Medicine and Health Sciences Commons^™

A Multivariate Analysis Of Nationwide Changes In Opioid Prescriptions From 2012-2016, Drishti Pillai, Leighton Ku

GW Research Days 2016 - 2020

Background

Between 2012 and 2016, the opioid overdose mortality rate in the U.S. almost doubled from 7.4 to 13.3 per 100,000 population, leading to calls for a national opioid crisis. This crisis has generated interest in Medicaid’s dual role as a health insurance system that provides reimbursement for both prescription opioid analgesics like Oxycodone used to treat chronic pain, which could inadvertently fuel addiction, and prescription opioids used as treatment medication to help people survive and recover from drug abuse, such as Naloxone.

Methods

In this study, we conduct a multi-variate analysis of Medicaid prescription drug utilization data for the …

Cross-Sectional Comparison Of Behavioral Risk Factors For Hiv/Hcv In People Who Inject Drugs (Pwid) In Egypt, Sarah Martinez, Amira A. Roess, Monica S. Ruiz, Atef Bakhoum, Ehab El Kharrat

GW Research Days 2016 - 2020

Background

Egypt has the greatest HCV prevalence worldwide at 15% and a concentrated HIV epidemic in male people who inject drugs (PWID) at 6.8%, who are at a high risk for HCV infection as well. Injection drug use is criminalized in Egypt, and there is limited availability of harm reduction programs. Drug-use and sexual risk behaviors between PWID and the general population have not been studied there.

Methods

To address this gap, a cross-sectional HIV/HCV epidemiological study of 632 consenting injection drug users in Cairo and Alexandria was conducted. Bivariate logistic regression analysis was done to evaluate the associations between …

(Video) Differences In Psychosocial And Behavioral Risk Profiles Of Cigarette Smokers And E-Cigarette Users Among Minnesota Adolescents: 2016, Tara E. Jenson

GW Research Days 2016 - 2020

Background/Objectives: Rates of cigarette smoking among adolescents have been trending downward, however rates of adolescent e-cigarette use rates are now twice those of adolescent cigarette smoking nationally. The objective of this study was to examine the association of demographic, socioeconomic, psychosocial and health behavioral factors as surveyed by the Minnesota Student Survey with cigarette smoking and e-cigarette use among Minnesota adolescents.

Methods: This study analyzed the 2016 Minnesota Student Survey (MSS), an anonymous, school-based, cross-sectional survey of students in grades five, eight, nine and eleven. The 2016 MSS contains a total of 168,733 records, 118,198 of which were …

Shelburne And Clark’S Harbour Quit Smoking: A Community-Based Smoking Cessation Initiative Process Evaluation, Georgeann Lois Macdonald Mn: Dnp, Anp, Rn, Accn, Np

Doctor of Nursing Practice Projects

Background: The prevalence of Canadian smokers is 14.6%. Clark’s Harbour and Shelburne’s rate of smoking increased from 15.6% in 2012 to 19.4% in 2015 (Propel Centre for Population Health Impact, 2015). It was imperative that innovative ways be found to reduce the smoking prevalence.

Objectives: 1) Identify a difference in the participants’ Stages of Change before and after completing the smoking cessation program. 2) Determine whether the participants quit smoking 3) Assess whether there was satisfaction with the program.

Methods: In this one group pre and post-test design, the participants completed a series of pre and post program questionnaires. The …

Prevalence And Correlates Of Depression And Alcohol Use Disorder Among Adults Attending Primary Health Care Services In Nepal: A Cross Sectional Study., Nagendra P Luitel, Emily C Baron, Brandon A Kohrt, Ivan H Komproe, Mark J D Jordans

Psychiatry and Behavioral Sciences Faculty Publications

BACKGROUND: Although depression and alcohol use disorder (AUD) are expected to be common among patients presenting to primary health care setting, there is limited research on prevalence of depression and AUD among people attending primary health care services in low-income countries. The aim of this study was to assess the prevalence of depression and AUD among adults attending primary care facilities in Nepal and explore factors associated with depression and AUD.

METHODS: We conducted a population-based cross-sectional health facility survey with 1474 adults attending 10 primary healthcare facilities in Chitwan district, Nepal. The prevalence of depression and AUD was assessed …

Perceived Access And Barriers To Care Among Illicit Drug Users And Hazardous Drinkers: Findings From The Seek, Test, Treat, And Retain Data Harmonization Initiative (Sttr)., Mika Matsuzaki, Quan M Vu, Marya Gwadz, Joseph A C Delaney, Irene Kuo, Maria Esther Perez Trejo, William E Cunningham, Chinazo O Cunningham, Katerina Christopoulos

Epidemiology Faculty Publications

BACKGROUND: Illicit drug use (DU) and hazardous drinking (HD) among marginalized populations may be associated with greater barriers to care.

METHODS: We used baseline data on the participants of the Seek, Test, Treat, and Retain data harmonization initiative. DU includes use of any illicit drugs within the past 6 months. HD was defined as scores ≥8 for men and ≥ 7 for women on Alcohol Use Disorders Identification Test within the past 12 months. Social support scores were assigned by summing scores from individual questions related to social support. Two outcomes for multivariable regression models and mediation analysis were perceived …

A Web Application To Increase Interest In Treatment Among Problem Drinkers, Daniel Z. Lieberman, Sheela Kadekar, Suena W. Huang, Melissa Lausin

Psychiatry and Behavioral Sciences Posters and Presentations

Problem: Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive effective interventions.

Approach: Can an automated, online program reach a hidden population of alcohol abusers who are not served by currently available treatment programs, and increase their interest in treatment?

Comparison Of Alcohol Abusers Who Seek Traditional Treatment Versus Those Who Use An Online Program, Suena Huang, Daniel Z. Lieberman

Psychiatry and Behavioral Sciences Posters and Presentations

Problem: Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive effective interventions.

Approach: Can an automated, online program reach a hidden population of alcohol abusers who are not served by currently available treatment programs?

The majority of individuals with alcohol use disorders do not receive treatment. Practical strategies are needed to expand opportunities for individuals to receive effective interventions. An online program was designed to increase users’ motivation for change, and users of this program were compared to a traditional help-seeking population. Data was collected from 1,297 individuals …

Predicting User Preferences For Educational Content Based On The Results Of An Automated Evaluation For Alcohol Use Problems, Daniel Z. Lieberman, Vilmaris Quinones Cardona, Kenneth Williams

Psychiatry and Behavioral Sciences Posters and Presentations

Computer programs may be more effective than traditional selfhelp manuals because they are interactive, and can automatically modify their content to meet the specific needs of a user. Successfully predicting the type of information that will be most relevant to an individual may lead to greater engagement with the program and better outcomes. The current study tests the association of information obtained during an automated evaluation for alcohol use problems with subsequent preference for educational modules.

Characteristics Of Participants In An On-Line Alcohol Abuse Evaluation Program, Daniel Z. Lieberman

Psychiatry and Behavioral Sciences Posters and Presentations

Access to treatment for substance abuse disorders is limited, and practical strategies are needed to expand opportunities for individuals to receive evidence-based interventions. Automated or semi-automated treatments have shown promise in other disorders. Identifying the characteristics of patients who will be able to benefit from this unconventional approach will increase the likelihood of success. The current study examined 1,297 individuals using an on-line alcohol evaluation program. Subjects had high scores on the AUDIT, and a substantial amount of ambivalence about the possible harm that their drinking caused, but very low levels of identifying themselves as actual problem drinkers.

Towards A Global Policy Against Alcohol Marketing To Youth: Challenges And Recommendations For Research., Alisa Padon, Rajiv N Rimal

Prevention and Community Health Faculty Publications

No abstract provided.

Reduced Nicotine Content Cigarettes In Smokers Of Low Socioeconomic Status: Study Protocol For A Randomized Control Trial., Nicolle M Krebs, Sophia I Allen, Susan Veldheer, Diane J Martinez, Kimberly Horn, Craig Livelsberger, Jennifer Modesto, Robin Kuprewicz, Ashley Wilhelm, Shari Hrabovsky, Abid Kazi, Alyse Fazzi, Jason Liao, Junjia Zhu, Emily Wasserman, Samantha M Reilly, Lisa Reinhart, Neil Trushin, Robinn E Moyer, Rebecca Bascom, Jonathan Foulds, John P Richie, Joshua E Muscat

Prevention and Community Health Faculty Publications

BACKGROUND:

The Family Smoking Prevention and Tobacco Control Act gave the Food and Drug Administration jurisdiction over the regulation of all tobacco products, including their nicotine content. Under this act, a major strategy to reduce harm from cigarette tobacco is lowering the nicotine content without causing unintended adverse consequences. Initial research on reduced nicotine content (RNC) cigarettes has shown that smokers of these cigarettes gradually decrease their smoking frequency and biomarkers of exposure. The effectiveness of this strategy needs to be demonstrated in different populations whose response to RNC cigarettes might be substantially mediated by personal or environmental factors, such …

Cohort Profile: Seek, Test, Treat And Retain United States Criminal Justice Cohort., Redonna Chandler, Michael S Gordon, Bridget Kruszka, Lauren N Strand, Frederick L Altice, Irene Kuo, +Several Additional Authors

Epidemiology Faculty Publications

BACKGROUND: The STTR treatment cascade provides a framework for research aimed at improving the delivery of services, care and outcomes of PLWH. The development of effective approaches to increase HIV diagnoses and engage PLWH in subsequent steps of the treatment cascade could lead to earlier and sustained ART treatment resulting in viral suppression. There is an unmet need for research applying the treatment cascade to improve outcomes for those with criminal justice involvement.

METHODS: The Seek, Test, Treat, and Retain (STTR) criminal justice (CJ) cohort combines data from 11 studies across the HIV treatment cascade that focused on persons involved …

E-Cigarettes And Smoking Cessation Among Pregnant Women: Insights From A Secondary Analysis Of A Randomized Controlled Trial, Shawn Chiang, Lorien Abroms

GW Research Days 2016 - 2020

Background: The use of electronic cigarettes is a rapidly expanding phenomenon. Currently, there is a scarcity of data to help guide decisions regarding the potential harm and benefits of e-cigarettes. This study examines whether pregnant smokers who used e-cigarettes are more likely to quit smoking than those who had never used e-cigarettes.

Methods: Data were drawn from the Quit4Baby study, a text-message-based smoking cessation randomized controlled trial. The sample was comprised of 481 participants with complete follow-up data at 1 month follow-up. Linear and logistics regression models to control for confounds were conducted to evaluate the association between e-cigarette use …

What May Be Associated With Young Adult E-Cigarette Use? Examination Of Key Correlates, Diane J. Martinez, Monique M. Turner, Kathleen Roche, Kimberly Horn

GW Research Days 2016 - 2020

Given increasing rates of e-cigarette use among young adults, research is needed on the attitudes and beliefs that drive use among this age group. Tobacco control approaches used to prevent cigarette smoking may not work as effectively for preventing e-cigarette use. To address this research gap, the present study applied the Integrated Behavior Model (IBM) encompassing the affect heuristic theory to examine the individual-level determinants (i.e., attitude, perceived norm, personal agency, intention, and e-cigarette risk perception) of young adults' e-cigarette use. The 2013-2014 Population Assessment of Tobacco and Health (PATH) Study Wave 1 baseline adult dataset consisted of 9,112 young …

Bridging The Divide White Paper: Pregnant Women And Substance Use: Overview Of Research & Policy In The United States, Darla Bishop, Liz Borkowski, Megan Couillard, Amy Allina, Susanna Baruch, Susan Wood

Jacobs Institute of Women's Health

This paper examines the current literature and policy implications of substance use and substance use disorders among pregnant and parenting women. While this is not meant to serve as an exhaustive literature review on this topic, it seeks to describe: current research on health effects of substance use and substance use disorders on pregnant women1 and their children; policies and programs that help ensure that pregnant women who use substances have access to the highest quality healthcare, including prenatal care; the current barriers to accessing treatment for substance use disorders for pregnant women, including those who are incarcerated; and the …

A Qualitative Analysis Of Smokers’ Perceptions About Lung Cancer Screening, Lindsay Gressard, Amy Degroff, Thomas B. Richards, Stephanie Melillo, Julia Kish-Doto, Christina L. Heminger, Elizabeth Rohan, Kristine Allen

Prevention and Community Health Faculty Publications

Background

In 2013, the US Preventive Services Task Force (USPSTF) began recommending lung cancer screening for high risk smokers aged 55–80 years using low-dose computed tomography (CT) scan. In light of these updated recommendations, there is a need to understand smokers’ knowledge of and experiences with lung cancer screening in order to inform the design of patient education and tobacco cessation programs. The purpose of this study is to describe results of a qualitative study examining smokers’ perceptions around lung cancer screening tests.

Methods

In 2009, prior to the release of the updated USPSTF recommendations, we conducted 12 120-min, gender-specific …

How Medicaid And Other Public Policies Affect Use Of Tobacco Cessation Therapy, United States, 2010-2014., Leighton Ku, Erin Brantley, Tyler Bysshe, Erika Steinmetz, Brian K. Bruen

Health Policy and Management Faculty Publications

INTRODUCTION: State Medicaid programs can cover tobacco cessation therapies for millions of low-income smokers in the United States, but use of this benefit is low and varies widely by state. This article assesses the effects of changes in Medicaid benefit policies, general tobacco policies, smoking norms, and public health programs on the use of cessation therapy among Medicaid smokers.

METHODS: We used longitudinal panel analysis, using 2-way fixed effects models, to examine the effects of changes in state policies and characteristics on state-level use of Medicaid tobacco cessation medications from 2010 through 2014.

RESULTS: Medicaid policies that require patients to …

Beer Potomania: A Challenging Case Of Hyponatremia, Hind Rafei, Raza Yunus, Parvinder S. Khurana

Medicine Faculty Publications

Beer potomania is a syndrome of hyponatremia associated with excessive beer drinking. Little or no salt content of beer results in marked reduction in the solute load to the kidney. This leads to impaired water clearance and dilutional hyponatremia. A 66-year-old man with history of alcoholism and alcoholic cardiomyopathy presented to the emergency room with tremors of his upper and lower extremities. He had a significant history of alcohol consumption, usually drinking 4 - 5 cans of beer per night for the past 34 years. In addition, he had consumed a fifth of a vodka bottle the day before presentation. …

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc, Hildi J. Hagedorn, Randall Brown, Michael Dawes, Eric Diepernick, Donald Myrick, Elizabeth M. Oliva, Todd H. Wagner, Jennifer P. Wisdom, Alex Harris

Health Policy and Management Faculty Publications

Background: Only 7.8% of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation components. …

Quantifying Syringe Exchange Program Operational Space In The District Of Columbia., Sean T. Allen, Monica Ruiz, Jeff Jones

Prevention and Community Health Faculty Publications

Syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs. In 2000, a buffer zone policy (the 1000 Foot Rule) was implemented in Washington, DC, that prohibited SEP operations within 1000 feet of schools. We examined changes in the amount of legal SEP operational space over time. We used data pertaining to school operations and their approximate physical property boundaries to quantify the impact of the 1000 Foot Rule on legal SEP operational space from its implementation in 2000-2013. Adherence to the 1000 Foot Rule reduced SEP operational space by more than 50 % …

Smoking Characteristics And Psychiatric Comorbidities Of Pregnant Smokers: An Analysis Of Quit4baby Randomized Controlled Trial, Shawn Chiang, Lorien C. Abroms, Jennifer M. Schindler-Ruwisch, Leah E. Leavitt

GW Research Days 2016 - 2020

Background: Text messaging or short message service (SMS) programs have been shown to be effective in helping adult smokers quit smoking (Abroms et al., 2014). However, to our knowledge, no prior research has examined psychiatric comorbidities associated with smoking in the text messaging context. The risk of smoking has been shown to increase as a function of the number of psychiatric illnesses with which a person is diagnosed (Aubin, Rollema, Svensson, & Winterer, 2012). The current study examined this association and other correlates of smoking-psychiatric comorbidity in a sample of U.S. pregnant smokers enrolled in Quit4Baby, a smoking cessation text …

Assessing The Effectiveness Of Partners In Quitting, A Text Message-Based Smoking Cessation Program, Rachael Schoenbrun

GW Research Days 2016 - 2020

This presentation will discuss the implementation of Partners in Quitting, a new text message-based smoking cessation program. It will also provide preliminary data on client engagement rates, program effectiveness, and program challenges. Partners in Quitting is an outreach program that has been implemented at Bread for the City, a large DC hub for free health and social services. Partners in Quitting provides an evidence-based, easily accessible, and comprehensive smoking cessation program to the clients of Bread for the City.

Assessing Syringe Exchange Program Access Among Persons Who Inject Drugs (Pwid) In The District Of Columbia, Sean T. Allen, Monica S. Ruiz, Jeff Jones

Prevention and Community Health Faculty Publications

Prior research has explored spatial access to syringe exchange programs (SEPs) among persons who inject drugs (PWID), but these studies have been based on limited data from short periods of time. No research has explored changes in spatial access to SEPs among PWID longitudinally. The purpose of this research is to examine spatial access to SEPs among PWID who accessed services at a SEP in Washington, District of Columbia (DC), from 1996 to 2010. The geometric point distance estimation technique was used to calculate the mean walking distance PWID traveled from the centroid point of their zip code of home …

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc., Hildi Hagedorn, Randall Brown, Michael Dawes, Eric Dieperink, Donald Hugh Myrick, Elizabeth Oliva, Todd Wagner, Jennifer P. Wisdom, Alex Harris

Health Policy and Management Faculty Publications

BACKGROUND: Only 7.8 % of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation …

Smoking Cessation Support For Pregnant Women: Role Of Mobile Technology., Christina L Heminger, Jennifer M. Schindler-Ruwisch, Lorien C. Abroms

Prevention and Community Health Faculty Publications

BACKGROUND: Smoking during pregnancy has deleterious health effects for the fetus and mother. Given the high risks associated with smoking in pregnancy, smoking cessation programs that are designed specifically for pregnant smokers are needed. This paper summarizes the current landscape of mHealth cessation programs aimed at pregnant smokers and where available reviews evidence to support their use.

METHODS: A search strategy was conducted in June-August 2015 to identify mHealth programs with at least one component or activity that was explicitly directed at smoking cessation assistance for pregnant women. The search for text messaging programs and applications included keyword searches within …

Legal Space For Syringe Exchange Programs In Hot Spots Of Injection Drug Use-Related Crime., Sean T Allen, Monica S. Ruiz, Jeff Jones, Monique M Turner

Prevention and Community Health Faculty Publications

BACKGROUND: Copious evidence indicates that syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs (PWID). The efficacy of SEPs in supporting the public health needs of PWID populations is partially dependent on their accessibility and consistent utilization among injectors. Research has shown that SEP access is an important predictor of PWID retention at SEPs, yet policies exist that may limit the geographic areas where SEP operations may legally occur. Since 2000 in the District of Columbia (DC), SEP operations have been subject to the 1000 Foot Rule (§48-1121), a policy that prohibits the …

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc., Hildi J Hagedorn, Randall Brown, Michael Dawes, Eric Dieperink, Donald Hugh Myrick, Elizabeth M Oliva, Todd H Wagner, Jennifer P. Wisdom, Alex H S Harris

Health Policy and Management Faculty Publications

BACKGROUND: Only 7.8 % of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation …

Using Neuroscience To Create A Paradigm Shift In Addiction Treatment And Theory, Tabitha E.H. Moses

Student Works

Drug abuse has long fascinated philosophers and scientists. Many different models have attempted to elucidate the mechanism behind drug addiction and analyze whether an addict has a choice in his behavior. The problem with these models is that they seem to suggest only two ways of viewing addiction. These models suggest either that a person cannot control his addiction and is therefore deserving of treatment, or that suggest a person can control their addictions and is not deserving of treatment, and instead needs threats of punishment to stop their behavior. I believe these approaches are too simplistic and do not …

Assessing Seasonality Of Travel Distance To Harm Reduction Service Providers Among Persons Who Inject Drugs., Sean T. Allen, Monica S. Ruiz, Amira Roess, Jeff Jones

Prevention and Community Health Faculty Publications

BACKGROUND: Prior research has examined access to syringe exchange program (SEP) services among persons who inject drugs (PWID), but no research has been conducted to evaluate variations in SEP access based on season. This is an important gap in the literature given that seasonal weather patterns and inclement weather may affect SEP service utilization. The purpose of this research is to examine differences in access to SEPs by season among PWID in the District of Columbia (DC).

FINDINGS: A geometric point distance estimation technique was applied to records from a DC SEP that operated from 1996 to 2011. We calculated …