Visualizing the Influence of Social Networks on Recovery:A Mixed-Methods Social Identity Mapping Study with Recovering Adolescents

BackgroundSocial recovery capital (SRC) refers to resources and supports gained through relationships and is vital to adolescent addiction recovery. Much is known about how substance use relates to social networks, but little is known about how other dimensions of social networks influence recovery (e.g., network size/exposure, degree of conflict). MethodsThis mixed-methods study sampled 28 adolescents who received treatment for alcohol and other drug (AOD) use disorder (14-19 yrs.: 71% male; M=17.32 yrs., SD=1.33; White 82%): 20 were recovery high school (RHS) students. Adolescents completed a social identity map for addiction recovery (SIM-AR), survey, and interview. Qualitative data were content analyzed and the data from the SIM-AR were quantified. ResultsOn average, participants reported belonging to five having 5 distinct groups (Range, 2-9; SD=1.63; M=27.89 people, SD = 20.09) in their network. Of their social network connections, on average, 51% drank alcohol and 46% used other substances. Larger networks involved more conflict (r=0.57). Participants were more likely to spend more time with groups that had greater proportions of non-substance usinge members; these relationships were stronger for RHS than for non-RHS students. Qualitative analyses revealed that youth reported their recovery-oriented groups as supportive, yet some felt their substance-using friends also supported their recovery.DiscussionSIM-AR was a useful measurement tool, and, through qualitative interviews, we identified unique aspects of youth’s social networks important for further examination. Research with recovering youth should examine SRC-related elements within their networks including relationship quality, belonging, and conflict, in addition to the substance use behaviors of network members. <br/

Occupational advice for Patients undergoing Arthroplasty of the Lower limb: An intervention development and feasibility study (The OPAL Study)

Background Hip and knee replacements are regularly performed for patients who work. There is little evidence about these patients’ needs and the factors influencing their return to work. There is a paucity of guidance to help patients return to work after surgery and a need for structured occupational advice to enable them to return to work safely and effectively. Objective(s) To develop an occupational advice intervention to support early recovery to usual activities including work which is tailored to the requirements of patients undergoing hip and knee replacements. To test the acceptability, practicality and feasibility of this intervention within current care frameworks Design An intervention mapping (IM) approach was used to develop the intervention. The research methods employed were: rapid evidence synthesis; qualitative interviews with patients and stakeholders; prospective cohort study; survey of clinical practice; modified Delphi consensus process. The developed intervention was implemented and assessed during the final feasibility stage of the IM process. Setting Orthopaedic departments within NHS secondary care. Participants Patients in work, and intending to return to work following primary elective hip and knee replacement surgery; healthcare professionals and employers. Interventions Occupational advice intervention. Main outcome measures Development of an occupational advice intervention. Fidelity of the developed intervention when delivered in a clinical setting. Patient and clinician perspectives of the intervention. Preliminary assessments of intervention effectiveness and cost. Results A cohort study (154 patients), 110 stakeholder interviews, survey of practice (152 respondents) and evidence synthesis provided the necessary information to develop the intervention. The intervention included information resources, personalized return to work plan and co-ordination from the healthcare team to support the delivery of 13 patient and 20 staff performance objectives (POs). To support delivery, a range of tools (e.g. occupational checklists, patient workbooks, employer information), roles (e.g. return-to-work coordinator) and training resources were created. Feasibility was assessed in 21 of the 26 patients recruited from 3 NHS trusts. Adherence with the defined performance objectives was 75% for patient POs and 74% for staff POs. The intervention was generally well received although the short timeframe available for implementation and concurrent research evaluation led to some confusion amongst patients and those delivering the intervention regarding its purpose and the roles and responsibilities of key staff. Limitations Implementation and uptake of the intervention was not standardized and was limited by the study timeframe. Evaluation of the intervention involved a small number of patients which limited the ability to assess it. Conclusions The developed occupational advice intervention supports best practice. Evaluation demonstrated good rates of adherence against defined performance objectives. However, a number of operational and implementation issues require further attention Future work The intervention warrants a randomised controlled trial to assess its clinical and cost effectiveness to improve rates and timing of sustained return to work after surgery. This research should include the development of a robust implementation strategy to ensure adoption is sustained. Funding This project was funded by the NIHR Health Technology Assessment programme (project number 15/28/02) Trial Registrations International Standard Randomised Controlled Trials Number Trial ID: ISRCTN27426982 International prospective register of systematic reviews (PROSPERO) Registration: CRD4201604523

Revelación de actitudes, creencias y comportamientos en la recuperación del consumo problemático de alcohol: una muestra de EE. UU.

Social support has been found to positively assist in recovery from problematic alcohol use. is project examined the relationship between disclosure of alcohol recovery status to social connections, and longest period of alcohol abstinence. This cross-sectional study had (N=154) adult participants from the US who were in recovery from problematic alcohol use. Beyond demographic data, participants reported on a variety of things including medical, psychiatric and recovery history. Longest period of alcohol abstinence was associated with participant’s level of openness to disclosure, belief in the efficacy of disclosing, number of social connections disclosed to and categories of people one disclosed to. e most common social connections disclosed to were close friends, support groups, and healthcare providers. Disclosing to one’s parents, grandparents and children corresponded to the longest periods of alcohol abstinence. Our findings suggest that disclosing recovery status to social connections may support longer periods of alcohol abstinenceSe ha comprobado que el apoyo social contribuye positivamente a la recuperación del consumo problemático de alcohol. Este proyecto examinó la relación entre la divulgación del estado de recuperación del alcohol a las conexiones sociales y el período más largo de abstinencia de alcohol. Este estudio transversal tuvo (N=154) participantes adultos de los Estados Unidos que se estaban recuperando del consumo problemático de alcohol. Más allá de los datos sociodemográficos, los participantes informaron sobre una variedad de cosas, incluyendo historia médica, psiquiátrica y de recuperación. El período más largo de abstinencia de alcohol se asoció con el nivel de apertura de los participantes a la divulgación, el número de conexiones sociales reveladas y las categorías de personas a las que se reveló. Las conexiones sociales más comunes reveladas fueron amigos cercanos, grupos de apoyo y proveedores de atención médica. Revelar a los padres, abuelos e hijos correspondía a los períodos más largos de abstinencia al alcohol. Nuestros hallazgos sugieren que revelar el estado de recuperación a las conexiones sociales puede apoyar períodos más largos de abstinencia al alcoho