Examining the Effects of a Comprehensive Community Intervention on Underage Drinking in Seven Kansas Communities

In the United States, underage drinking, or alcohol consumption by individuals younger than 21 years, is the most common type of substance abused by youth. Underage drinking is associated with violent and risky sexual behaviors, and is a major predictor of later alcohol abuse in adulthood. A number of antecedents are associated with underage drinking including social norms, social access, and enforcement of alcohol policies. The Strategic Prevention Framework (SPF) is a model developed by the Substance Abuse and Mental Health Services Administration to guide communities in addressing substance abuse through effective prevention efforts. While most states in the nation have received funding to implement the framework, there are few published studies that exist examining the effects of SPF implementation on underage drinking outcomes. The two studies presented in the dissertation used a mixed-methods approach to examine the effects of a comprehensive community intervention on underage drinking outcomes in seven Kansas communities implementing the SPF model. The second study further examines the association between the level of intensity, or dose, of the comprehensive community change interventions (i.e., program, policy, practice changes) across the seven communities and improvements in underage drinking outcomes over time. The results show a 34.3% reduction in past 30-day self-reported alcohol consumption among youth between 2006 and 2012. Additionally, a strong and statistically significant correlation existed between the intensity of community change interventions and underage drinking outcomes. The study provides empirical support for the Strategic Prevention Framework as an effective approach for implementing comprehensive interventions to reduce and prevent underage drinking in communities

Improving community readiness for change through coalition capacity building: Evidence from a multisite intervention

Often, community coalitions are facilitators of community-level changes when addressing underage drinking. Although studies have shown that enhancing coalition capacity is related to improved internal functioning, the relationship between enhanced capacity and community readiness for change is not well established. The present study used a pretest–posttest design to examine whether enhancing coalition capacity through training and technical assistance was associated with improved community readiness and coalition-facilitated community-level changes. Seven Kansas communities engaged in an intensive capacity building intervention through implementation of the Strategic Prevention Framework. The results indicated strong correlations between increased coalition capacity, changes in community readiness stages, and the number of community changes facilitated. The results suggest that strengthening coalition capacity through training and technical assistance may improve community readiness for change and enable the implementation of community-wide program and environmental changes

Effects of Anxiety and Coping on Past 90-Day Opioid Misuse among Indian Adults during COVID-19

Substance use, especially opioid use, is an ongoing public health crisis in India that is compounded by the COVID-19 pandemic. Approximately 22 million Indian citizens use opiates, yet there are no empirical studies that analyze the prevalence of use during a global pandemic in India. Further exploration is needed about the prevalence of opioid use among south Asian Indian adults to (1) Identify if sociodemographic variables such as gender, education, and employment are significantly associated with 90-day opioid use and (2) identify whether anxiety or coping influence the rate of 90-day opioid use regardless of sociodemographic variables. Results indicated both anxiety and coping were significantly and independently associated with past 90-day opioid use, women were significantly more likely to endorse past 90-day opioid misuse than men, and Both lower education and less than full-time employment were also significantly associated with greater frequency of past 90-day opioid misuse. Overall, the study’s results highlight the need for more concentrated investigations into substance use among South Indians, as well as tailored use substance prevention programs that consider social determinants of health when treating patients

Psychosocial Impacts of COVID: An International Observational Study

International observational study examining predictors of COVID social distancing and hand washin

Racial disparities in COVID-19 impacts in Michigan, USA

Several racial disparities have been observed in the impacts of COVID-19 in the United States. In this paper, we used a representative sample of adults in Michigan to examine differences in COVID-19 impacts on Blacks and Whites in four domains: direct, perceived, political, and behavioral. We found that in the initial wave of the outbreak in May 2020, Blacks were more likely to be diagnosed or know someone who was diagnosed, or more likely to lose their job compared to Whites. Additionally, Blacks differed significantly from Whites in their assessment of COVID-19’s threat to public health and the economy, the adequacy of government responses to COVID-19, and the appropriateness of behavioral changes to mitigate COVID-19’s spread. Although in many cases these views of COVID-19 were also associated with political ideology, this association was significantly stronger for Whites than Blacks. We conclude by discussing the implications of an ongoing and highly politicized public health crisis that has racially disparate impacts in multiple domains

Predictors of Social Distancing and Hand Washing among Adults in Five Countries during COVID-19

Proper hand washing and social distancing measures have been promoted as mitigating strategies to slow the spread of COVID-19 across the world. However, no study to date has investigated the risk and protective characteristics associated with practicing proper hand washing or social distancing. The present study examined the effects of such characteristics among 2,509 adults from the United States, Italy, Spain, the Kingdom of Saudi Arabia, and India. In the overall sample, age was significantly associated with social distancing (b = 0.07, β = 0.36, p = .001) but not hand washing. Lesbian women and gay men were less likely to engage in social distancing (b = -0.92, β = -0.07, p = .001) and hand washing (b = -0.39, β = -0.08, p < .001) relative to their heterosexual peers. No significant differences were found in the overall sample with regard to education level or employment status, but rural (b = -0.45, β = -0.07, p = .003) respondents were significantly less likely to practice social distancing compared to their urban counterparts. Furthermore, both suburban (b = -0.12, β = -0.06, p = .014) and rural (b = -0.13, β = -0.05, p = .022) respondents were significantly less likely to practice appropriate hand washing compared to their urban peers. Taken together, the results suggest multiple nuanced disparities exist regarding social distancing and hand washing among adults internationally. As such, more tailored and culturally-responsive clinical and community-based interventions may be needed to promote preventive measures to mitigate existing COVID-related disparities

Improving community readiness for change through coalition capacity building: Evidence from amultisite intervention

Often, community coalitions are facilitators of community-leve lchanges when addressing underage drinking. Although studies have shown that enhancing coalition capacity is related to improved internal functioning, the relationship between enhanced capacity and community readiness for change is not well established. The present study used a pretest–post test design to examine whether enhancing coalition capacity through training and technical assistance was associated with improved community readiness and coalition-facilitated community-level changes. Seven Kansas communities engaged in an intensive capacity building intervention through implementation of the Strategic Prevention Framework. The results indicated strong correlations between increased coalition capacity, changes in community readiness stages, and the number of community changes facilitated. The results suggest that strengthening coalition capacity through training and technical assistance may improve community readiness for change and enable the implementation of community-wide program and environmental changes

Associations between sociodemographic characteristics and substance use disorder severity among methamphetamine-using men who have sex with men.

Background: Men who have sex with men (MSM) have elevated rates of substance use disorders (SUDs) and differences across sociodemographic sub-groups of MSM are associated with a greater risk of deleterious outcomes. Although studies have shown that MSM report greater rates of polysubstance use relative to other adult populations, the associations between sociodemographic characteristics and both acute substance use and substance use severity among methamphetamine-using MSM are unknown. Objectives: The present study examines associations between sociodemographic characteristics and (a) recent substance use and (b) SUD severity. Method: From March 2014 to January 2016, 286 methamphetamine-using MSM were recruited to complete a baseline Audio Computer-Assisted Self-Interview (ACASI) assessment and the SCID MINI. Multivariable analyses employed generalized structural equation modeling given the non-continuous nature of the endogenous variables. Results: All measured sociodemographic characteristics except gay self-identification were significantly associated with recent substance use (all ps ≤ .05), and all characteristics except current homelessness were significantly associated with diagnostic SUD severity (all ps ≤ .05). However, nuanced risks were observed in participants' use of specific substances regarding recent substance use and substance use severity. Conclusion: These results suggest that multiple factors contribute to the risks of SUD severity among methamphetamine-using MSM. As such, these results are useful in the tailoring of clinical and psychosocial intervention strategies that serve this and other high-risk populations

Associations between sociodemographic characteristics and substance use disorder severity among methamphetamine-using men who have sex with men.

Background: Men who have sex with men (MSM) have elevated rates of substance use disorders (SUDs) and differences across sociodemographic sub-groups of MSM are associated with a greater risk of deleterious outcomes. Although studies have shown that MSM report greater rates of polysubstance use relative to other adult populations, the associations between sociodemographic characteristics and both acute substance use and substance use severity among methamphetamine-using MSM are unknown. Objectives: The present study examines associations between sociodemographic characteristics and (a) recent substance use and (b) SUD severity. Method: From March 2014 to January 2016, 286 methamphetamine-using MSM were recruited to complete a baseline Audio Computer-Assisted Self-Interview (ACASI) assessment and the SCID MINI. Multivariable analyses employed generalized structural equation modeling given the non-continuous nature of the endogenous variables. Results: All measured sociodemographic characteristics except gay self-identification were significantly associated with recent substance use (all ps ≤ .05), and all characteristics except current homelessness were significantly associated with diagnostic SUD severity (all ps ≤ .05). However, nuanced risks were observed in participants' use of specific substances regarding recent substance use and substance use severity. Conclusion: These results suggest that multiple factors contribute to the risks of SUD severity among methamphetamine-using MSM. As such, these results are useful in the tailoring of clinical and psychosocial intervention strategies that serve this and other high-risk populations