Medicine and Health Sciences Commons^™

Behavioral And Enhanced Perinatal Intervention (B-Epic): A Randomized Trial Targeting Tobacco Use Among Opioid Dependent Pregnant Women, Amanda Fallin-Bennett, Michelle R. Lofwall, Teresa M. Waters, Paul Nuzzo, Janine Barnett, Letitia Ducas, Andrea Mccubbin, Niraj R. Chavan, Lisa Blair, Kristin Ashford

Nursing Faculty Publications

Background

Opioid use during pregnancy is a significant public health issue. The standard of care for treating opioid use disorder during pregnancy includes medications for opioid disorder (MOUD). However, tobacco use often goes unaddressed among pregnant women on MOUD. In 2018, our team received a National Institute on Drug Abuse (NIDA) funded R34 to conduct a three year-randomized trial to test the feasibility of a novel tobacco intervention for pregnant women receiving MOUD.

Aims

The aims of this study are: (1) to determine the impact of the B-EPIC intervention on maternal tobacco use and stage of change; (2) to determine …

Covid-19 And Opioid Use In Appalachian Kentucky: Challenges And Silver Linings, Rachel Vickers-Smith, Hannah L.F. Cooper, April M. Young

Journal of Appalachian Health

Appalachian Kentucky is currently fighting two public health emergencies – COVID-19 and the opioid epidemic – leaving the area strapped for resources to care for these ongoing crises. During this time, people who use opioids (PWUO) have increased vulnerability to fatal overdoses and drug-related harms (e.g., HIV). Disruption of already limited services posed by COVID-19 could have an especially detrimental impact on the health of PWUO. Though the COVID-19 pandemic is jeopardizing hard-won progress in fighting the opioid epidemic, innovations in state policy and service delivery brought about by the pandemic may improve the health of PWUO long-term if they …

Substance Use Prevention Services In Juvenile Justice And Behavioral Health: Results From A National Survey, Rodney Funk, Hannah K. Knudsen, Larkin S. Mcreynolds, John P. Bartkowski, Katherine S. Elkington, Ellen H. Steele, Jessica M. Sales, Christy K. Scott

Behavioral Science Faculty Publications

BACKGROUND: This study examined the national availability of substance use prevention (SUP) within juvenile justice (JJ) and their primary behavioral health (BH) providers, and the relationships between the availability of SUP and agency-level measures of organizational structure, staffing, and youth characteristics. A three-stage national probability sampling process was used to select participants for a national survey that included, among other facets of community supervision (CS) and BH practices, questions on agency characteristics, youth characteristics, whether the agency/provider directly provided SUP services, and whether the agency/provider directly provided substance use and/or mental health treatment. This paper focuses on SUP services along …

A Nutritional And Environmental Analysis Of Local Food Pantries Accessible To College Students In Rural North Carolina, Emily E. Frymark, Jonathon Stickford, Alisha Farris

Journal of Appalachian Health

Introduction: Food insecurity is a growing concern among college students and is especially prevalent in rural areas. Food pantries often serve as a resource to food insecure individuals yet, their policies, standards, and nutritional quality vary due to the unpredictability of food donations.

Purpose: To examine the nutritional quality of food items and adherence of best practices at local food pantries accessible to college students near a university in rural Appalachia.

Methods: Three food pantries in North Carolina were selected due to their proximity to a local, rural university. Food items were analyzed for nutrient and food …

Psychosocial Mediators Of Perceived Stigma And Suicidal Ideation Among Transgender Women, Krishna Kiran Kota, Laura F. Salazar, Rachel E. Culbreth, Richard A. Crosby, Jamal Jones

Health, Behavior & Society Faculty Publications

BACKGROUND: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

METHODS: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact …

Access To Autism Spectrum Disorder Services For Rural Appalachian Citizens, Angela Scarpa, Laura S. Jensen, Denis Gracanin, Sharon L. Ramey, Angela V. Dahiya, L. Maria Ingram, Jordan Albright, Alyssa J. Gatto, Jen P. Scott, Lisa Ruble

Journal of Appalachian Health

Background: Low-resource rural communities face significant challenges regarding availability and adequacy of evidence-based services.

Purposes: With respect to accessing evidence-based services for Autism Spectrum Disorder (ASD), this brief report summarizes needs of rural citizens in the South-Central Appalachian region, an area notable for persistent health disparities.

Methods: A mixed-methods approach was used to collect quantitative and qualitative data during focus groups with 33 service providers and 15 caregivers of children with ASD in rural southwest Virginia.

Results: Results supported the barriers of availability and affordability of ASD services in this region, especially relating to the need for more ASD-trained providers, …

Relationship Between Initial Prescription Opioid Exposure Length And Future Opioid Use Disorder Diagnosis In Opioid Naive Adolescents, Eric Lindahl

Theses and Dissertations--Pharmacy

Objectives: The long-term risks associated with the use of short-term prescription opioids in opioid naïve adolescents in not well characterized. The purpose of this study was to explore the potential association between the days’ supply of the initial prescription opioid exposure and the rates of diagnosed OUD in the subsequent 3-year period. Methods: We conducted a retrospective cohort study using a nationwide database of commercially-insured adolescents aged 12-17 at the time of the index opioid fill. A multivariable Cox Proportional Hazard regression model was developed to analyze the association of interest while accounting for known risk factors for the development …

Neonatal Abstinence Syndrome: Effectiveness Of Targeted Umbilical Cord Drug Screening In Determining Risk Of Withdrawal, Alecia Karr

DNP Projects

Neonatal Abstinence Syndrome (NAS) is a condition in which an infant experiences withdrawal from uterine exposure to various substances such as caffeine, nicotine, amphetamines, THC, opioids, benzodiazepines, and other types of substances. Depending on the severity of the symptoms, these infants may experience a longer hospital stay and may need treatment and monitoring in the neonatal intensive care unit (NICU), resulting in an increase in healthcare costs. The objective of this project was to determine if targeted drug screening of newborns was effective in determining infants at risk of NAS based on a positive screening result. This study utilized a …

Evaluating Providers’ Perceptions On Preconception Care For Women With Sud, Corinna Hughes

DNP Projects

Background: Substance use disorders (SUDs) has become an epidemic. Women of reproductive age with SUDs have particularly complex healthcare needs including an increased risk of having an unintended pregnancy and associated sequela of negative birth outcomes (NBO). Little is known about how medication assisted treatment (MAT) providers are adequately addressing their unique needs. Identifying provider barriers and tools to address the reproductive needs of women with SUDs can optimize their health outcomes and prevent NBOs.

Purpose: The purpose of this study was to evaluate MAT Nurse Practitioners’ (NPs) knowledge and perceptions of providing preconception care to women with …

National Guard Members With Suicide Ideation: The Impact Of Stigma, Mental Health, And Trauma History On Treatment-Seeking Outcomes, Amy Brown

Theses and Dissertations--Social Work

Background. Veterans are overrepresented among suicide deaths in the United States, representing 20% of annual suicide deaths but only about 1% of the U.S. population (Department of Veteran Affairs, 2010). Of all military suicide deaths in 2016, one-third (33.4%) were in the National Guard or Reserves (Department of Defense, 2018). Previous suicidal ideation or behavior (SIB) has been shown to increase risk of subsequent ideation or behavior in both active duty and veteran samples (Bryan, Rudd, & Wertenberger, 2016; Hazlett et al., 2016) but studies of SIB specific to National Guard service members were not found.

Access and Barriers to …

Stress And Cancer Treatment: How A Family’S Adaptability And Cohesion Affects Financial Stress, Emily Marie Johnson

Theses and Dissertations--Family Sciences

According to the American Cancer Society (2019), it is estimated that 1,762,450 new cancer diagnoses occurred in 2019 in the United States. Currently, cancer remains one of the leading causes of death worldwide (American Cancer Society, 2019). As cancer affects the family, roles within the family will shift (e.g., transitioning to a caregiving relationship), causing each family member to adapt. With the costs of cancer steadily increasing, this potentially leaves a devastating impact on the family. When considering family function in terms of Family Systems, John Rolland created the Family Systems Illness Model to explain how families adapt to an …

Briding The Gap: Treatment Engagement Profiles And Outcomes Utilizing Novel Models, Allison Koetter

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background. The opioid epidemic is a public health emergency that requires collaboration between both private and public sectors to increase access to and capacity for efforts directed at treatment, prevention, and recovery. The Commonwealth of Kentucky via funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) created their State Targeted Response to the Opioid Crisis (Opioid STR) in order to help address these needs. The University of Kentucky, as an awardee of these funds, decided on an approach to highlight the Emergency Department (ED) bridge model, which links patients discharged from EDs and the hospital (inpatient addiction consult …

Ethanol Sustains Phosphorylated Tau Protein Immunofluorescence In The Cultured Neonatal Rat Hippocampus: Implications For Fetal Alcohol Spectrum Disorders, Caleb Seth Bailey

Theses and Dissertations--Psychology

Fetal Alcohol Spectrum Disorders (FASDs) are comprised of developmental, behavioral, and cognitive abnormalities caused by prenatal alcohol exposure, affecting an estimated 2%-5% of childrenand costing up to $4 billion annually in the United States alone. Although some behavioral therapies can help, the biochemical mechanisms that underpin FASDs need further elucidation for development of more efficacious therapeutics. The tau protein modulates cytoskeletal structure in neurons, and thereby plays an integral role in proper development and function of the central nervous system, but its function is altered by its phosphorylation state, such that increased phosphorylation reduces tau protein function. The tau protein …

Escalation And Reinstatement Of Fentanyl Self-Administration In Male And Female Rats, Samantha G. Malone

Theses and Dissertations--Psychology

Escalation of intake and craving are two DSM-5 hallmark symptoms of opioid use disorder (OUD). Objectives: This study determined if escalation measured by long access (LgA) self-administration and craving measured by reinstatement are related. Adult male and female Sprague-Dawley rats were trained to self-administer (SA) fentanyl across 7 daily 1-h sessions, followed by 21 SA sessions of either 1- or 6-h duration. Assignment to short access (ShA) and long access (LgA) groups was randomly determined for both males and females. Following 14 1-h extinction sessions, Experiment 1 assessed reinstatement induced by either fentanyl (10 or 30 μg/kg) or yohimbine (1 …