Research News Roundup: May 8, 2025

Source: Agency for Healthcare Research and Quality (US); 2025 Apr. Report No.: 25-EHC002. Bookshelf ID: NBK613891

Authors: Gerald Gartlehner, Sheila V. Patel, Laura Hart, Wendi Rotunda, Shannon Kugley, Manny Schwimmer, … Meera Viswanathan

Abstract:

Objectives: To assess the impact of implementation strategies for mental health and substance use screening and counseling for children and adolescents in primary care as recommended by the United States Preventive Services Task Force and Bright Futures Periodicity Schedule.

Data sources: PubMed®, PsycInfo®, Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature®, as well as gray literature sources, reference lists, and technical experts.

Review methods: We followed the Agency for Healthcare Research and Quality Methods Guide for Effectiveness and Comparative Effectiveness Reviews, adapting it with classifications from the Expert Recommendations for Implementing Change (ERIC) and the Effective Practice and Organisation of Care (EPOC) taxonomies. We searched for studies published from January 1, 2010, through July 26, 2024, and selected studies that compared strategies for implementing mental health and substance use screening and counseling interventions for children and adolescents in primary care with another implementation strategy or no strategy. We evaluated randomized and nonrandomized controlled trials and interrupted time series studies. Studies conducted outside the United States were evaluated separately.

Results: We included 11 studies from the United States and 2 from other countries. Studies focused on screening and counseling for depression and suicide risk, eating disorders, substance use disorders, and general behavioral health risk factors. Implementation approaches were multifaceted and consisted of learning collaboratives, providing support to clinicians, adding new team members to incorporate behavioral health into primary care, and using technology. Overall, our confidence in the available evidence was limited, with numerous outcomes receiving a very low strength of evidence rating. When compared to clinical interventions where only minimal or no strategies were employed, the use of implementation strategies consistently resulted in higher screening rates and increased initiation of treatments. Few studies assessed patient outcomes, and clinician support neither reduced risk behaviors nor increased referrals for specialty substance use treatment. Different types of implementation approaches appeared to have comparable effectiveness. The evidence on the impact of implementation strategies on inequities in the delivery of recommended interventions for populations at risk for disparities was limited to a single study focused on clinician support for screening for depression and suicide risk, and yielded very low strength of evidence. We did not identify any studies on implementation of screening for anxiety or maternal depression among teenage mothers. Furthermore, none of the included studies assessed the acceptability or feasibility of the implementation approaches utilized, nor were patients’ quality of life or adverse events assessed.

Conclusions: The identified implementation approaches may increase screening and brief interventions. The evidence, however, is uncertain. Different types of implementation strategies appear to have comparable effectiveness.

To read the full text of the article, please visit the publisher’s website.

Journal: Drug and Alcohol Dependence, 2025, doi: 10.1016/j.drugalcdep. 2025.112674

Authors: Mohammad Ghasoub, Chloe Scholten, Meaghan Perdue, Madison Long, Curtis Ostertag, Preeti Kar, … Catherine Lebel

Abstract:

Background: Prenatal alcohol exposure (PAE) occurs in ~10 % of pregnancies and can cause behavioral and neurological deficits, including alterations to white matter pathways involved in language processing. Language and communication skills are generally left-lateralized in the brain, and this asymmetry is associated with better performance in typically developing individuals, while alterations to this association are found in children with language challenges. However, the degree of asymmetry and its relationship with language skills remain poorly understood in children with PAE.

Methods: 200 datasets collected from 98 children (46 with PAE) aged 4-8 years were included here. Language skills were assessed using the Children’s Communication Checklist, 2nd edition (CCC-2) parent report. Diffusion MRI was used to examine white matter microstructure and asymmetry in five major language white matter pathways. Measures of white matter microstructure were extracted (fractional anisotropy and mean diffusivity), and a laterality index was calculated. Linear mixed models were used to test associations between language scores and white matter laterality, and whether PAE moderates this relationship.

Results: Children with PAE had lower language scores than controls across all CCC-2 indices. Both groups had similar patterns of white matter asymmetry; however, leftward white matter lateralization was associated with worse language scores in children with PAE, but better language scores in unexposed children.

Conclusion: Our findings show alterations to the white matter asymmetry-language relationship in children with PAE. This may indicate an altered language processing mechanism that could underlie language deficits observed in many individuals with PAE.

To read the full text of the article, please visit the publisher’s website.

Journal: JAMA Network Open, 2025, doi:10.1001/jamanetworkopen. 2025.6069

Authors: Valerie S. Ganetsky, Noa Krawczyk, & Alene Kennedy-Hendricks

Abstract:

Importance: Treatment retention for pregnant individuals with opioid use disorder (OUD) is critical, especially during the high-potency synthetic opioid (HPSO) era. Current data on the relationship between medication for opioid use disorder (MOUD) receipt in specialty substance use treatment facilities and retention are needed for this population.

Objective: To examine the association between MOUD inclusion in treatment and 6-month treatment retention among pregnant individuals with OUD in publicly funded specialty treatment facilities during the HPSO era.

Design, Setting, and Participants: This cross-sectional study pooled data from January 1, 2015, to December 31, 2021, from the Treatment Episode Data Set-Discharges, a national dataset managed by the Substance Abuse and Mental Health Services Administration that tracks annual discharges from state-licensed, publicly funded substance use treatment facilities. Individuals who were pregnant at the time of admission, reported an opioid (heroin, nonprescription methadone, or other opiates and synthetics) as their primary substance, and were discharged from ambulatory, nonintensive outpatient facilities were included. Data were analyzed November 2023 to April 2024.

Exposure: MOUD inclusion in a treatment episode.

Main Outcomes and Measures: The main outcome was treatment retention (length of stay >6 months vs ≤6 months). To account for the nonrandom assignment to MOUD, inverse probability of treatment–weighted logistic regression models were estimated adjusting for sociodemographics; substance use, mental health, and treatment history; treatment admission–related variables; census division; state policy characteristics; and year fixed effects.

Results: Of 29 981 treatment episodes, most involved individuals aged 25 to 34 years (19 106 [63.7%]). Approximately two-thirds of 29 071 episodes in the final analysis (19 884 [68.4%]) included MOUD across all study years. From 2015 to 2021, MOUD inclusion in treatment episodes increased by 9.1 percentage points, from 65.0% to 74.1%. Treatment episodes with MOUD were associated with greater odds of 6-month treatment retention compared with those without MOUD (adjusted odds ratio, 1.86 [95% CI, 1.72-2.01]). This finding translated to an estimated 14.2 percentage point greater adjusted probability of 6-month retention among treatment episodes with MOUD (43.1%) vs those without it (28.9%).

Conclusions and Relevance: In this cross-sectional study of treatment episodes from ambulatory, nonintensive facilities, MOUD inclusion among pregnant individuals was associated with significant improvements in treatment retention. However, retention remained low during the HPSO era. These findings underscore the importance of MOUD in improving OUD-related outcomes in this high-risk population.

To read the full text of the article, please visit the publisher’s website.

Journal: Tobacco Use Insights, 2025, doi: 10.1177/1179173X251336468

Author: Allison A Temourian, Anna V. Song, & Anna E. Epperson

Abstract:

Background: Existent research examining perceptions of nicotine addiction use largely surface level items that fail to address the complexity of nicotine addiction. Additional investigation is needed to better understand people’s perceptions of nicotine addiction and whether these align with measures of nicotine dependence. Understanding these perceptions about nicotine addiction may help provide insight into vaping intentions and behavior. This study examines the validity of the Nicotine Addiction Perceptions (NAP) scale, a novel measure designed to assess perceptions of addictive vaping behavior that aligns with the clinical dimensions of tobacco use disorder.

Methods: Data were collected from U.S. adults via Prolific (n = 549). As part of scale development and validation a confirmatory factor analysis and psychometric evaluation was conducted. The NAP’s reliability, convergent, discriminant, and criterion validity were established.

Results: A five-factor solution returned acceptable fit on all model indices (RMSEA = 0.050; CFI = 0.994; TLI = 0.993). The NAP was significantly related to assessments of perceived risk, 6 month quit intentions, the number of quit intentions over the past year, and past 30-day e-cigarette use (P’s < .05). Findings also indicate support for discriminant validity.

Conclusions: Findings suggest that for most, perceptions of nicotine addiction may not fully align with the clinical criteria of addiction, which may be due to the lack of education surrounding the clinical definition. Future research examining perceptions of nicotine addiction can utilize the NAP scale to better understand people’s understanding of addiction and its relationship to vaping-related behavior.

To read the full text of the article, please visit the publisher’s website.