Wearable Activity Tracker Use and Physical Activity Among Informal Caregivers in the United States: Quantitative Study

Background: With an increase in aging population and chronic medical conditions in the United States, the role of informal caregivers has become paramount as they engage in the care of their loved ones. Mounting evidence suggests that such responsibilities place substantial burden on informal caregivers and can negatively impact their health. New wearable health and activity trackers (wearables) are increasingly being used to facilitate and monitor healthy behaviors and to improve health outcomes. Although prior studies have examined the efficacy of wearables in improving health and well-being in the general population, little is known about their benefits among informal caregivers. Objective: This study aimed to examine the association between use of wearables and levels of physical activity (PA) among informal caregivers in the United States. Methods: We used data from the National Cancer Institute’s Health Information National Trends Survey 5 (cycle 3, 2019 and cycle 4, 2020) for a nationally representative sample of 1273 community-dwelling informal caregivers—aged ≥18 years, 60% (757/1273) female, 75.7% (990/1273) had some college or more in education, and 67.3% (885/1273) had ≥1 chronic medical condition—in the United States. Using jackknife replicate weights, a multivariable logistic regression was fit to assess an independent association between the use of wearables and a binary outcome: meeting or not meeting the current World Health Organization’s recommendation of PA for adults (≥150 minutes of at least moderate-intensity PA per week). Results: More than one-third (466/1273, 37.8%) of the informal caregivers met the recommendations for adult PA. However, those who reported using wearables (390/1273, 31.7%) had slightly higher odds of meeting PA recommendations (adjusted odds ratios 1.1, 95% CI 1.04-1.77; P=.04) compared with those who did not use wearables. Conclusions: The results demonstrated a positive association between the use of wearables and levels of PA among informal caregivers in the United States. Therefore, efforts to incorporate wearable technology into the development of health-promoting programs or interventions for informal caregivers could potentially improve their health and well-being. However, any such effort should address the disparities in access to innovative digital technologies, including wearables, to promote health equity. Future longitudinal studies are required to further support the current findings of this study

Motivations for Treatment Engagement in a Residential Substance Use Disorder Treatment Program: A Qualitative Study

Aims: The aim of this study was to explore perspectives on motivations for treatment engagement from substance use disorder (SUD) clients in a long-term residential rehabilitation program. Design and Methods: A convenience sample of 30 clients who were enrolled in a year-long SUD treatment program at a residential rehabilitation facility took part in in-depth interviews. Interview transcripts were analyzed using the directed content analysis approach. Results: Participant accounts indicated that their treatment engagement was motivated by factors that aligned with the six primary constructs of the Health Belief Model: (i) perceived susceptibility (eg, believing that their substance use required intervention and that they were prone to relapse), (ii) perceived severity (eg, substance use negatively impacted their health and harmed their close relationships), (iii) perceived benefits (eg, opportunities for a better life, reconnecting with family members and close friends, & avoiding legal consequences), (iv) perceived barriers (eg, the length of the treatment program), (v) cues to actions (eg, decisive moments, elements of the treatment program, & faith and spirituality), and (vi) self-efficacy in remaining abstinent (eg, treatment program provided them with skills and experiences to maintain long-term sobriety). Discussion: Our analysis indicates that participants’ treatment engagement was linked to their beliefs regarding the severity of their substance use disorder, their treatment program’s ability to help them avoid future relapse, and their own capability to act upon the strategies and resources provided by the treatment program. A theoretical understanding of these aspects can contribute to the future planning of precision interventions

“Waterpipe Is Like a Wife”: Qualitative Assessment of Perspectives on Waterpipe Smoking Dependence

Background: Waterpipe (WP) smoking has become a global public health problem in recent decades and growing evidence indicates that it can cause nicotine dependence. Most evidence on WP dependence to date has been derived from survey- or laboratory based studies. This study employed qualitative methods to explore WP users’ perceptions of dependence in Aleppo, Syria.Methods: A total of 15 focus groups were conducted with 64 adult WP smokers (51 males and 13 females) using a semi-structured interview. All focus group discussions were audiotaped, transcribed, and coded using directed content analysis. Findings: Several WP dependence features were consistent with those commonly reported by cigarette smokers. These included positively reinforced features, such as smoking’s association with social gatherings and cultural connectedness, and negatively reinforced features including relief of withdrawal symptoms, stress, and boredom. Although interest in quitting was low, many users perceived quitting WP to be difficult and an indicator of loss of control over smoking, a common marker of dependence. Several observed dependence features were specific to WP, including transitioning from social smoking to smoking alone, and adapting one’s behavior to the considerable effort normally required to engage in WP smoking despite inconvenience or cost, and often atthe expense of other reinforcers such as social interaction.Conclusion: The general and specific features of WP dependence need to be considered in developing instruments to measure WP dependence, in clinical assessment of WP dependence, and in developing cessation programs

Mono- versus polydrug abuse patterns among publicly funded clients

To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category–other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse

Recent Changes and Trends in the Practice of Applied Anthropology

The emergent global economy of the 21st century will create an ever greater need for research-based information and pragmatic utilization of social science skills, creating new work opportunities for applied anthropologists in a variety of settings. However, anthropologists may need to adjust their traditional roles and tasks, approaches and methods, and priorities and guidelines to practice their craft effectively. Anthropological training and education must be based in sound ethnographic techniques, using contemporary tools, participatory methods, and interdisciplinary knowledge in order to accommodate faster-paced work environments and to disseminate their findings efficiently to a diverse audience while fulfilling the goal of empowering and enabling humans around the world to address social, economic, and health issues, along with other pressing concerns facing their communities. © 2008 American Anthropological Association

Changing food production strategies among Garhwali resettlers in the Himalayas

This article discusses the changing systems of food production among Garhwali resettlers who were forcibly displaced due to the construction of the Tehri Dam in North India. Resettling to a drastically new environment affected their traditional food production strategies and rendered them vulnerable to the vagaries of transition, including the forced adaptation to new cash crop-based farming systems, restricted hunting and fishing areas, and limited access to dairy products. These changes led to an inadequate supply of food and nutrients, especially protein, for these resettlers. Using ethnographic methods, this study illustrates that resettling an agrarian community to a new ecological area significantly changes their food production practices in ways that leave them vulnerable to the potential risk of an impoverished diet. Copyright © 2004 Taylor & Francis

Predictors of substance abuse treatment outcomes in Tennessee

In planning and implementing programs to treat substance abuse, it is important to understand which factors influence post-treatment abstinente. This article identifies and analyzes several variables important in predicting the likelihood of abstinence among substance abuse clients. The data used in this study was collected from 1,350 clients treated for alcohol of drug abuse in residential, halfway house, or outpatient facilities in Tennessee. We analyzed 22 variables as possible treatment outcome predictors by using two statistical procedures: stepwise logistic regression analysis and Quick, Unbiased, Efficient, Statistical Tree (QUEST) analysis, a tree-structured classification algorithm analysis. We found one pre-treatment, five in-treatment, and three post-treatment variables to be significant predictors of treatment outcome: previous treatment history, perceived helpfulness of the treatment, simultaneous treatment for mental health, number of days in treatment, completion of treatment, special skills training during treatment, obtaining healthcare services for major physical health problem after treatment, living with someone using alcohol or drugs post treatment, and arrest record since treatment

Gender effects on client-spousal collateral agreement levels in substance abuse posttreatment reports

This study examines gender effects on client-spousal collateral agreement in substance abuse posttreatment reports and assesses the dependability of spousal collaterals in corroborating these reports. Study participants included 178 male clients with female spousal collaterals (male client dyads) and 58 female clients with male spousal collaterals (female client dyads) who completed follow-up interviews 6 months post admission. Interviews were conducted from July 2002 to June 2004. Levels of agreement were examined by dyad type for responses to 13 questions regarding clients\u27 treatment experiences and treatment effectiveness. A simple kappa coefficient was calculated to measure the degree of nonchance agreement between clients and their spouses using SAS/Base, SAS/Stat, and SAS/IML. Agreement levels between the two dyads were compared and examined whether gender differences in agreement levels were significant. Agreement levels were found to be high, ranging from 80.4 to 97.1% for male client dyads and from 76.5 to 100% for female client dyads. Six of the 13 questions for male client dyads and 8 of the 13 questions for female client dyads revealed excellent or substantial nonchance agreement. Questions related to domestic violence had poor nonchance agreement, with Victim of domestic violence since treatment having the lowest score for the male client dyad. Only one question, Currently on probation or parole, showed a significant difference across genders, as males revealed a significantly higher level of agreement. Moderate to substantial agreement was determined for 11 out of the 13 questions regardless of gender effects. This study provides empirical data affirming the high dependability of spousal collaterals to validate responses about clients\u27 substance abuse following treatment. However, the study revealed a high degree of disagreement among both male client dyads and female client dyads regarding questions related to domestic violence (including whether the client had committed or been a victim of domestic violence). Following rigorous gender analyses, this study reveals little difference overall in agreement levels between gender dyads