Medicine and Health Sciences Commons^™

A Quality Improvement Project For Co-Occurring Disorders In Outpatient Behavioral Health, Erin Sheehan

Erin Sheehan

Understanding Relationships In Health Related Quality Of Life For Parents Of Children With Autism Spectrum Disorder, Norah Louise Johnson

Norah L Johnson

Nurses encounter many parents of children with autism spectrum disorder (ASD). Both parents are under stress that ultimately impacts their health related quality of life (HRQL). Few studies assess the mediators of parenting stress on HRQL for both parents. This study explored the relationship of parenting stress, family functioning and HRQL for parenting dyads of children with ASD. Lazarus and Folkman's (1984) Transactional Model of Stress and Coping and Lakey and Cohen's (2000) Social Support Theory framed the study. Implementing a cross sectional, descriptive design, 387 parents (n=64 dyads) of ASD-affected children, from 46 states, completed web-based surveys. Demographics, the …

Invisible, Underserved, And Diverse: The Health Of Women In Prison, Janette Taylor, R. Williams, M. Eliason

Janette Y. Taylor

In the United States of America, women are the fastest growing segment of the criminal justice system. They are entering the system with far greater physical and mental health problems than men, but with fewer health services. Additionally, within this expanding population of incarcerated women, are disproportionately represented poor women of color with serious health needs. This article: a) uses an ecosocial model to examine and critique the health and healthcare of women in prison, b) examines social structures that influence incarceration and health status, and c) proposes reconsideration of current prison health services and education.

Health Status And Resources Of Rural Homeless Women And Children, Martha Craft-Rosenberg, S. Powell, Kennith Culp

Martha J. Craft-Rosenberg

The purpose of this research is to describe the health status and health resources for homeless women and children in a Midwestern rural community. A group of 31 rural homeless women in a shelter participated in the study by answering questions on the Rural Homeless Interview developed by the investigators. The findings revealed higher than expected rates of illness, accidents, and adverse life events, with the incidence ofsubstance abuse and mental illness being comparable to data from other homeless populations. The data on children were limited by lack of knowledge on the part of their mothers. Some mothers reported that …

Health Status And Resources Of Rural Homeless Women And Children, Martha Craft-Rosenberg, S. Powell, Kennith Culp

Kennith R. Culp

The purpose of this research is to describe the health status and health resources for homeless women and children in a Midwestern rural community. A group of 31 rural homeless women in a shelter participated in the study by answering questions on the Rural Homeless Interview developed by the investigators. The findings revealed higher than expected rates of illness, accidents, and adverse life events, with the incidence ofsubstance abuse and mental illness being comparable to data from other homeless populations. The data on children were limited by lack of knowledge on the part of their mothers. Some mothers reported that …

Smoking Cessation Among Persons With Co-Occurring Substance Use Disorder And Mental Illness, Chizimuzo T.C. Okoli, Milan Khara

Chizimuzo T.C. Okoli

Aims: A history of either a substance use disorder (SUD) or psychiatric disorder (PD) is associated with tobacco use. However, there is limited information available on tobacco dependence treatment outcomes among individuals with co-occurring SUD and PD. Methods: Data from 202 participants enrolled in a tobacco dependence treatment program in an outpatient clinic setting were analysed. Findings: In multivariate analysis, having a history of SUD only (OR =.11, 95% CI = .02–.76) and having a co-occurring SUD and PD (OR = .13, 95% CI = .02–.81), as compared to having neither, were significant predictors of a lower likelihood of achieving …

Trauma, Psychiatric Disorders, Substance Use, And Smoking Among Women, Chizimuzo T.C. Okoli, Nancy Poole, Natalie Hemsing, Karin O'Leary

Chizimuzo T.C. Okoli

Despite decreasing smoking rates among women in the general population, there remain subgroups of women characterized by high nicotine dependence, who remain less able to quit.

One subgroup of women who continue to smoke at rates higher than the general population are those who: have past experiences of trauma, are vulnerable to psychiatric disorders and have substance use problems/addictions.

However, the prevalence of the co-occurrence of trauma, psychiatric disorders, and substance use problems/ addictions, with smoking among women has not previously been synthesized.

The purpose of this study is to conduct a comprehensive review to identify the prevalence of smoking …

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Substance Use And Psychiatric Disorders, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings

• Smoking abstinence at end of program:
• Intent to treat analysis: 32.2% (83/258)
• Among program completers: 41.3% (83/201)

• Significant predictors of abstinence:
• Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder.
• Having a lower CO level at program enrolment was a significant predictor of being more likely to quit
• Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Disorders, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Gender-Specific Profiles Of Tobacco Use Among Non-Institutionalized People With Serious Mental Illness, Joy L. Johnson, Pamela A. Ratner, Leslie A. Malchy, Chizimuzo T.C. Okoli, Ric M. Procyshyn, Joan L. Bottorff, Marlee Groening, Annette Schultz, Marg Osborne

Chizimuzo T.C. Okoli

Background: In many countries, smoking remains the leading preventable cause of death. In North America, reductions in population smoking levels are stabilising and, in recent years, those involved in tobacco control programming have turned their attention to particular segments of society that are at greatest risk for tobacco use. One such group is people with mental illness. A picture of tobacco use patterns among those with mental illness is beginning to emerge; however, there are several unanswered questions. In particular, most studies have been limited to particular in-patient groups. In addition, while it is recognised that men and women differ …

Smoking Cessation Outcomes Among Individuals With Co-Occurring Substance Use Disorder History And Mental Illness, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND: A history of substance use disorder and/or mental illness is associated with tobacco use. However, there is limited information available on tobacco dependence treatment outcomes in such populations. OBJECTIVES: To examine the effects of a history of substance use disorder and/or mental illness on smoking cessation outcomes. METHODS: Data from 202 participants enrolled in a tobacco treatment program were analyzed. Information on sociodemographics, tobacco use and quit attempt history, social supports for quitting, Fagerstrom Test for Nicotine Dependence scores, importance and confidence in quitting smoking, expired carbon monoxide level, substance use history, mental health history, and previous pharmacotherapy use …

Smoking Cessation In Patients With Substance Use Disorders: The Vancouver Coastal Health Tobacco Dependence Clinic, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Review: Community-Based Participatory Research Approach To Address Mental Health In Minority Populations, Mona Shattell, Jeanne Stacciarini, Maria Coady-Madden, Brenda Wiens

Mona Shattell

In this review, a synthesis of studies employing community-based participatory research (CBPR) to address mental health problems of minorities, strengths and challenges of the CBPR approach with minority populations are highlighted. Despite the fact that minority community members voiced a need for innovative approaches to address culturally unique issues, findings revealed that most researchers continued to use the traditional methods in which they were trained. Moreover, researchers continued to view mental health treatment from a health service perspective.

Intensive Tobacco Dependence Treatment For Clients With Substance Use Disorder And/Or Mental Illness, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND •Drug treatment populations are disproportionately affected by morbidity and mortality due to tobacco use. However, with appropriately intensive intervention, individuals in drug treatment settings can succeed in their efforts towards smoking cessation. •The Tobacco Dependence Clinic (TDC) is a program that provides smoking cessation counseling and up to 26 weeks of free pharmacotherapy for clients through Vancouver Coastal Health Addiction Services , British Columbia, Canada. There are currently three clinic sites: Pacific Spirit, Three Bridges, and Downtown Community Health Centre (DCHC). •The purpose of this study is to provide 2-year pilot evaluation data (in terms of program completion and …

Assessing Secondhand Tobacco Smoke Exposure Among Persons With Severe And Persistent Mental Illness, Chizimuzo T.C. Okoli, Joy L. Johnson, Leslie Malchy

Chizimuzo T.C. Okoli

Background

• Secondhand tobacco smoke (SHS) exposure increases the risk for cancer, respiratory illness, and cardiovascular disease.

• Individuals with severe and persistent mental illness (SPMI) have a higher smoking prevalence than the general population, placing them at increased risk for related morbidity and mortality.

• Given the higher smoking prevalence in this population, the risk for SHS exposure among smokers and nonsmokers with SPMI should be an issue of concern. Yet, SHS exposure in this population is understudied.

• The purpose of our study was to examine the correlates of SHS exposure in this population. Our specific aims were …