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1.
BMC Public Health ; 20(1): 467, 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32264848

RESUMO

BACKGROUND: The marketing of alcohol influences patterns of alcohol consumption. Existing studies have focused, for the most part, on adolescents and the links between exposure to marketing and alcohol initiation. In France, the Evin law, a French exception, was set up in 1991 with the aim of regulating this exposure to marketing, but since 2009 it has been severely compromised. Alcohol consumption causes severe damage, which may be seenfrom 1 standard unit per day and mostly among adults who are regular users of alcohol. In this at-risk population, studies analysing the impact of marketing are sparse. The specific objectives include (i) the evaluation of the perception of alcohol marketing by patients with an AUD (ii) gaining understanding of the links between alcohol marketing and patients with AUD behaviours (iii) the development of alcohol demarketing strategy in patients receiving AUD coaching. METHODS: Our main objective isto evaluate the impact of marketing on a population with an AUD. The methodology was in 4 steps: step 1 is a pre-test (N = 100) selecting type of alcohol consumed and type of marketing stimuli identified by patients aged 18 + with an AUD. Step 2 is a qualitative study (N = 20), with in-depth interview, to understand links between alcohol marketing and patients with AUD behaviours. Step 3 is a quantitative study(N = 600) to confirm these links and the impact of alcohol marketing on patients with AUD behaviours. Step 4 is an interventional step, including and testing the impact of demarketing intervention on patients with AUD while using the results of the three first steps (N = 120). DISCUSSION: This study will contribute to a better definition of the impact of alcohol marketing on patients with AUD and will enable identification of the determinants of this impact. These data will inform the development of interventions that take into account demarketingstrategies on patients under AUD management. TRIAL REGISTRATION: The Trial registrationregistration number is NCT03876132, and it was registered on the 15th march 2019.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/prevenção & controle , Comportamento de Busca de Informação , Marketing/métodos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Projetos de Pesquisa , Fatores de Risco , Adulto Jovem
4.
BMC Public Health ; 20(1): 358, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32188436

RESUMO

BACKGROUND: The widespread under-screening and under-treatment of alcohol use disorder (AUD) contributes to its health and socioeconomic burden. We conducted a mixed-methods (qualitative and qualitative) study in people with alcohol use disorder (PWAUD) to explore their expectations, as well as barriers and levers to AUD care. METHODS: Individuals with AUDIT > 15 (N = 179) were interviewed using computer-assisted interviews in several medical and non-medical sites (e.g., bars) (quantitative substudy). We also conducted semi-structured face-to-face interviews with 36 PWAUD (qualitative substudy). Using logistic regression, we explored factors associated with having previously received/sought care for AUD. Three major themes were identified in the qualitative textual analysis using a descending hierarchical classification. RESULTS: Not socializing with heavy drinkers (AOR [95%CI]:3.84[1.66-8.85]), regular smoking (9.72[3.91-24.15]) and feeling discriminated against (2.35[1.10-5.05]) were independent levers to having sought/received care for AUD, while being aged < 50 and employment were independent barriers. The five predominant themes in PWAUD discourses emerging from the textual analysis were: drinking context, medical care, alcohol treatment, tobacco/addiction and family. When triangulating results from the logistic regression and the textual analysis, two barriers (social drinking and difficulties with the medical care system), and two levers (family influence and tobacco addiction), emerged. CONCLUSION: These results underline the need for interventions targeting families and the social network to increase awareness about AUD and related care. Simplified and novel comprehensive care trajectories are urgently needed to reduce the clinical and public health burden of AUD.


Assuntos
Alcoolismo/prevenção & controle , Programas de Rastreamento , Adulto , Alcoolismo/epidemiologia , Feminino , França/epidemiologia , Acesso aos Serviços de Saúde , Humanos , Masculino , Programas de Rastreamento/psicologia , Pessoa de Meia-Idade , Motivação , Pesquisa Qualitativa , Fatores Socioeconômicos , Inquéritos e Questionários
6.
BMC Public Health ; 20(1): 30, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914971

RESUMO

BACKGROUND: Young people account for more than a quarter of new HIV infections in the US, with the majority of cases among young men who have sex with men; young transgender women are also vulnerable to infection. Substance use, particularly alcohol misuse, is a driver of sexual transmission and a potential barrier to engagement in the HIV prevention and care continuum, however vulnerable youth are difficult to reach for substance use services due, in part, to complex social and structural factors and limited access to health care. The Community Prevention Services Task Force recommends electronic screening and brief intervention as an evidence-based intervention for the prevention of excessive alcohol consumption; however, no prior studies have extended this model to community-based populations of youth that are susceptible to HIV infection. This paper describes the study protocol for an electronic screening and brief intervention to reduce alcohol misuse among adolescents and young adults vulnerable to HIV infection in community-based settings. METHODS: This study, Step Up, Test Up, is a randomized controlled trial of an electronic alcohol screening and brief intervention among youth, ages 16-25, who are vulnerable to HIV infection. Individuals who present for HIV testing at one of three community-based locations are recruited for study participation. Eligibility includes those aged 16-25 years, HIV-negative or unknown HIV status, male or trans female with a history of sex with men, and English-speaking. Participants who screen at moderate to high risk for alcohol misuse on the Alcohol Use Disorders Identification Test (AUDIT) are randomized (1:1) to either an electronic brief intervention to reduce alcohol misuse or a time-and attention-matched control. The primary outcome is change in the frequency/quantity of recent alcohol use at 1, 3, 6 and 12-month follow-up. DISCUSSION: Testing of evidence-based interventions to reduce alcohol misuse among youth vulnerable to HIV infection are needed. This study will provide evidence to determine feasibility and efficacy of a brief electronically-delivered intervention to reduce alcohol misuse for this population. TRIAL REGISTRATION: ClinicalTrials.gov number, NCT02703116, registered March 9, 2016.


Assuntos
Alcoolismo/prevenção & controle , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/psicologia , Programas de Rastreamento/métodos , Psicoterapia Breve , Pessoas Transgênero/psicologia , Populações Vulneráveis/psicologia , Adolescente , Adulto , Feminino , Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Projetos de Pesquisa , Medição de Risco , Pessoas Transgênero/estatística & dados numéricos , Resultado do Tratamento , Populações Vulneráveis/estatística & dados numéricos , Adulto Jovem
9.
Rev. esp. drogodepend ; 44(4): 69-78, oct.-dic. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-187264

RESUMO

El grupo de autoayuda para alcohólicos más extendido en todo el mundo es Alcohólicos Anónimos (AA). Por esta razón, se decidió estudiar los motivos de los alcohólicos para seguir acudiendo a las reuniones de esta comunidad. Así pues, se realizó un estudio cualitativo exploratorio con cuatro personas con más de diez años de abstinencia que forman parte de un grupo de AA de Cataluña, a partir de grabar, transcribir y analizar una entrevista semiestructurada. Los resultados indican que todos los motivos de los participantes para seguir acudiendo a las reuniones de la comunidad son: miedo a recaer, para ayudar, para seguir creciendo y por la relación con el grupo


The most widespread group of self-help for alcoholics in the world is Alcoholics Anonymous (AA). For this reason, it was decided to study the motives of alcoholics to continue attending the meetings of this community. Thus, a qualitative exploratory study was conducted with four people with more than ten years of abstinence who are part of an AA group in Catalonia, by recording, transcribing and analyzing a semi-structured interview. The results indicate that all participants agreed that the reasons to continue attending community meetings are: fear of relapse, to help, to continue growing and because of the relationship with the group


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Alcoolismo/prevenção & controle , Alcoolismo/psicologia , Alcoólicos Anônimos/organização & administração , Grupos de Autoajuda , Pesquisa Qualitativa , Análise de Dados
10.
S Afr Med J ; 109(12): 971-977, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31865961

RESUMO

BACKGROUND: Alcohol, tobacco and unregulated substance use contributes to the global burden of disease. Admission to hospital provides an opportunity to screen patients for substance use and offer interventions. OBJECTIVES: To determine the prevalence and nature of substance use and treatment as well as interest in harm reduction among inpatients from four hospitals in the City of Tshwane, South Africa. METHODS: In a cross-sectional study, sociodemographic and substance use data were collected from 401 patients using the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test. Demographic characteristics were analysed using descriptive statistics. Bivariate and multivariate analyses of moderate- to high-risk tobacco and unregulated substance use in relation to demographic characteristics were also done. RESULTS: Most patients were South African (88%) and black African (79%), over half were female (57%), and they were relatively young (median age 38 years). Most (82%) lived in formal housing. Over half (56%) had completed high school, and 33% were formally employed. Bivariate analysis found substance use-related admission to be higher where scores for tobacco and unregulated substance use were moderate to high (13% v. 0.3%, p<0.05). A notably higher (p<0.1) proportion of participants with no/low tobacco and unregulated substance use had completed high school, were employed and were cohabiting/married compared with those with moderate to high scores. Across the hospitals, 32% (129/401) of the participants had moderate- to high-risk use of at least one substance: tobacco (28%, 111/401), alcohol (10%, 40/401), cannabis (7%, 28/401), opioids (2%, 9/401) and sedatives (2%, 9/401). Of these 129 participants, 10% had accessed professional help, many (67%, 78/129) wanted to learn more about harm reduction, and most (84%, 108/129) said that they were willing to participate in a community-based harm reduction programme. Multivariate analysis found moderate- to high-risk tobacco and unregulated substance use to be positively associated with male sex (adjusted odds ratio (aOR) 7.9, 95% confidence interval (CI) 2.9 - 21.5), age <38 years (aOR 3.3, 95% CI 1.2 - 8.9), moderate- to high-risk alcohol use (aOR 3.1, 95% CI 1.1 - 8.4; p=0.027) and being admitted to Tshwane District Hospital (aOR 3.6, 95% CI 1.1 - 12.2). It was negatively associated with employment (aOR 0.2, 95% CI 0.1 - 0.6). CONCLUSIONS: Moderate- to high-risk substance use is an undetected, unattended comorbidity in the hospital setting in Tshwane, particularly among young, single, unemployed men. Clinicians should identify and respond to this need. Further research is required on the implementation of in-hospital substance use screening and treatment interventions.


Assuntos
Redução do Dano , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adulto , Alcoolismo/epidemiologia , Alcoolismo/prevenção & controle , Estudos Transversais , Escolaridade , Emprego , Feminino , Hospitais Públicos , Humanos , Masculino , Abuso de Maconha/epidemiologia , Abuso de Maconha/prevenção & controle , Estado Civil , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Admissão do Paciente , Prevalência , Fatores Sexuais , África do Sul/epidemiologia , Tabagismo/epidemiologia , Tabagismo/prevenção & controle
13.
Metas enferm ; 22(8): 14-20, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184994

RESUMO

Objetivo: analizar el consumo de distintas sustancias adictivas en jóvenes universitarios de la Comunidad Valenciana en función de distintas características sociodemográficas y académicas. Método: estudio descriptivo transversal realizado en 2016 en ocho universidades valencianas (n= 26.529). El grupo de investigación NECOPSED de la Universidad CEU Cardenal Herrera diseñó un cuestionario ad hoc a través de un grupo focal en el que se incluyeron variables sociodemográficas (sexo, edad), académicas (titulación, curso) y de frecuencia de consumo de sustancias (de 1 nunca a 7 consumo diario), entre otras, que se administró en aulas seleccionadas por conveniencia. Se realizaron análisis uni y bivariantes. Resultados: en la muestra (n= 520) hubo un 61,2% de mujeres y la media de edad fue de 20,73 años. Las drogas más consumidas fueron alcohol (= 4,91), tabaco (= 3,17) y el cannabis (= 2,06). Se encontró un mayor consumo de todas las sustancias en los hombres, así como un aumento del mismo paralelo a la edad, con superioridad estadísticamente significativa en varias de ellas (p≤ 0,05). No hubo diferencias entre estudiantes de titulaciones relacionadas con la salud y el resto (p> 0,05). Conclusión: las sustancias más consumidas son el alcohol, el tabaco y el cannabis. El consumo de sustancias se asoció con el sexo y la edad, pero no con la titulación académica


Objective: to analyze the use of different addictive substances in young university students from the Valencian Community, according to different sociodemographical and academic characteristics. Method: a descriptive cross-sectional study conducted in 2016 in eight Valencian universities (n= 26.529). The NECOPSED Research Team from the Universidad CEU Cardenal Herrera designed an ad hoc questionnaire through a focus group, including the following variables: sociodemographical (gender, age), academic (career, year), and frequency of substance use (from 1= never to 7= daily use), among others, which was administered in classrooms selected by convenience. Univariate and bivariate analyses were conducted. Results: the sample (n= 520) included 61.2% of women, and the mean age was 20.73 years. The most common drugs used were alcohol (= 4.91), tobacco (= 3.17) and cannabis (= 2.06). A higher use of all substances was found in men, as well as an increase parallel to age, with statistically significant superiority in some of them (p≤ 0.05). There were no differences between students from careers associated with health and the rest (p> 0.05). Conclusion: the substances more used were alcohol, tobacco and cannabis. Substance use was associated with gender and age, but not with academic grade


Assuntos
Humanos , Masculino , Feminino , Adulto , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Abuso de Maconha/prevenção & controle , Tabagismo/prevenção & controle , Alcoolismo/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estudos Transversais , Inquéritos e Questionários
14.
Nat Commun ; 10(1): 3934, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477694

RESUMO

Drug addiction is a chronic relapsing disorder of compulsive drug use. Studies of the neurobehavioral factors that promote drug relapse have yet to produce an effective treatment. Here we take a different approach and examine the factors that suppress-rather than promote-relapse. Adapting Pavlovian procedures to suppress operant drug response, we determined the anti-relapse action of environmental cues that signal drug omission (unavailability) in rats. Under laboratory conditions linked to compulsive drug use and heightened relapse risk, drug omission cues suppressed three major modes of relapse-promotion (drug-predictive cues, stress, and drug exposure) for cocaine and alcohol. This relapse-suppression is, in part, driven by omission cue-reactive neurons, which constitute small subsets of glutamatergic and GABAergic cells, in the infralimbic cortex. Future studies of such neural activity-based cellular units (neuronal ensembles/memory engram cells) for relapse-suppression can be used to identify alternate targets for addiction medicine through functional characterization of anti-relapse mechanisms.


Assuntos
Cocaína/farmacologia , Condicionamento Operante/efeitos dos fármacos , Sinais (Psicologia) , Neurônios/fisiologia , Córtex Pré-Frontal/efeitos dos fármacos , Alcoolismo/fisiopatologia , Alcoolismo/prevenção & controle , Animais , Cocaína/administração & dosagem , Comportamento Compulsivo/fisiopatologia , Comportamento Compulsivo/prevenção & controle , Condicionamento Operante/fisiologia , Inibidores da Captação de Dopamina/farmacologia , Masculino , Córtex Pré-Frontal/fisiopatologia , Ratos Long-Evans , Ratos Sprague-Dawley , Ratos Transgênicos , Recidiva , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
15.
J Stud Alcohol Drugs ; 80(4): 423-430, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31495379

RESUMO

OBJECTIVE: Electronic music dance events (EMDEs) at nightclubs attract young adults engaging in high-risk alcohol and other drug (AOD) use. Studies show that most patrons arrive at clubs in groups and that these peer groups influence drinking. Therefore, peer groups are a natural context for preventing risk behaviors. This article examined outcomes of a randomized controlled trial of a group-based mobile intervention at nightclubs, Nightlife Safety Plans (NSP). METHOD: The sample comprised 352 groups, consisting of 959 participants (45.3% female) at 41 events across seven nightclubs hosting EMDEs. Club patrons were surveyed anonymously and completed breath tests as they entered and exited clubs. Oral fluid samples collected from patrons at exit assessed drug use. Analyses examining assignment to NSP versus a control condition on fire safety predicted individual- and group-level protective strategy use and AOD use, controlling for background variables. RESULTS: At the individual level, participation in NSP was related to increased protective actions to keep group members safe. No effects were found on actions to keep oneself safe or in response to overuse. At the group level, assignment to NSP was related to a higher average number of group safety strategies. Participation in NSP was associated with lower blood alcohol concentration but unrelated to tetrahydrocannabinol and cocaine. CONCLUSIONS: NSP appears to be efficacious for increased protective actions to keep group members safe from overuse and for reduced blood alcohol concentration among EMDE patrons. The findings support the use of an intervention utilizing group-based strategies presented proximal to risk settings.


Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/prevenção & controle , Atividades de Lazer/psicologia , Adolescente , Concentração Alcoólica no Sangue , Testes Respiratórios , Cocaína/sangue , Dronabinol/sangue , Feminino , Humanos , Masculino , Grupo Associado , Assunção de Riscos , Inquéritos e Questionários , Adulto Jovem
17.
Addict Sci Clin Pract ; 14(1): 32, 2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429802

RESUMO

BACKGROUND: This study protocol describes a proposed randomized controlled trial that builds upon a successful pilot intervention study to address problematic and dangerous drinking among young adult college students studying abroad in foreign environments. Despite universities and colleges citing alcohol misuse as the most concerning issue for their students abroad, most institutions offer no empirically-based prevention efforts tailored to this at-risk population. The proposed intervention attempts to fill a major gap for the nearly 333,000 students completing study abroad programs each year by using empirically-based and theoretically-informed risk and protective factors to correct misperceived peer drinking norms and promote cultural engagement abroad. In addition to preventing heavy and problematic drinking, the intervention seeks to prevent risky sexual behaviors (e.g., sex without a condom) and experience of sexual violence victimization, which are strikingly common among study abroad students and have the potential for lasting physical and psychological effects upon return home. METHODS/DESIGN: We will conduct a randomized controlled trial of an intervention with a sample of 1200 college students studying abroad from approximately 50 US universities and colleges. The brief, online intervention is text and video based and contains evidence-based components of personalized normative feedback to correct students' misperceived drinking norms, content to promote engagement with the cultural experience abroad and address difficulties adjusting to life in the foreign environment, and tips and strategies to prevent risky sexual behaviors and sexual violence victimization abroad. Participants will complete online surveys at five time points (predeparture, first month abroad, last month abroad, 1-month post-return, and 3-months post-return) to assess for intervention effects on drinking behavior, drinking consequences, risky sex, and sexual violence outcomes. We will examine whether the mechanisms targeted by the intervention (changes in perceived norms, engagement in the cultural experience abroad) serve as mediators of intervention efficacy. DISCUSSION: The proposed study has the potential to fill an important gap in the research literature and provide empirical support for an online accessible, brief, and targeted approach that can easily be distributed to study abroad students to help prevent heavy alcohol use and sexual risk abroad. Trial registration ClinicalTrials.gov Identifier NCT03928067.


Assuntos
Alcoolismo/prevenção & controle , Promoção da Saúde/organização & administração , Sexo Seguro , Delitos Sexuais/prevenção & controle , Universidades , Feminino , Humanos , Internacionalidade , Internet , Masculino , Fatores de Risco , Assunção de Riscos , Comportamento Sexual , Meio Social , Adulto Jovem
18.
Trials ; 20(1): 515, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31426835

RESUMO

BACKGROUND: Current population surveys suggest around 20% of Australians meet diagnostic criteria for an alcohol use disorder. However, only a minority seek professional help due to individual and structural barriers, such as low health literacy, stigma, geography, service operating hours and wait lists. Telephone-delivered interventions are readily accessible and ideally placed to overcome these barriers. We will conduct a randomised controlled trial (RCT) to examine the efficacy of a standalone, structured telephone-delivered intervention to reduce alcohol consumption, problem severity and related psychological distress among individuals with problem alcohol use. METHODS/DESIGN: This is a single site, parallel group, two-arm superiority RCT. We will recruit 344 participants from across Australia with problem alcohol use. After completing a baseline assessment, participants will be randomly allocated to receive either the Ready2Change (R2C) intervention (n = 172, four to six sessions of structured telephone-delivered intervention, R2C self-help resource, guidelines for alcohol consumption and stress management pamphlets) or the control condition (n = 172, four phone check-ins < 5 min, guidelines for alcohol consumption and stress management pamphlets). Telephone follow-up assessments will occur at 4-6 weeks, 3 months, 6 months and 12 months post-baseline. The primary outcome is the Alcohol Use Disorders Identification Test (AUDIT) score administered at 3 months post-baseline. Secondary outcomes include change in AUDIT score (6 and 12 months post-baseline), change in number of past-month heavy drinking days, psychological distress, health and wellbeing, quality of life, client treatment evaluation and cost effectiveness. DISCUSSION: This study will be one of the first RCTs conducted internationally to examine the impact of a standalone, structured telephone-delivered intervention to address problem alcohol use and associated psychological morbidity. The proposed intervention is expected to contribute to the health and wellbeing of individuals who are otherwise unlikely to seek treatment through mainstream service models, to reduce the burden on specialist services and primary care providers and to provide an accessible and proportionate response, with resulting cost savings for the health system and broader community. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12618000828224 . Pre-registered on 16 May 2018.


Assuntos
Alcoolismo/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Telefone , Consumo de Bebidas Alcoólicas/psicologia , Humanos , Projetos de Pesquisa , Tamanho da Amostra , Grupos de Autoajuda
20.
Manchester; The National Institute for Health and Care Excellence (NICE); Aug. 2019. 28 p.
Monografia em Inglês | BIGG | ID: biblio-1014988

RESUMO

This guideline covers interventions in secondary and further education to prevent and reduce alcohol use among children and young people aged 11 up to and including 18. It also covers people aged 11 to 25 with special educational needs or disabilities in full-time education. It will also be relevant to children aged 11 in year 6 of primary school.


Assuntos
Humanos , Criança , Adolescente , Adulto , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Alcoolismo/prevenção & controle , Inglaterra/epidemiologia
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