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1.
Dev Psychol ; 2024 Jul 08.
Article de Anglais | MEDLINE | ID: mdl-38976438

RÉSUMÉ

Parents' socialization beliefs have implications for the psychological adjustment of their children through their parenting behaviors; however, such pathways have rarely been established among Chinese American families. The present study examined how Chinese American parents' goals for their children to take on bicultural values and behaviors (i.e., bicultural socialization beliefs) influenced their child's level of depressive symptoms in emerging adulthood through their parenting behaviors and the level of parent-child alienation. Data came from Waves 2 (adolescence) and 3 (emerging adulthood) of a longitudinal study of 444 Chinese American families. Mothers' reports of their bicultural socialization beliefs positively predicted adolescents' reports of mothers' autonomy-supporting behaviors and interdependence-focused shaming behaviors. In addition, there was a significant and negative indirect effect of mothers' bicultural socialization beliefs on emerging adult depressive symptoms through adolescents' reports of mothers' autonomy-supporting behaviors and emerging adults' reports of alienation to their parents. In contrast, there was a significant and positive indirect effect from fathers' reports of their bicultural socialization beliefs to emerging adult depressive symptoms, through emerging adults' reports of alienation only. Findings contribute to our understanding of bicultural processes in Chinese American families and establish that parents' beliefs have significant implications for the psychological adjustment of Chinese American youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

2.
AIDS Behav ; 2024 Jun 20.
Article de Anglais | MEDLINE | ID: mdl-38900313

RÉSUMÉ

Peer advocacy can promote HIV protective behaviors, but little is known about the concordance on prevention advocacy(PA) reports between people living with HIV(PLWH) and their social network members. We examined prevalence and correlates of such concordance, and its association with the targeted HIV protective behavior of the social network member. Data were analyzed from 193 PLWH(index participants) and their 599 social network members(alters). Kappa statistics measured concordance between index and alter reports of PA in the past 3 months. Logistic and multinomial regressions evaluated the relationship between advocacy concordance and alter condom use and HIV testing behavior and correlates of PA concordance. Advocacy concordance was observed in 0.3% of index-alter dyads for PrEP discussion, 9% for condom use, 18% for HIV testing, 26% for care engagement, and 49% for antiretroviral use discussions. Fewer indexes reported condom use(23.5% vs. 28.1%;[Formula: see text]=3.7, p=0.05) and HIV testing(30.5% vs. 50.5%; [Formula: see text]=25.3, p<0.001) PA occurring. Condom advocacy concordance was higher if the index and alter were romantic partners(OR=3.50; p=0.02), and lower if the index was 10 years younger than the alter(OR=0.23; p = 0.02). Alters had higher odds of using condoms with their main partner when both reported condom advocacy compared to dyads where neither reported advocacy(OR=3.90; p<0.001) and compared to dyads where only the index reported such advocacy(OR = 3.71; p=0.01). Age difference and relationship status impact advocacy agreement, and concordant perceptions of advocacy are linked to increased HIV protective behaviors. Alters' perceptions may be crucial for behavior change, informing strategies for improving advocacy.

3.
J Neurosci ; 44(23)2024 Jun 05.
Article de Anglais | MEDLINE | ID: mdl-38839340

RÉSUMÉ

A decade ago, in 2013, and over the course of 4 summer months, three separate observations were reported that each shed light independently on a new molecular organization that fundamentally reshaped our perception of excitatory synaptic transmission (Fukata et al., 2013; MacGillavry et al., 2013; Nair et al., 2013). This discovery unveiled an intricate arrangement of AMPA-type glutamate receptors and their principal scaffolding protein PSD-95, at synapses. This breakthrough was made possible, thanks to advanced super-resolution imaging techniques. It fundamentally changed our understanding of excitatory synaptic architecture and paved the way for a brand-new area of research. In this Progressions article, the primary investigators of the nanoscale organization of synapses have come together to chronicle the tale of their discovery. We recount the initial inquiry that prompted our research, the preceding studies that inspired our work, the technical obstacles that were encountered, and the breakthroughs that were made in the subsequent decade in the realm of nanoscale synaptic transmission. We review the new discoveries made possible by the democratization of super-resolution imaging techniques in the field of excitatory synaptic physiology and architecture, first by the extension to other glutamate receptors and to presynaptic proteins and then by the notion of trans-synaptic organization. After describing the organizational modifications occurring in various pathologies, we discuss briefly the latest technical developments made possible by super-resolution imaging and emerging concepts in synaptic physiology.


Sujet(s)
Récepteur de l'AMPA , Synapses , Récepteur de l'AMPA/métabolisme , Récepteur de l'AMPA/composition chimique , Synapses/métabolisme , Synapses/ultrastructure , Animaux , Humains , Transmission synaptique/physiologie , Nanostructures/composition chimique
4.
Soc Sci Med ; 352: 117004, 2024 May 21.
Article de Anglais | MEDLINE | ID: mdl-38815285

RÉSUMÉ

Health-related social control (HRSC) includes efforts to regulate or influence others' health behaviors and is an important way interpersonal relationships can affect individual-level health. This study used egocentric network data to describe the size and composition of HRSC networks, identify trajectories of HRSC receipt, and examine how HRSC is related to binge drinking and alcohol-related problems. Data come from a U.S. nationally representative sample of 1235 adults age 30 and older (baseline mean age = 52, 52% female, 64% White) who completed four annual surveys between 2019 and 2022. On average, 30% of adults' network members were HRSC agents who told or reminded them to do things to protect their health. At baseline, 50% of respondents identified a spouse/partner as a HRSC agent, 56% a relative, 46% a friend, and 12% someone else. Respondents' relationships with HRSC agents were generally strong, 93% of agents were described as people "whose opinion matters," and only 10% were described as hassling or making life difficult for the respondent. Growth mixture modeling identified five trajectories of HRSC receipt over the four-year period: Stable High (36% of sample), Stable Moderate (47%), Stable Low (14%), Decreasing (2%), and Increasing (2%). Binge drinking was relatively consistent for the three Stable HRSC classes (ranging from 11% to 15% of individuals), decreased steadily for the Increasing HRSC class (32%-16%), and fluctuated for the Decreasing HRSC class (decreasing from 10% to 2%, then increasing to 8%). For alcohol problems, the Increasing HRSC class showed the largest increase (2%-21%) before dropping to near-baseline levels (4%), whereas the Decreasing HRSC class fluctuated during the first three waves followed by no individuals reporting alcohol problems at the last wave. Results highlight the importance of examining heterogeneity in adults' HRSC experiences because of its implications for understanding social influences on health-related behaviors.

5.
Dev Cell ; 2024 May 27.
Article de Anglais | MEDLINE | ID: mdl-38815583

RÉSUMÉ

Local mRNA translation in axons is critical for the spatiotemporal regulation of the axonal proteome. A wide variety of mRNAs are localized and translated in axons; however, how protein synthesis is regulated at specific subcellular sites in axons remains unclear. Here, we establish that the axonal endoplasmic reticulum (ER) supports axonal translation in developing rat hippocampal cultured neurons. Axonal ER tubule disruption impairs local translation and ribosome distribution. Using nanoscale resolution imaging, we find that ribosomes make frequent contacts with axonal ER tubules in a translation-dependent manner and are influenced by specific extrinsic cues. We identify P180/RRBP1 as an axonally distributed ribosome receptor that regulates local translation and binds to mRNAs enriched for axonal membrane proteins. Importantly, the impairment of axonal ER-ribosome interactions causes defects in axon morphology. Our results establish a role for the axonal ER in dynamically localizing mRNA translation, which is important for proper neuron development.

7.
AIDS Behav ; 28(7): 2454-2462, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38642213

RÉSUMÉ

Receiving peer advocacy has been shown to result in increased HIV protective behaviors, but little research has gone beyond assessment of the mere presence of advocacy to examine aspects of advocacy driving these effects. With baseline data from a controlled trial of an advocacy training intervention, we studied characteristics of HIV prevention advocacy received among 599 social network members of persons living with HIV in Uganda and the association of these characteristics with the social network members' recent HIV testing (past six months) and consistent condom use, as well as perceived influence of advocacy on these behaviors. Participants reported on receipt of advocacy specific to HIV testing and condom use, as well as on measures of advocacy content, tone of delivery, support for autonomous regulation, and perceived influence on behavior. Receiving HIV testing advocacy and condom use advocacy were associated with recent HIV testing [65.2% vs. 51.4%; OR (95% CI) = 1.77 (1.11-2.84)], and consistent condom use with main sex partner [19.3% vs. 10.0%; OR (95% CI) = 2.16 (1.12-4.13)], respectively, compared to not receiving advocacy. Among those who received condom advocacy, perceived influence of the advocacy was positively correlated with consistent condom use, regardless of type of sex partner; support of autonomous regulation was a correlate of consistent condom use with casual sex partners, while judgmental advocacy was a correlate of consistent condom use with serodiscordant main partners. Among those who received testing advocacy, HIV testing in the past 6 months was positively correlated with receipt of direct support for getting tested. In multiple regression analysis, perceived influence of both HIV testing and condom use advocacy were positively correlated with advocacy that included access information and support of autonomous regulation; confrontational advocacy and judgmental advocacy were independent positive correlates of perceived influence of testing and condom use advocacy, respectively. These findings support associations that suggest potential benefits of peer advocacy from PLWH on HIV testing and condom use among their social network members, and indicate that advocacy content, tone of delivery, and support of autonomous regulation advocacy may play an important role in the success of advocacy.


Sujet(s)
Préservatifs masculins , Infections à VIH , Dépistage du VIH , Groupe de pairs , Partenaire sexuel , Soutien social , Humains , Ouganda , Préservatifs masculins/statistiques et données numériques , Mâle , Femelle , Infections à VIH/prévention et contrôle , Infections à VIH/psychologie , Adulte , Dépistage du VIH/statistiques et données numériques , Partenaire sexuel/psychologie , Défense du patient , Adulte d'âge moyen , Connaissances, attitudes et pratiques en santé , Jeune adulte , Comportement sexuel , Rapports sexuels protégés
8.
Obes Res Clin Pract ; 18(2): 147-153, 2024.
Article de Anglais | MEDLINE | ID: mdl-38575407

RÉSUMÉ

BACKGROUND: This prospective cohort study aimed to investigate the associations between gestational weight gain (GWG) and long-term postpartum maternal weight gain, body mass index (BMI), waist circumference (WC), and the risk of general and abdominal obesity, beyond motherhood (some 27 y after childbirth). METHODS: Participants were 1953 women enrolled in the Mater-University of Queensland Study of Pregnancy cohort study that started in the early 1980 s, with the most recent follow-up at 27 y postpartum. We examined the prospective associations of GWG in pregnancy with weight, BMI, and WC and the risk of adiposity 27 y after the index pregnancy. We used linear and multinomial logistic regressions to examine the independent effect of GWG on each outcome, adjusting for potential confounders and mediators. RESULTS: The average GWG during pregnancy was 14.88 kg (SD 5.24). One in four women (25.50%) gained below the Institute of Medicine (IOM) recommendations and one in three (34.00%) gained excess weight during pregnancy. Every 100 g/week increment of GWG was associated with 2.0 (95% CI: 1.5, 2.6) kg, 0.7 (0.5, 0.9) kg/m2, 1.3 (0.8, 1.8) cm greater body weight, BMI, and WC, respectively 27 y postpartum. Women who gained inadequate weight in pregnancy had significantly lower odds of general obesity (OR; 0.70, 95% CI:0.53,0.94) or abdominal obesity (0.73; 0.56,0.96), whereas those who gained excess gestational weight had much higher odds of general obesity (4.49; 3.36,6.00) and abdominal obesity (3.09; 2.29,4.16). These associations were independent of potential confounders. CONCLUSION: Maternal GWG in pregnancy independently and strongly predicted beyond motherhood weight gain trajectory. GWG within IOM recommendation may prevent long-term development of both general and central obesity.


Sujet(s)
Indice de masse corporelle , Prise de poids pendant la grossesse , Obésité abdominale , Période du postpartum , Tour de taille , Prise de poids , Humains , Femelle , Grossesse , Obésité abdominale/épidémiologie , Études prospectives , Prise de poids pendant la grossesse/physiologie , Adulte , Prise de poids/physiologie , Facteurs de risque , Queensland/épidémiologie
9.
Int J Behav Med ; 2024 Mar 22.
Article de Anglais | MEDLINE | ID: mdl-38519810

RÉSUMÉ

BACKGROUND: HIV prevention advocacy empowers persons living with HIV (PLWH) to act as advocates and encourage members of their social networks to engage in protective behaviors such as HIV testing, condom use, and antiretroviral therapy (ART) adherence. We examined correlates of HIV prevention advocacy among PLWH in Uganda. METHOD: A cross-sectional analysis was conducted with baseline data from 210 PLWH (70% female; mean age = 40 years) who enrolled in a trial of an HIV prevention advocacy training program in Kampala, Uganda. The baseline survey, which was completed prior to receipt of the intervention, included multiple measures of HIV prevention advocacy (general and specific to named social network members), as well as internalized HIV stigma, HIV disclosure, HIV knowledge, positive living (condom use; ART adherence), and self-efficacy for HIV prevention advocacy. RESULTS: Consistent with our hypotheses, HIV disclosure, HIV knowledge, consistent condom use, and HIV prevention advocacy self-efficacy were all positively correlated with at least one measure of HIV prevention advocacy, after controlling for the other constructs in multiple regression analysis. Internalized HIV stigma was positively correlated with advocacy in bivariate analysis only. CONCLUSION: These findings identify which characteristics of PLWH are associated with acting as change agents for others in their social network to engage in HIV protective behaviors.

10.
Neurophotonics ; 11(1): 014415, 2024 Jan.
Article de Anglais | MEDLINE | ID: mdl-38545127

RÉSUMÉ

The Frontiers in Neurophotonics Symposium is a biennial event that brings together neurobiologists and physicists/engineers who share interest in the development of leading-edge photonics-based approaches to understand and manipulate the nervous system, from its individual molecular components to complex networks in the intact brain. In this Community paper, we highlight several topics that have been featured at the symposium that took place in October 2022 in Québec City, Canada.

11.
Inquiry ; 61: 469580241238422, 2024.
Article de Anglais | MEDLINE | ID: mdl-38528788

RÉSUMÉ

Opioid overdose and Opioid Use Disorder (OUD) statistics underscore an urgent need to significantly expand access to evidence-based OUD treatment. Office Based Opioid Treatment (OBOT) has proven effective for treating OUD. However, limited access to these treatments persists. Recognizing the need for significant investment in clinical, behavioral, and translational research, the Indiana State Department of Health and Indiana University embarked on a research initiative supported by the "Responding to the Addictions Crisis" Grand Challenge Program. This brief presents recommendations based on existing research and our own analyses of medical claims data in Indiana, where opioid misuse is high and treatment access is limited. The recommendations cover target providers, intervention focus, priority regions, and delivery methods.


Sujet(s)
Buprénorphine , Troubles liés aux opiacés , Humains , Analgésiques morphiniques/effets indésirables , Buprénorphine/usage thérapeutique , Traitement de substitution aux opiacés/méthodes , Troubles liés aux opiacés/traitement médicamenteux , Soins ambulatoires
12.
Soc Psychiatry Psychiatr Epidemiol ; 59(3): 431-442, 2024 Mar.
Article de Anglais | MEDLINE | ID: mdl-37072564

RÉSUMÉ

PURPOSE: Mental health research has powerfully documented inequities related to characteristics, such as ethnicity and gender. Yet how and where disparities like unmet need occur have been more elusive. Drawing from a now modest body of research that deployed the Network Episode Model (NEM), we examine how individuals create patterns of response to mental health problems, influenced by the culture and resources embedded in their social networks. METHODS: The Person-to-Person Health Interview Study (P2P; N ~ 2,700, 2018-2021) provides representative, community-based, NEM-tailored data. Both descriptive, latent class and multinomial regression analyses mark mental health care-seeking patterns, including individuals consulted and activities used, as well as the influence of the structure and cultural content of social networks. RESULTS: Latent class analysis detected five pathways with good fit statistics. The Networked General Care Path (37.0%) and The Kin General Care Path (14.5%) differ only in whether friends are activated in using the general care sector. The Networked Multi-Sector Care Path (32.5%) and The Saturated Path (12.6%) involve family, friends, and both general and specialty care with only the latter expanding consultation to coworkers and clergy. The Null Path (3.3%), or no contacts, is not used as perceived problem severity increases. Network size and strength are associated with the more complex pathways that activate ties, respectively. Trust in doctors is associated with pathways that include specialty providers but not others at work or church. Race, age, and rural residence have specific pathway effects, while gender has no significant impact. CONCLUSIONS: Social networks propel individuals with mental health problems into action. Tie strength and trust produce care responses that are fuller and more targeted. Considering the nature of homophily, results also suggest that majority status and college education are clearly implicated in networked pathways. Overall, findings support community-targeted rather than individually based efforts to increase service use.


Sujet(s)
Services de santé mentale , Santé mentale , Humains , Amis , Confiance , Prestations des soins de santé
13.
J Hosp Med ; 19(1): 35-39, 2024 01.
Article de Anglais | MEDLINE | ID: mdl-37880922

RÉSUMÉ

Since most care for children with medical complexity (CMC) is delivered daily in communities by multiple caregiving individuals, that is, caregiving networks, tools to assess and intervene across these networks are needed. This study evaluated the feasibility of applying social network analysis (SNA) to describe caregiving networks. Because hospitalization is among the most frequently used outcomes for CMC, exploratory correlations between network characteristics and CMC hospital use were evaluated. Within 3 weeks, the goal network enrollment was achieved, and all feasibility measures were favorable. Network characteristics correlated with hospital use, that is, smaller, denser networks, with more closed-loop communication correlated with fewer hospital days. Networks with more professional caregivers also correlated with fewer hospital days. SNA is a feasible tool to study CMC caregiving networks. Preliminary data support rigorous hypothesis testing using SNA methods. Network-based interventions to improve CMC health may be an important future direction.


Sujet(s)
Aidants , Analyse des réseaux sociaux , Enfant , Humains , Études de faisabilité , Hospitalisation , Hôpitaux
14.
Soc Psychiatry Psychiatr Epidemiol ; 59(3): 443-453, 2024 Mar.
Article de Anglais | MEDLINE | ID: mdl-37069339

RÉSUMÉ

PURPOSE: The persistent gap between population indicators of poor mental health and the uptake of services raises questions about similarities and differences between social and medical/psychiatric constructions. Rarely do studies have assessments from different perspectives to examine whether and how lay individuals and professionals diverge. METHODS: Data from the Person-to-Person Health Interview Study (P2P), a representative U.S. state sample (N ~ 2700) are used to examine the overlap and correlates of three diverse perspectives-self-reported mental health, a self/other problem recognition, and the CAT-MH™ a validated, computer adaptive test for psychopathology screening. Descriptive and multinominal logit analyses compare the presence of mental health problems across stakeholders and their association with respondents' sociodemographic characteristics. RESULTS: Analyses reveal a set of socially constructed patterns. Two convergent patterns indicate whether there is (6.9%, The "Sick") or is not (64.6%, The "Well") a problem. The "Unmet Needers" (8.7%) indicates that neither respondents nor those around them recognize a problem identified by the screener. Two patterns indicate clinical need where either respondents (The "Self Deniers", 2.9%) or others (The "Network Deniers", 6.0%) do not. Patterns where the diagnostic indicator does not suggest a problem include The "Worried Well" (4.9%) where only the respondent does, The "Network Coerced" (4.6%) where only others do, and The "Prodromal" (1.4%) where both self and others do. Education, gender, race, and age are associated with social constructions of mental health problems. CONCLUSIONS: The implications of these results hold the potential to improve our understanding of unmet need, mental health literacy, stigma, and treatment resistance.


Sujet(s)
Compétence informationnelle en santé , Santé mentale , Humains , Autorapport , Niveau d'instruction , Psychopathologie
15.
Fam Process ; 2023 Dec 03.
Article de Anglais | MEDLINE | ID: mdl-38044261

RÉSUMÉ

Adopted adolescents create identity narratives conceptualizing their connections to their families of adoption and birth. Previous work with a sample of adoptive adolescents identified a sub-group who reported negative experiences regarding adoption as part of their navigating of adoptive identity processes (the "Unsettled" group). The current study examined interviews with adolescents in the "Unsettled" group to elucidate these negative experiences, specifically through identifying the relationship challenges linked to adoption. Participants included 30 adopted adolescents (18 females, 12 males) from a longitudinal study of adoptive families. All the adolescents (M age = 15.2 years) were domestically adopted in infancy by heterosexual couples who were the same race as the adolescents (29 White, 1 Mexican American). Thematic analysis revealed six themes reflecting adolescents' relationship challenges as related to adoption, both in terms of interpersonal interactions and how relational experiences influenced adolescents' thoughts and feelings of past, present, and future selves: (a) Negative experiences in relationships with adoptive family members, (b) Negative experiences in relationships with birth family members, (c) Difficulties in the adoptive kinship network, (d) Negative thoughts and feelings toward the self as an adopted person, (e) Negative views toward adoption as a form of building a family, and (f) Negative connections between adoption and future relationships. Multiple subthemes were also identified that built upon topics within the adoption and family systems literature, such as communication among family members, navigation of birth family contact, and adopted adolescents' perceptions of loss. Also identified were four profiles across themes. Implications for mental health providers and adoption professionals are discussed.

16.
J Fam Psychol ; 2023 Nov 30.
Article de Anglais | MEDLINE | ID: mdl-38032654

RÉSUMÉ

Research has identified family dynamics within adoptive families as essential to understanding adopted individuals' adjustment. However, there has been a lack of attention to the intricacies of adoptive family context, especially dyadically and as a group. This study examines data from 177 adoptive families from the Minnesota/Texas Adoption Research Project, a longitudinal study of families who participated in domestic U.S. infant adoptions. Study participants are from the second and third collection waves, during adolescence and emerging adulthood. Participants completed interviews and questionnaires at home (Wave 2) or online (Wave 3). The present study examines family context in relation to parent-child incompatibility (match between parent expectations and child's behavior from the Parenting Stress Inventory) and how family context during adolescence (Family Assessment Device, Family Inventory of Life Events, Brief Symptom Inventory) is associated with concurrent and later adjustment (Youth and Adult Self Reports). Family context variables were hypothesized to predict parents' and their spouses' ratings of incompatibility using actor-partner interdependence models. Varied actor and partner effects of family dysfunction, parent distress, and family stressors on ratings of parent-child incompatibility were found. Using regressions, family context variables were hypothesized to have positive associations with adolescent and adult adjustment. Variables accounted for significant variance in adopted individuals' outcomes when considering symptom type (internalizing, externalizing) and age (adolescence, emerging adulthood), though many variables did not have a significant main effect. Results allow for better understanding of differential associations of family context with adjustment for adopted individuals and families. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

18.
Digit Health ; 9: 20552076231194934, 2023.
Article de Anglais | MEDLINE | ID: mdl-37654721

RÉSUMÉ

Objective: This study aimed to create and develop a well-designed, theoretically driven, evidence-based, digital, decision Tool to Empower Parental Telling and Talking (TELL Tool) prototype. Methods: This developmental study used an inclusive, systematic, and iterative process to formulate a prototype TELL Tool: the first digital decision aid for parents who have children 1 to 16 years of age and used donated gametes or embryos to establish their families. Recommendations from the International Patient Decision Aids Standards Collaboration and from experts in decision aid development, digital health interventions, design thinking, and instructional design guided the process. Results: The extensive developmental process incorporated researchers, clinicians, parents, children, and other stakeholders, including donor-conceived adults. We determined the scope and target audience of the decision aid and formed a steering group. During design work, we used the decision-making process model as the guiding framework for selecting content. Parents' views and decisional needs were incorporated into the prototype through empirical research and review, appraisal, and synthesis of the literature. Clinicians' perspectives and insights were also incorporated. We used the experiential learning theory to guide the delivery of the content through a digital distribution plan. Following creation of initial content, including storyboards and scripts, an early prototype was redrafted and redesigned based on feedback from the steering group. A final TELL Tool prototype was then developed for alpha testing. Conclusions: Detailing our early developmental processes provides transparency that can benefit the donor-conceived community as well as clinicians and researchers, especially those designing digital decision aids. Future research to evaluate the efficacy of the TELL Tool is planned.

19.
Harm Reduct J ; 20(1): 120, 2023 09 01.
Article de Anglais | MEDLINE | ID: mdl-37658379

RÉSUMÉ

Problem opioid use and opioid-related drug overdoses remain a major public health concern despite attempts to reduce and monitor opioid prescriptions and increase access to office-based opioid treatment. Current provider-focused interventions are implemented at the federal, state, regional, and local levels but have not slowed the epidemic. Certain targeted interventions aimed at opioid prescribers rely on populations defined along geographic, political, or administrative boundaries; however, those boundaries may not align well with actual provider-patient communities or with the geographic distribution of high-risk opioid use. Instead of relying exclusively on commonly used geographic and administrative boundaries, we suggest augmenting existing strategies with a social network-based approach to identify communities (or clusters) of providers that prescribe to the same set of patients as another mechanism for targeting certain interventions. To test this approach, we analyze 1 year of prescription data from a commercially insured population in the state of Indiana. The composition of inferred clusters is compared to Indiana's Public Health Preparedness Districts (PHPDs). We find that in some cases the correspondence between provider networks and PHPDs is very high, while in other cases the overlap is low. This has implications for whether an intervention is reaching its intended provider targets efficiently and effectively. Assessing the best intervention targeting strategy for a particular outcome could facilitate more effective interventions to tackle the ongoing opioid use epidemic.


Sujet(s)
Mauvais usage des médicaments prescrits , Épidémies , Surdose d'opiacés , Troubles liés aux opiacés , Humains , Analgésiques morphiniques/usage thérapeutique , Santé publique , Mauvais usage des médicaments prescrits/prévention et contrôle , Épidémies/prévention et contrôle
20.
J Behav Med ; 46(6): 930-939, 2023 12.
Article de Anglais | MEDLINE | ID: mdl-37702912

RÉSUMÉ

Cervical cancer (CC) is the most common cancer among women in Uganda, yet lifetime CC screening is as low as 5%. Training women who have screened for CC to engage in peer advocacy could increase uptake of CC screening in social networks. We conducted a randomized controlled trial of a peer-facilitated, manualized, 7-session group intervention to train women to engage in CC prevention advocacy. Forty women recently screened for CC (index participants) enrolled and were assigned to receive the intervention (n = 20) or wait-list control (n = 20). Each index was asked to recruit up to three female social network members (alters) who had not been screened for CC (n = 103 enrolled alters). All index and alter participants were assessed at baseline and month-6 follow-up. All but one (n = 39; 98%) index and 98 (95%) alter participants completed the month 6 assessment. In multivariate regression models controlling for baseline outcome measures and demographic covariates, intervention alters were more likely to have been screened for CC at month 6 [67% vs. 16%; adjusted OR (95% CI) = 12.13 (4.07, 36.16)], compared to control alters. Data also revealed significant increased engagement in CC prevention advocacy, among both index and alter participants in the intervention group at month 6, compared to the control group. The intervention was highly effective in increasing CC screening uptake among social network members, and engagement in CC prevention advocacy among not only intervention recipients, but also targets of advocacy, suggesting the potential for wide dissemination of CC knowledge.Trial Registration. NIH Clinical Trial Registry NCT04960748 ( clinicaltrials.gov ).


Sujet(s)
Tumeurs du col de l'utérus , Humains , Femelle , Tumeurs du col de l'utérus/diagnostic , Tumeurs du col de l'utérus/prévention et contrôle , Dépistage précoce du cancer , Ouganda , Groupe de pairs , Réseautage social
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