psychological support from their workplaces. This paper provides recommendations to support HCP mental health by both ameliorating distress caused by the COVID-19 pandemic as well as protecting the health and wellness of HCPs more generally. HCPs and institutions that employ them should seek out or provide access to mental health resources and services, engage with or provide opportunities and activities to actively address mental health, and improve communication regarding COVID-19 or other topics HCPs demonstrate interest in.

Why Re-Invent the Wheel? Social Network Approaches Can Be Used to Mitigate SARS-CoV-2 Related Disparities in Latinx Seasonal Farmworkers.

Latinx seasonal farmworkers are essential workers and are at elevated risk for SARS-CoV-2 in the United States. Risk factors for SARS-CoV-2 are unique to this population and include crowded living conditions, isolated social networks, and exploitative working environments. The circumstances and cultural values of Latinx seasonal farmworkers pose a unique challenge to public health authorities working to contain the spread of SARS-CoV-2. This community is in dire need of urgent public health research to identify opportunities to prevent SARS-CoV-2 transmission: social network methods could be the solution. Using previously collected and new information provided by a team of experts, this commentary provides a brief description of Latinx seasonal farmworker disparities that affect tracking and treating SARS-CoV-2 in this important group, the challenges introduced by SARS-CoV-2, and how social network approaches learned from other infectious disease prevention strategies can address these disparities.

Menopausal Hormone Therapy and Suicide in a National Sample of Midlife and Older Women Veterans.

BACKGROUND: Among midlife and older women, menopause symptoms and menopausal hormone therapy have been linked to mental health disorders and other comorbidities related to suicide. However, the role of hormone therapy as a prognostic factor of suicide risk is largely unknown. OBJECTIVES: To examine associations between menopausal hormone therapy, suicide attempts, and suicide among midlife and older women Veterans. RESEARCH DESIGN: In this longitudinal analysis of national Veterans Health Administration data from women Veterans aged 50 years and above, we used Fine-Gray proportional hazards models to examine associations between menopausal hormone therapy (prescribed in 2012-2013) and incident suicide attempts and suicide (index date-2016). MEASURES: Menopausal hormone therapy and psychoactive medications from pharmacy records; suicide attempts and suicide from national suicide data repositories; demographic variables, medical and psychiatric diagnoses, and substance use disorders from electronic medical record data and International Classification Diagnoses-9-CM codes. RESULTS: In this national sample of 291,709 women Veterans (mean age 60.47, SD 9.81), 6% were prescribed menopausal hormone therapy at baseline. Over an average of 4.5 years, 2673 had an incident suicide attempt (93%) or death by suicide (7%). Adjusting for age, race, and medical diagnoses, menopausal hormone therapy was associated with increased risk of suicide attempt (hazard ratio 1.41; 95% confidence interval, 1.22-1.64) and over 2-fold increased risk of death by suicide (hazard ratio 2.47; 95% confidence interval, 1.58-3.87). Associations with death by suicide remained significant after accounting for psychiatric comorbidity and psychoactive medications. CONCLUSIONS: Menopausal hormone therapy may be an important indicator of suicide risk among midlife and older women.