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Abstracts From The 25th Annual Health Care Systems Research Network Conference, April 8–10, 2019, Portland, Oregon

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of nonprofit health systems with embedded research departments whose scientists are dedicated to public domain research. The network’s annual conference serves as a forum for research teams to disseminate study findings, stimulate new collaborations, and share insights about conducting research in real-world care settings. Abstracts accepted for presentation at HCSRN 2019 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official scientific journal of the conference.

Association Of Cohort And Individual Substance Use With Risk Of Transitioning To Drug Use, Drug Use Disorder, And Remission From Disorder: Findings From The World Mental Health Surveys, Louisa Degenhardt, Chrianna Bharat, Meyer D. Glantz, Nancy A. Sampson, Ali Al-Hamzawi, Jordi Alonso, Laura H. Andrade, Brendan Bunting, Alfredo Cia, Giovanni De Girolamo, Peter De Jonge, Koen Demyttenaere, Oye Gureje, Josep Maria Haro, Meredith G. Harris, Yanling He, Hristo Hinkoy, Aimee Nasser Karam, Elie G. Karam, Andrzej Kiejna, Viviane Kovess-Masfety, Victor Lasebikan, Sing Lee, Daphna Levinson, Maria Elena Medina-Mora, Zeina Mneimneh, Fernando Navarro-Mateu, Marina Piazza, Jose Posada-Villa, Kate Scott, Dan J. Stein, Hisateru Tachimori, Nathan L. Tintle, Yolanda Torres, Ronald C. Kessler

Faculty Work Comprehensive List

Importance: Limited empirical research has examined the extent to which cohort-level prevalence of substance use is associated with the onset of drug use and transitioning into greater involvement with drug use.

Objective: To use cross-national data to examine time-space variation in cohort-level drug use to assess its associations with onset and transitions across stages of drug use, abuse, dependence, and remission.

Design, Setting, and Participants: The World Health Organization World Mental Health Surveys carried out cross-sectional general population surveys in 25 countries using a consistent research protocol and assessment instrument. Adults from representative household samples were interviewed face-to-face in the …

Examining Sex Differences In The Association Between A Partner's Antisocial Behavior And One's Own Substance Use, Jasmine R. Jones, Jessica E. Salvatore Phd, Rebecca L. Smith Phd, Msw, Amy Adkins Phd

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

Is There An Association Between Social Support And Substance Use In College Students?, Emily Ramos, Elizabeth Prom-Wormley Phd

IRBEH/Spit for Science Publications and Presentations

No abstract provided.

Impulsivity Of Sexual Trauma Survivors And Their Use Of Alcohol And Substances, Kayla Mclean, Jasmin Vassileva Phd

IRBEH/Spit for Science Publications and Presentations

The current study investigates the associations of neurocognitive ‘choice’ impulsivity (delay discounting) and personality ‘trait’ impulsivity (UPPS) with alcohol and substance use among college students reporting history of sexual trauma. Spit For Science data was used as the sample, specifically looking at cohort Y5(N=2476). A bivariate correlation was used to compare different substances and alcohol use to different facets of the UPPS trait impulsivity and correlations were used to measure the relationship between different levels of delay discounting (small, medium, large, overall) with alcohol and substance use among students reporting history of sexual trauma.

Psychosocial Differences In Far Right, Far Left, Islamic, And Single Issue Lone Extremists, Tamara Marie Lamontagne

Walden Dissertations and Doctoral Studies

Acts of lone extremism are on the rise, yet little is known about who commits these acts. Research in this area has failed to delineate by extremist subtype. This has led to the misconception these acts and actors present with such variance psychosocially that they cannot be predicted. The purpose of this research was to assess whether statistically significant relationships exist between lone extremist subtypes on the psychosocial variables of mental illness, substance use, and having radicalized friends or family members. The conceptual framework for this study was De La Corte's psychosocial principles of terrorism, which addressed the social and …

Designed Cultural Adaptation And Delivery Quality In Rural Substance Use Prevention: An Effectiveness Trial For The Keepin’ It Real Curriculum, Michael L. Hecht, Youngju Shin, Jonathan Pettigrew, Michelle Miller-Day, Janice L. Krieger

Communication Faculty Articles and Research

This study examined how cultural adaptation and delivery quality of the school-based intervention keepin’ it REAL (kiR) influenced adolescent substance use. The goal of the study was to compare the effectiveness of the multi-cultural, urban (non-adapted) kiR intervention, a re-grounded (adapted) rural version of the kiR intervention and control condition in a new, rural setting. A total of 39 middle schools in rural communities of two states in the USA were randomly assigned to one of three conditions (i.e., control, non-adapted urban kiR, and adapted rural kiR). Data included adolescent self-reported lifetime substance use and observers’ ratings of delivery quality …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Maine Health Access Foundation Addiction Care Program: Interim Evaluation Report, Mary Lindsey Smith Phd, Katie Rosingana Ba, Frances Jimenez Ba, Rachel M. Gallo Mph, Mark Richards Bs

Substance Use Research & Evaluation

No abstract provided.

Improving Access To Collegiate Substance Use Prevention Resources, Sarah Danko

Senior Honors Projects

The incidence of substance use has been increasing at an alarming rate and declared a public health epidemic. Certain subpopulations, including the collegiate population, are at an increased risk for developing a substance use disorder. According to The National Center on Addiction and Substance Abuse, 22.9% of college students meet the criteria for a substance use disorder. This rate is markedly high compared to the rate amongst the general public of 8.5%. A number of factors predispose college students to alcohol and substance use disorders. These factors include increased freedom, social pressures, and high-demand academic workload. Despite the scope of …

A Model For Rigorously Applying The Exploration, Preparation, Implementation, Sustainment (Epis) Framework In The Design And Measurement Of A Large Scale Collaborative Multi-Site Study, Jennifer E. Becan, John P. Bartkowski, Danica K. Knight, Tisha R. A. Wiley, Ralph Diclemente, Lori Ducharme, Wayne N. Welsh, Diana Bowser, Kathryn Mccollister, Matthew Hiller, Anne C. Spaulding, Patrick M. Flynn, Andrea Swartzendruber, Megan F. Dickson, Jacqueline Horan Fisher, Gregory A. Aarons

Center on Drug and Alcohol Research Faculty Publications

Background

This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners.

Methods

The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the …

Knitting As An Adjunctive Treatment For Substance Use Disorder: A Mixed Methods Multiple Case Study, Aubriana M. Teeley

Antioch University Dissertations & Theses

Substance abuse disorder is a characterized by the presence of cognitive, behavioral, and physiological symptoms from substance use with continued use despite these consequences. It has serious individual and societal implications, such as negative health effects, overdose, poor work and school performance, negative impacts on relationships, and even death. Economic effects include more frequent use of emergency and hospital services as compared to peers without substance use disorder. A variety of treatments for substance use are available, including inpatient and outpatient programs accompanied by behavioral interventions, individual or group psychotherapy, or 12-step programs. However, there is no one treatment that …

Genetic Moderation Of Cocaine Subjective Effects By Variation In The Tph1, Tph2, And Slc6a4 Serotonin Genes, Michelle A Patriquin, Sara C Hamon, Mark J Harding, Ellen M Nielsen, Thomas F Newton, Richard De La Garza, David A Nielsen

Staff and Researcher Publications

Objective: This study investigated variants of tryptophan hydroxylase (TPH)1, TPH2, and SLC6A4 in the moderation of the subjective effects of cocaine.

Methods: Non-treatment-seeking cocaine-dependent individuals (N=66) were intravenously administered saline and cocaine (40 mg) in a randomized order. Participants self-reported subjective effects of cocaine using a visual analog scale starting before administration of saline or cocaine (-15 min) to up to 20 min after infusion. Self-report ratings on the visual analog scale ranged from 0 (no effect) to 100 (greatest effect). Participants were genotyped for the TPH1 rs1799913, TPH2 rs4290270, and SLC6A4 5-HTTLPR variants. Repeated-measures analysis of covariance was used …

The Impact Of Brief Intervention Workshops On Addiction Provider Knowledge, Skills, And Attitudes Toward Evidence-Based Practices, Diana M. Doumas, Susan Esp, Raissa Miller

Counselor Education Faculty Publications and Presentations

This study evaluated the impact of Motivational Interviewing (MI) and Screening, Brief Intervention, and Referral to Treatment (SBIRT) workshops on post-training knowledge, skills, negative attitudes, and interest in implementing evidence-based practices (EBPs). Participants (N = 70) were primarily mental health counselor (41.4%), social workers (20.0%), substance abuse counselors (15.7%), school counselors (5.7%) and nursing professionals (4.3%) who selected the one or two day workshop for continuing education credit. Participants attended either a Basic MI training workshop (one day) or a Basic MI training plus an Advanced MI/SBIRT training workshop (two day) to assess if exposure to two EBPs would improve …

Serious Mental Illness Among Young Adult Women Who Use Drugs In The Club Scene: Co-Occurring Biopsychosocial Factors, Maayan Lawental, Hilary L. Surratt, Mance E. Buttram, Steven P. Kurtz

Center for Health Services Research Faculty Publications

Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami’s club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a …

A Study Of Innovation In Model Project Design: Addressing Mental Health Symptoms Among Co-Occurring Substance Use And Mentally Ill Clients Who Are Homeless In A Local Community Clinic Setting, Isis Dian Martel

Graduate Theses and Dissertations

Homeless persons with co-occurring substance use combined with mental illness constitute a particularly vulnerable subgroup with complex service needs. Unfortunately, the capacity to deliver critical treatment services has been extremely limited causing many from this population to remain untreated. Untreated co-occurring disorders can lead to a host of difficulties for both the individual and the community (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011). Developing community based intervention services in Arkansas is a key activity necessary in strategically addressing this problem (Barbee, Gonzales, & Shelor, 2016). In partnership with the Arkansas Division of Behavioral Health Services, a local community treatment provider …

Psychosocial Factors Related To The Intergenerational Transmission Of Externalizing Behaviors In Early Midlife, Chenshu Zhang, Judith S. Brook, Neo K. Morojele, Mario De La Rosa, Carl G. Leukefeld, David W. Brook

Behavioral Science Faculty Publications

Background: To study the intergenerational transmission of externalizing behaviors. Methods: Participants came from a community-based random sample of residents in two upstate New York counties (N = 548). Data were collected from mothers at mean age 40 and from their children from adolescence (mean age = 14, SD = 2.8) to early midlife (mean age = 43, SD = 2.8) at seven time points. Structural equation modeling (SEM) was used to study the psychosocial factors as related to externalizing behaviors in early midlife. Results: First, maternal externalizing behaviors were indirectly associated with the offspring's externalizing behaviors …

Substance Use And Bullying Victimization Among Middle And High School Students: Is Positive School Climate A Protective Factor?, Diana M. Doumas, Aida Midgett, April D. Johnston

Counselor Education Faculty Publications and Presentations

This study examined the relationship between substance use, bullying victimization, and school climate among middle and high school students (N = 498). Bullying victimization predicted substance use, particularly among high schools students. Additionally, among high school students, victims with positive perceptions of school climate reported less illicit drug use.

Emerging Adults And Recovery Capital: Barriers And Facilitators To Recovery, Alex Elswick

Theses and Dissertations--Family Sciences

Substance use disorders are chronic brain disorders and must therefore be treated on an ongoing basis. Accordingly, the concept of recovery capital has been developed to account for the internal and external resources that an individual can mobilize in order to recover from a substance use disorder. However, the concept has scarcely been applied to emerging adults. Although they are at twice the risk of developing a substance use disorder relative to their adult or adolescent counterparts, emerging adults in addiction and recovery are understudied. This phenomenological study aims to explore and describe the experience of emerging adults in recovery …

Pill Poppin’ Nation: Substance Use, Mental Health, And Treatment Among Criminal Justice-Involved African Americans, Joi-Sheree' P. Knighton

Theses and Dissertations--Educational, School, and Counseling Psychology

The purpose of this dissertation was to examine substance use-related outcomes among criminal justice-involved African Americans using a multiple manuscript format. The Centers for Disease Control and Prevention has deemed nonmedical prescription opioid use an epidemic. National estimates indicate approximately 3.9% of African Americans engage in nonmedical prescription opioid use. Research suggests African Americans involved in the criminal justice system may be significantly at risk of substance use more generally; yet, there are no known estimates of nonmedical opioid use among this subgroup. Rising rates of nonmedical opioid use also has implications for discussing barriers to treatment among socioeconomically marginalized …

"You're Doing Fine, Right?": Adolescent Siblings Of Substance Abusers, Cynthia E. Clarfield

Antioch University Dissertations & Theses

There has been a rising interest in addiction medicine and addiction treatment in both the medical and behavioral health science fields. Research suggests having a family member with a substance abuse problem has negative impacts on both physical and mental health (Orford, Copello, Velleman, & Templeton, 2010a). Despite advances toward understanding the experiences of family members affected by a loved one's addiction, the siblings of substance abusers have been largely excluded from scientific research and literature. As a result, little is known about how siblings experience the impacts of a brother or sister's addiction; even less is known about the …

Sexual Behavior And Substance Use Among Women Across The Spectrum Of Sexual Orientation, Margaret M. Wolff

Dissertations and Theses

Background: Compared to non-sexual minority women, sexual minority women are at greater risk for substance use and abuse, sexual risk behaviors, and unplanned teen pregnancy; few studies measure differing associations by sexual orientation (e.g., identity, behavior, attraction) or discordance (e.g., heterosexually-identified women with female partners) components. Minority stress may explain sexual minority women’s health disparities; thus, as U.S. policies evolve to reflect growing acceptance of all sexual minorities, research should examine sexual minority women’s health risk behaviors using multidimensional constructs of sexual orientation.

Methods: Using the female sample of the 2002-2013 National Survey of Family Growth (Aims 1-2 n=25,523; …

E-Cigarette Use Among Students And E-Cigarette Specialty Retailer Presence Near Schools, Georgiana Bostean, Catherine M. Crespi, Patsornkarn Vorapharuek, William J. Mccarthy

Sociology Faculty Articles and Research

Objective. This study examined the association between presence of e-cigarette specialty retailers near schools and e-cigarette use among middle and high school students in Orange County (OC), CA.

Methods. The OC subsample of the 2013-2014 California Healthy Kids Survey (N=67,701) was combined with geocoded e-cigarette retailers to determine whether a retailer was present within one-quarter mile of each public school in OC. Multilevel logistic regression models evaluated individual-level and school-level e-cigarette use correlates among middle and high school students.

Results. Among middle school students, the presence of an e-cigarette retailer within one-quarter mile of their school predicted …

Ptsd Symptom Severities, Interpersonal Traumas, And Benzodiazepines Are Associated With Substance-Related Problems In Trauma Patients, Jeffrey Guina, Ramzi W. Nahhas, Adam J. Goldberg, Seth Farnsworth

Population and Public Health Sciences Faculty Publications

Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors …

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

The Mental Health Of Children And Adolescents : Report On The Second Australian Child And Adolescent Survey Of Mental Health And Wellbeing, David Lawrence, Sarah Johnson, Jennifer Hafekost, Katrina Boterhoven De Haan, Michael Sawyer, John Ainley, Stephen R. Zubrick

Wellbeing

Based on a survey conducted in the homes of over 6,300 families with children and/or adolescents aged 4 to 17 years, this report presents a comprehensive picture of the mental health of young Australians. It documents the prevalence and type of mental health problems, the impact of those problems on families and young people themselves and the role of health and education services in providing assistance. While the primary sources of information were parents and carers, the survey also engaged directly with young people 11 years and older who completed their own survey. This information provides unique insights about aspects …

Brief Intervention For Truant Youth Sexual Risk Behavior And Marijuana Use, Richard Dembo, Rhissa Briones-Robinson, Kimberly Barrett, Rocio Ungaro, Ken C. Winters, Steven Belenko, Lora M. Karas, Laura Gulledge, Jennifer Wareham

Faculty Publications

Substance use and sexual risk behaviors are common among adolescents, but research has focused attention on alcohol use. Much less is known about the relationship of marijuana use and sexual risk behavior among high-risk, especially truant, youths. We report interim findings from a NIDA-funded experimental, brief intervention (BI) study involving truant youths and their parents/guardians. Longitudinal data were analyzed to study (1) the relationships between the youths' marijuana use and sexual risk behavior and (2) the effects of a substance use BI on their marijuana use and sexual risk behavior. A growth model analysis for parallel processes was conducted to …

Substance Use And Drug Distribution At The Individual Level: A Grounded Theory Approach, Evan Thomas Stanforth

Electronic Theses and Dissertations

Substance use regularly occurs among individuals that distribute drugs and there is a limited amount of research that has examined both use and distribution. A grounded theory approach was used to develop a framework for analyzing relationships between use and distribution behaviors. 15 participants (five female, 10 male) that had experience selling drugs and using drugs were recruited from a residential substance abuse treatment center. Each participant was interviewed for one hour with an interview protocol aligning with the stage of analysis. A model was developed to explain Involvement and Integration in a Drug World with the codes Substance Use, …

Drinking Buddies: Who Are They And When Do They Matter?, Cathy Lau-Barraco, Ashley N. Linden

Psychology Faculty Publications

The present study sought to further examine the role of peers on alcohol use and problems among young adults. In particular, we focused on a specific subset of peers in one's social network mostly for activities related to alcohol use called "drinking buddies." The presence of drinking buddies in one's social network has been shown to predict heavy drinking uniquely over time but few studies have focused on potential factors moderating the relationship. Consequently, an aim of present study was to examine the influence of drinking buddies on alcohol outcomes and the extent to which the relationship may be dependent …

Caffeinated Alcohol Consumption Profiles And Associations With Use Severity And Outcome Expectancies, Cathy Lau-Barraco, Robert J. Milletich, Ashley N. Linden

Psychology Faculty Publications

Growing evidence suggests that the consumption of caffeinated alcoholic beverages (CAB) may be riskier than alcohol alone. Efforts to identify patterns of CAB use and the correlates of such drinking patterns could further our conceptualization of and intervention for this health issue. Consequently, the current study aimed to (1) identify distinct classes of CAB users, (2) examine differences between classes on measures of alcohol and caffeine problems, and (3) compare distinct classes of CAB users on caffeine and alcohol outcome expectancies. Participants were 583 (31% men) undergraduate students from a psychology research pool. Latent profile analysis models were derived using …