The Family Check-Up Online: A Telehealth Model for Delivery of Parenting Skills to High-Risk Families with Opioid Use Histories

Journal: Frontiers in Psychology, 2021, doi:10.3389/fpsyg.2021.695967

Authors: Elizabeth A. Stormshak, Jordan M. Matulis, Whitney Nash & Yijun Cheng

Abstract: Growing opioid misuse in the United States has resulted in more children living with an adult with an opioid use history. Although an abundance of research has demonstrated a link between opioid misuse and negative parenting behaviors, few intervention efforts have been made to target this underserved population. The Family Check-Up (FCU) has been tested in more than 25 years of research, across multiple settings, and is an evidence-based program for reducing risk behavior, enhancing parenting skills, and preventing the onset of substance use. It is designed to motivate parents to engage in positive parenting practices and to change problematic parenting and has been tested across a variety of ages including early childhood and adolescence. It is highlighted in NIDA’s Principles of Substance Use Prevention for Early Childhood: A research-based guide as one of only three effective selective prevention programs for substance abuse among families with young children. Recently, we developed an online version of the FCU that has now been adapted for early childhood and families with opioid use histories. The online platform and telehealth model allow for wide-scale dissemination, ease of training with community providers, and increased public health reach for families in remote, rural areas. This is particularly important when targeting families with opioid misuse and addiction because there are high rates of addiction in remote areas, yet few services available. In this article, we describe the FCU Online and review new content in the model that targets a population of young adult parents with substance abuse histories, including opioid use. New modules include content focused on harm reduction for this high-risk population of parents, such as safety in the home, substance use while parenting, and managing conflict with partners and friends.

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Do Policies to Increase Access to Treatment for Opioid Use Disorder Work?

Journal: NBR Working Papers, 2021, doi: 10.3386/w29001

Authors: Eric Barrette, Leemore Dafny & Karen Shen

Abstract: Even among commercially-insured individuals, opioid use disorder (OUD) is undertreated in the U.S.: nearly half receive no treatment within 6 months of a new diagnosis. Using a difference-in-differences specification exploiting the extension of insurance parity requirements for substance disorder treatment to small group enrollees in 2014, we find that parity increases utilization of residential treatment but decreases utilization of agonist medications, the standard of care. We find direct interventions to increase access to medication may be more promising: increases in the county-level share of physicians able to prescribe agonists are associated with substitution toward medication-assisted treatment.

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Adolescent Use of and Susceptibility to Heated Tobacco Products

Journal: Pediatrics, 2021, doi: 10.1542/peds.2020-049597

Authors: Shuwen Li, Katherine Braden, Yue-Lin Zhuang & Shu-Hong Zhu

Abstract:
Background and Objectives: A leading brand of heated tobacco products (HTPs), IQOS, was authorized to be sold in the United States in 2019. Researchers have examined the awareness and use of HTPs among US adults. In this study, we examined high school students’ awareness, use, and susceptibility pertaining to HTPs.

Methods: A large, cross-sectional population survey of randomly sampled 10th- and 12th-graders in California (N = 150 516) was conducted online during school hours from September 2019 to March 2020.

Results: Overall, 8.9% (95% confidence interval [CI], 8.7%–9.1%) of California high school students had heard of HTPs. Approximately 0.67% (95% CI, 0.61%–0.73%) had ever tried HTPs, and 0.20% (95% CI, 0.17%–0.23%) were current users (ie, ∼30% of ever users continued to use HTPs at the time of survey). Among those who never tried HTPs, 18.3% (95% CI, 17.9%–18.8%) were susceptible to future use. The susceptibility to HTP use was greater among users of cigarettes or e-cigarettes than among nonusers.

Conclusions: The awareness of HTPs among adolescents was remarkable given the low availability of products at the time of survey. Only a small percentage of adolescents experimented with HTPs. However, almost a third of those who had experimented with HTPs continued to use them. This high ratio and the fact that almost 1 out of 5 never users were susceptible to future HTP use should put the public health community on high alert as more HTP products are coming into the market, with promotion of these products likely to increase.

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Neighborhood Disadvantage and the Sales of Unhealthy Products: Alcohol, Tobacco and Unhealthy Snack Food

Journal: BMC Public Health, 2021, doi: 0.1186/s12889-021-11442-z

Authors: Lauren A. Wallace, Rajib Paul, Shafie Gholizadeh, Wlodek Zadrozny, Caitlan Webster, Melanie Mayfield & Elizabeth F. Racine

Abstract:
Background: Individuals may use unhealthy coping mechanisms such as alcohol, tobacco, and unhealthy snack consumption. The purpose of this study was to assess how neighborhood disadvantage is associated with sales of alcohol, tobacco, and unhealthy snacks at stores of a discount variety store chain.

Methods: Alcohol, tobacco, and unhealthy snack sales were measured monthly for 20 months, 2017–2018, in 16 discount variety stores in the United States. Mixed effects linear regressions adjusted for population size, with store-specific random effects, to examine the relationship of weekly unit sales with three outcome variables and neighborhood disadvantage, measured using the Area Deprivation Index (ADI).

Results: The discount variety stores were located in neighborhoods where the median ADI percentile was 87 [interquartile range 83,89], compared to the median ADI percentile of 50 for all US communities, indicating that the stores were located in substantially disadvantaged neighborhoods. For every 1% increase in ADI, weekly unit sales of unhealthy snack food increased by 43 [95% confidence interval, CI 28–57], and weekly unit sales of tobacco products increased by 11.5 [95% CI 5–18] per store. No significant relationship between neighborhood disadvantage and the weekly unit sales of alcohol products was identified.

Conclusions: The positive relationship between neighborhood disadvantage and the sale of tobacco and snack foods may help explain the pathway between neighborhood disadvantage and poor health outcomes. It would be useful for future research to examine how neighborhood disadvantage influences resident health-related behaviors.

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Assessing How a Tobacco-free Campus Leads to Attitude Change and Support among Students, Faculty, and Staff

Journal: Tobacco Prevention & Cessation, 2021, doi: 10.18332/tpc/138224

Authors: Trevin E. Glasgow, Carrie A. Miller, D. Jeremy Barsell, Elizabeth K. Do & Bernard F. Fuemmeler

Abstract:
Introduction: Universities are increasingly considering tobacco-free campus policies to help promote a healthy learning and working environment. We assessed attitudes of students, faculty, and staff, before and after the implementation of a tobacco-free campus policy at a large, urban university. We also examined individual factors associated with these attitudes.

Methods: An independent panel design method was used to assess students, faculty and staff about their tobacco product use, attitudes towards tobacco policies, and support for cigarette and e-cigarette bans 3 months before and 7 months after a university-wide policy change to ban tobacco and e-cigarettes on campus. Survey participants before the policy change included 636 students and 1356 faculty/ staff. Survey participants after the policy change included 1000 students and 574 faculty/staff. We conducted separate multiple linear and logistic regression models for students and faculty/staff.

Results: Attitudes towards tobacco-free campus policies did not improve for students, but did for faculty/staff. Support for bans of cigarettes and e-cigarettes on campus increased following the policy change among both students and faculty/staff. Students were more willing to ask their friends to stop vaping post-policy, but did not differ in their willingness to ask friends to stop smoking. Among the individual factors considered, gender and use of cigarettes and e-cigarettes were predictive of attitudes among both students and faculty/staff. Women were more likely to support and have more positive attitudes towards bans, while current tobacco product users were less likely to support tobacco product bans and have less positive attitudes towards tobacco policies.

Conclusions: Attitudes towards tobacco-free campus policies changed pre- to post- policy among faculty/staff, but not among students. However, both students and faculty/staff were more supportive of tobacco product bans following the policy change. Individual factors associated with support and attitudes were identified.

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