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Freiin, Von Hammerstein-Equord Cora Fee. "Mindfulness et addictions : évaluation du programme MBRP (Mindfulness-Based Relapse Prevention) chez des patients présentant une addiction avec ou sans substance." Thesis, Paris 10, 2018. http://www.theses.fr/2018PA100131.
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L’objectif de ce travail de thèse était d’évaluer la faisabilité, l’acceptabilité et de fournir des résultats préliminaires du programme MBRP (Mindfulness Based relapse prevention) pour le traitement des addictions. Dans un premier lieu ce travail nous a permis de démontrer que ce programme représentait un type de prise en charge thérapeutique acceptable et faisable pour le traitement du trouble de l’usage de l’alcool. La participation au programme augmentait le niveau de pleine conscience et de flexibilité psychologique et réduisait le craving. Ensuite, nous avons pu identifier que la pratique à domicile, occupant une place centrale dans les traitements basés sur la pleine conscience, était facilitée par la motivation initiale des participants et de leur sentiment d’auto-efficacité quant à la capacité de mettre en place une pratique, à l’inverse, l’impression de « mal faire » ou l’absence d’effets immédiats de la pratique présentait un frein à la pratique autonome. Nous avons également pu rendre compte de l’intérêt de ce programme pour le traitement du trouble lié à la pratique de jeu d’argent et de hasard. A travers nos résultats descriptifs, nous avons pu montrer que la méditation de pleine conscience était un outil dont la majorité des patients joueurs se saisissaient volontiers pour gérer les envies de jeu et l’impulsivité. Nous avons trouvé que la participation au programme a permis de réduire la pratique de jeu, les symptômes de jeu, le craving, ainsi que les symptômes dépressifs et anxieux et augmenter le niveau de pleine conscience. Par ailleurs nous avons pu montrer à travers un cas clinique, que l’association de la pratique de pleine conscience et de training cognitif, pouvait représenter une prise en charge complémentaire et augmenter le contrôle de soi, chez une patiente résistante aux TCC classiques. Nous avons également montré que l’initiation à la pleine conscience chez des soignants travaillant dans le domaine de l’addictologie a été très bien accueillie, qu’en moyenne ils ont participés à 4 séances sur 5 et qu’ils ont tous mis en place une pratique autonome après l’initiation en groupe. Pour finir nous avons validé le Transdiagnostic Craving Trigger Questionnaire (TCTQ) visant à évaluer les déclencheurs de craving, dans une population présentant un trouble de l’usage de l’alcool. Nos analyses ont montré une solution à trois facteurs, les émotions désagréables, les émotions agréables et les déclencheurs externes et pensées associées aux consommations. Finalement ce travail de thèse nous a permis de conclure que le programme MBRP est un programme qui a tout son intérêt pour le traitement des addictions avec ou sans substances. Nous avons pu montrer qu’il agissait sur des processus sous-jacents de cette pathologie tels que les affectes dépressifs et l’anxiété, qu’il permettait de réduire le craving et qu’il mobilisait des ressources telles que la flexibilité psychologique. Nous avons l’objectif de conduire des travaux supplémentaires afin de pouvoir statuer sur son efficacité en comparaison à une condition contrôleThe purpose of this work was to investigate feasibility, acceptability and preliminary outcomes of the MBRP (Mindfulness Based relapse prevention) program as a treatment of addictions. First, this work allowed us to establish that this program represented an acceptable and feasible therapeutic approach as a treatment for alcohol use disorders and that it increased the level of mindfulness and psychological flexibility and reduced craving. Secondly, we were able to identify that home practice, which is central to mindfulness-based treatments, was facilitated by the participants' initial motivation and their feeling of self-efficacy in terms of their ability to set up a practice, while the impression of "doing wrong" or the absence of immediate effects of the practice was a barrier to it. We have also been able to highlight the interest of this program as a treatment for gambling disorder. Through our descriptive results, we showed that mindfulness meditation was a tool that most gamblers readily used to manage craving and impulsive behavior. In addition, we found that participating in the program reduced gambling, gambling symptoms, craving, as well as depression and anxiety and increased mindfulness levels. In addition, we were able to show by examining a case report that the combination of the MBRP program and cognitive training could increase self-control in a patient who was resistant to conventional CBTs. We have also shown that the initiation to mindfulness among caregivers working in an addiction facility has been very well received. On average they participated in 4 out of 5 sessions and, all set up a personal home practice after the group initiation. Finally, we validated the Transdiagnostic Craving Trigger Questionnaire (TCTQ) to assess craving triggers in a population with an alcohol use disorder. Our analyses showed a three-factor solution, composed of unpleasant emotions, pleasant emotions and external triggers and associated thoughts. This thesis work allowed us to conclude that the MBRP program has a strong interest in the treatment of addictive disorders, with or without substances. We were able to show that it worked on underlying processes of this disorder, such as depression and anxiety, that it reduced craving and that it was a way of mobilizing resources, such as psychological flexibility. Our objective is to carry out further research which would allow us to state on its efficacy as compared to a control condition
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Sierra-Scroccaro, Nathalie. "Adolescence et addictions : quelles interventions envisager pour les parents de jeunes consommateurs ?" Thesis, Rennes 2, 2015. http://www.theses.fr/2015REN20005.
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Les addictions constituent un problème majeur de santé publique et soulèvent de nombreuses questions sur le plan clinique et psycho-pathologique ainsi que sur leur prise en charge. Toutefois, si elles sont d’un intérêt certain dans le domaine de la recherche scientifique, ce n’est que récemment que la souffrance des proches, et plus encore celle des parents de jeunes adolescents, sont l’objet de travaux pour les chercheurs comme pour les professionnels.L’objectif de cette recherche qualitative et exploratoire est d’étudier les vécus des parents d’adolescents ayant des pratiques addictives. Elle est réalisée au sein d’un dispositif de prévention en addictologie.Ce sont en majorité des mères qui consultent pour leurs fils. Généralement, ces adolescents ou jeunes adultes sont âgés entre 15 et 23 ans, aux prises avec un problème de consommation de cannabis, d’alcool, de jeux vidéo et vivent chez leurs parents.Six formes de vécus parentaux et certaines configurations familiales en lien avec les conduites addictives des adolescents ont pu être identifiées à l’aide de quinze vignettes cliniques.Les addictions des jeunes interpellent la fonction maternelle, en tant que médiatrice de la fonction paternelle. De même, le sujet adolescent convoquerait chez la mère, un objet répondant à la question du réel d’une autre jouissance, en tant qu’une suppléance à l’absence de signifiant.Ces résultats permettent d’interroger les possibilités d’interventions en clinique auprès de ces familles d’une part, et de réfléchir à un nouveau dispositif d’accompagnement médico-psycho-social d’autre partAddiction constitutes a major public health problem and raises numerous questions from a clinical and psychopathological perspective as well as on young users’ care. Even though certain interest has been shown in the field of scientific research on the subject, only recently has the suffering of the parents of young teenagers been the object of researchers’ and professionals’ studies.The objective of this qualitative and exploratory study is to examine the personal experiences of the parents of teenagers suffering from addiction. It was carried out at a prevention and treatment center for addiction.Mothers who consult for their sons make up the majority of those who consult. Generally, these teenagers or grown-up young adults are between the ages of 15 and 23, live at home with their parents, and battle against excessive use of cannabis, alcohol, and video games.Six forms of parental personal experiences and certain family configurations in connection with the addictive behaviors of the teenagers were identified by means of fifteen clinical cases.The addictions of the young people in question call out to the maternal function as a mediator of the paternal function.Additionally, the adolescent subject summons within his/her mother an object in response to the question of the real of the Other jouissance, as a substitution in the absence of the signifier.These results allow us to question the possibilities of clinical interventions with these families, and to think about new tools of medical-psychosocial support
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Phillips, Kristina T. "Applying the Relapse Model to Harm Reduction: The Development and Evaluation of the Harm Reduction Self-Efficacy Questionnaire." Connect to this title online, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=bgsu1131342662.
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Orobon, Frédéric. "Santé publique et libertés individuelles. L’exemple des conduites par lesquelles on peut se nuire à soi-même." Thesis, Lyon 3, 2012. http://www.theses.fr/2012LYO30009/document.
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Selon l’expertise épidémiologique, le tabagisme, la consommation excessive d’alcool, le manque d’exercice physique et une alimentation mal équilibrée expliqueraient 40% des décès avant 65 ans dans les pays les plus riches. Cet argument chiffré fait comprendre que la prévention, qui vise la réforme des conduites individuelles, est appelée à prendre une place croissante dans les politiques de santé publique, car, pour réduire cette mortalité dite précoce, qui est aussi socialement déterminée, l’augmentation des dépenses médicales de santé n’aura sans doute qu’un impact marginal. Nous voulons montrer à travers ce travail que la prévention, tournée vers les conduites individuelles, est digne d’un intérêt philosophique, car, à leur manière, les messages de prévention parlent du « bien », ou, d’ « un bien », mais aussi de maux qui seraient évitables par des « conduites vertueuses ». Toutefois, une des particularités de ce discours, peut-être piloté par un désir de contrôle social des conduites, est de postuler soit un individu introuvable, dont les désirs seraient sans opacité ni contradiction et dont l’action se déduirait toujours de la connaissance, soit un individu que la peur de la maladie et de la mort rendrait enfin « raisonnable ». En quoi les conduites dites à risques pour leurs auteurs sont-elles motivées par la recherche du plaisir ? Relèvent-elles nécessairement de l’ignorance ou de l’aveuglement ? Prévenir les maux évitables par une réforme des conduites individuelles autorise-t-il à faire de la santé une fin en soi ? Nous tenterons de répondre à ces questions en esquissant une éthique de la prévention conciliant santé publique et libertés individuellesAccording to epidemiological reports, smoking, excessive alcohol drinking, the lack of exercise as well as unbalanced food habits would account for fourty per cent of mortality before the age of sixty-five in the wealthiest countries. This argument based on statistics clearly shows that prevention whose purpose is to change individual lifestyles is bound to have an increasing part in public health policies. Indeed, to reduce what is called premature death, which is also socially determined, the increase of medical expenses is likely to have but little impact. Through this work, we want to show that prevention when it applies to individual lifestyles deserves philosophical interest as, in their own way, prevention messages refer to good or a kind of good. They also refer to evils that could be prevented by “virtuous behaviours”. However, one of the characteristics of this position – that might aim at a control of people’s conducts – is to postulate either the existence of an individual still to be found, whose desires would be obvious and unambiguous, whose action would always result from knowledge, or of one that the fear of illness and death would make sensible at last. To what extent are risk behaviours caused by the pursuit of pleasure? Do they necessarily stem from ignorance and blindness? Should preventing avoidable evils through a reform of individual conducts allow the authorities in charge in those issues to consider health as a goal in itself? We will try to answer these questions by outlining an ethic approach of prevention that balances public health and individual liberty
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Denti, Elisabetta. "Habitudes et addiction à internet chez les adolescents italiens : impact sur la fonction visuelle d'un protocole de dramathérapie." Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCB018.
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En 2017, il n'est plus nécessaire de se rappeler un numéro de téléphone par cœur, de patienter gentiment pour goûter les fruits et légumes de saison ou d'attendre quelqu’un à la gare avec impatience sans avoir eu de ses nouvelles : les émotions sont d'avantage liées à des moyens de communication bien plus immédiats. Le rythme naturel du temps qui passe dans nos vies semble s’apparenter pour l'homme (et pour la femme) du nouveau millénaire, davantage à une accélération effrénée et constante, une course contre le temps, dans l'illusion d'un monde instantané, hyper-rapide, super efficace : un monde « smart ». De cette manière, plutôt que d'écouter et de respecter le rythme naturel de notre respiration, de notre corps, nous choisissons à chaque instant de courir toujours plus vite, dans l'illusion omnipotente de gagner la course contre le temps, l'infaillible gardien de notre existence. Nous exprimons le désir d'être constamment connecté, créant l'illusion de l'hyper-présence. L'évolution technologique a radicalement transformé notre style de vie, notre manière de communiquer, notre propre expérience humaine et émotive. Si d'un côté la révolution technologique à laquelle nous appartenons, et dont nous continuons à en être les acteurs a permis la transformation globale des processus de communication de masse, celle-ci a en même temps permis l'émergence de nouvelles fragilités et la manifestation évidente de psychopathologies en relation à Internet. C’est à partir de la consultation de plus de 240 articles scientifiques internationaux et avec les données fournies sur la prévalence de ces nouvelles formes d’addiction en Asie (le continent technologiquement plus avancé et concerné à ce sujet), que le comité scientifique APA (American Psychiatric Association – Société Américaine de Psychiatrie) a décidé d’introduire l’Internet Gaming Disorder dans la dernière version du DSM, en Mai 2013. Le domaine de l’addiction à Internet est une frontière extrêmement emmêlée et complexe qui représente un nœud névralgique des discussions d'une partie de la communauté scientifique internationale. Voraces et habiles consommatrices des nouvelles technologies, les nouvelles générations sont particulièrement exposées au risque de développer ces nouvelles formes de dépendance. Il est nécessaire que la communauté scientifique internationale s'interroge sur de nouvelles stratégies d'intervention pour pouvoir intercepter et accueillir ces formes de malaise juvénile, qu’elle sache les définir pour les identifier et les soigner grâce à des protocoles d'intervention pour répondre de manière toujours plus efficace aux besoins réels des ces jeunes consommateurs. D'où l’intérêt de développer des projets de recherche portant sur ce sujet. Cette thèse, décrit donc un problème en émergence et la proposition d’une approche thérapeutique possible face à ces nouvelles formes d’addiction avec les arts thérapies, plus précisément avec la dramathérapie. Le cadre expérimental de cette thèse s’articule en deux parties : la première partie correspond à l’étude des répercussions physiologiques notamment sur la variation des compétences visuelles par rapport à un usage abusif ou addictif des écrans. Cette étude, qui constitue la principale expérience psychopédagogique de prévention de cette thèse, a été adressée à 250 adolescents italiens sains. La deuxième partie est une expérience clinique de prise en charge des addictions à Internet, auprès d’un public de 13 adolescents et jeunes adultes atteints du syndrome d’Asperger, addictifs aux jeux vidéo. Un dernier projet de dramathérapie adressé à des adolescents et des jeunes adultes, souffrant d’addiction aux substances constitue l’ouverture du regard clinique face aux comorbidités possibles qui caractérisent la pratique clinique de notre champ d’étude. (...)In 2017, there is no longer a need to remember a phone number by heart, wait for the right time to taste seasonal fruit or vegetables, or wait for someone at the station without having news briefly before hugging him on the train quay Emotions are more closely related to much more immediate communication flows. The natural rhythm of time flowing in our lives seems to be synonymous for the man (and the woman) of the new millennium of a frantic and constant acceleration against time, in the illusion of a flashy world, super-fast, super-efficient: a smart world. In this way, instead of listening to and respecting the natural rhythm of our breath, our body, we choose at any time to run faster and faster, in the omnipotent illusion of winning the race against time, the unreliable guardian of our existence. We express the desire to be constantly connected, creating the illusion of hyper-presence. Technological development has radically changed our lifestyle, our way of communicating, our human and emotional, individual and collective experience. On the one hand, the technological revolution has allowed the global transformation of the mass communication process and is an inexhaustible source of knowledge and discovery; not to be demonized but to be explored with intelligence and curiosity; it has at the same time led to the emergence of new vulnerabilities and manifestations of Internet-related psychopathological discomfort. It is through the consultation of over 240 international scientific articles and data on the prevalence of these new forms of dependence in Asia (the continent most technologically advanced and involved in this regard), that the American Psychiatric Association (APA) decided to introduce the Internet Gaming Disorder in its latest version of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in May 2013. The field of Internet addiction is an extremely tangled and complex border that represents a nerve node discussion in part of the international scientific community. Voracious consumers and clever users of new technologies, that is the new generations, seem to be particularly at risk of developing these dependencies. This is why it is important to develop research projects and it is urgent to propose psycho-educational prevention projects for the adolescent population. This thesis describes an emergency problem and the proposal of a possible approach facing these new addiction forms through arts therapies, more precisely through dramatherapy. The experimental part of this thesis is articulated in two parts: the first one corresponds to the study of physiological repercussion on variations of visual skills related to the use or abuse of screen use.This study, that represents the psycho pedagogical and prevention experience of this thesis, was addressed to 250 Italian sound teenagers. The second part consists of a clinical experience of cure of Internet addiction addressed to 13 video games addicted adolescents and young adults with Asperger syndrome. A further project of dramatherapy addressed to drugs addicted adolescents and young adults represents a clinical perspective in front of possible comorbidities that characterize the clinical practice in our field of study. The dramatherapy approach in the field of prevention and cure of web related addictions is considered regarding two important aspects: the recovery and reclamation of the body and sensory experience (size altered in the virtual experience facing the monitors) and the possibility to expose the person to a gaming experience through a shared transitional space. The body dimension, completely abandoned or altered in the virtual experience, is recovered and exalted through dramatherapy. The therapeutical approach is born, grows and develops in the body. In our view the stage represents the appropriate mediation between the virtual space of the abuse and real space of existence. (...)
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Hirsch, Jameson K., Edward C. Chang, and Jessica K. Rabon. "A Positive Psychological Approach to Suicide: Theory, Research, and Prevention." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/5487.
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Book Summary: This inspiring resource presents theories, findings, and interventions from Positive Suicidology, an emerging strengths-based approach to suicide prevention. Its synthesis of positive psychology and suicidology theories offers a science-based framework for promoting wellbeing to complement or, if appropriate, replace traditional deficit-driven theories and therapies used in reducing suicidal thoughts and behaviors. Coverage reviews interpersonal, intrapersonal, and societal risk factors for suicide, and identifies protective factors, such as hope and resilience, that can be enhanced in therapy. From there, chapters detail a palette of approaches and applications of Positive Suicidology, from the powerful motivating forces described in Self-Determination Theory to meaning-building physical and social activities.
Among the topics covered:
Future-oriented constructs and their role in suicidal ideation and enactment. Gratitude as a protective factor for suicidal ideation and behavior: theory and evidence. Considering race and ethnicity in the use of positive psychological approaches to suicide. The Six R’s framework as mindfulness for suicide prevention. Community-based participatory research and empowerment for suicide prevention. Applied resiliency and suicide prevention: a strengths-based, risk-reduction framework.
Psychotherapists, counselors, social workers, psychiatrists, and health psychologists, as well as educators, clergy and healthcare professionals, will find A Positive Psychological Approach to Suicide an invaluable source of contemporary evidence-based strategies for their prevention and intervention efforts with suicidal clients.
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Mediuta, Irena. "Mokyklose taikomų prevencinių priemonių prieš narkotikų plitimą efektyvumo vertinimas (Vilniaus Gerosios Vilties vidurinės mokyklos atvejis)." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2013~D_20130902_092431-07026.
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Informacijos apie narkotines medžiagas ir jų keliamą pavojų yra labai daug, tačiau iškyla klausimas, ar minėta informacija išaiškinama mokiniams, ar mokykloje atliekamos prevencijos priemonės prieš narkomanijos plitimą yra efektyvios. Taip pat labai svarbu žinoti, kaip tas pačias prevencijos priemones mokykloje vertina mokiniai, jų tėvai ir mokytojai, nes siekiant veiksmingai vykdyti narkotikų vartojimo prevenciją būtina derinti visų atsakingųjų pusių nuomonę. Atlikta daug įvairių tyrimų, tačiau mažai dėmesio skiriama tyrimams, kokios yra mokykloje taikomos prevencijos priemonės ir kaip jas vertina mokiniai, jų tėvai ir mokytojai.While conducting preventive activities, it is worth to find out not only the schoolchildren, their parents and school teachers attitudes towards the preventive measures of a preventive job opportunities and organizing activities to be taken into account. As well as the preventive work is important to involve young people themselves in this way, students will feel useful, contributing to the overall performance, which will only achieve even better results.
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Hagemeier, Nicholas E., Arsham Alamian, Matthew M. Murawski, and Robert P. Pack. "Factors Associated With Provision of Addiction Treatment Information by Community Pharmacists." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1324.
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Community pharmacists in the United States have significant opportunity to engage in community-level prescription substance abuse prevention and treatment efforts, including dissemination of information specific to available addiction treatment options. Our cross-sectional study of Tennessee community pharmacists noted that 26% had previously provided addiction treatment facility information to one or more patients in the past. The purpose of this study was to employ multivariate modeling techniques to investigate associations between community pharmacist and community pharmacy factors and past provision of addiction treatment information to pharmacy patients. Multivariate logistic regression indicated having addiction treatment facility information in a pharmacy setting (aOR=8.19; 95% CI=4.36–15.37), having high confidence in ability to discuss treatment facility options (aOR=4.16; 95% CI=2.65–6.52), having participated in prescription opioid abuse-specific continuing education (aOR=2.90; 95% CI=1.70–4.97), being male (aOR=2.23; 95% CI=1.38–3.59), and increased hours per week in the practice setting (aOR=1.02; 95% CI=1.004–1.05) were all significantly associated with provision of information about addiction treatment. Dissemination of addiction treatment information, improvements in communicative self-efficacy beliefs, and dissemination of prescription opioid abuse-specific continuing education are modifiable factors significantly associated with increased provision of addiction treatment information by community pharmacists.
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Krowka, Jessica Ann. "The Lived Experience of Recovery From Heroin Addiction." University of Akron / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=akron1555951788174113.
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Hagemeier, Nicholas E. "Prescription Drug Abuse: Past, Present and Prevention." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1426.
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Mathis, Stephanie M. "National Prevention Week: A Focus on Prescription Drug Misuse." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/3199.
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Dowling, Karilynn, Marc Fleming, Sarah Melton, and Nicholas E. Hagemeier. "Quaternary Prevention: Four States’ Approaches to Naloxone Dissemination." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1411.
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Naloxone has received increased public health attention in recent years given its effectiveness in the reversal of opioid overdoses. Despite continued increases in overdose death rates attributable to opioids, approaches to naloxone dissemination, prescribing and dispensing are quite variable across states. On the public health prevention continuum, naloxone dissemination and use could be considered quaternary prevention —actions taken to identify individuals at risk of over-medication, protect them from new medical invasion and suggest interventions which are ethically acceptable.
This presentation will describe approaches to overdose death prevention with naloxone in four states: Maine, Tennessee, Texas and Virginia. Particular emphasis will be placed on the role of community pharmacies in increasing naloxone dissemination. Attendees will be informed about recent legislative, educational and profession-specific prevention strategies and will thereafter engage in active learning to apply prevention strategies in their respective states. In addition to discussing barriers to and suggestions for increased naloxone uptake, presenters will describe assessments that can be used to evaluate overdose risk and subsequent naloxone co-prescribing/dispensing.
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Hagaman, Angela M., and Stephanie M. Mathis. "The ETSU Center for Prescription Drug Abuse Prevention and Treatment." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/3200.
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Mast, Maria R. "Understanding Risk Factors in Opioid Addiction in Franklin County, Ohio." Franklin University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=frank1616006262553234.
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Gilliam, Holly, Ivy Click, J. A. Basden, R. Carico, H. Flippin, C. Murray, and Nicholas E. Hagemeier. "Community Pharmacists’ Engagement in Neonatal Abstinence Syndrome Prevention." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1445.
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Pack, Robert P., and Nicholas Hagemeier. "Prescription Drug Abuse Prevention Efforts at ETSU." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/1355.
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Oxley, Vanessa, and n/a. "The impact of becoming or wanting to become smokefree for Maori." University of Otago. Te Tumu - School of Maori, Pacific and Indigenous Studies, 2004. http://adt.otago.ac.nz./public/adt-NZDU20070502.151701.
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Since the introduction of tobacco into New Zealand, smoking and smoking related illnesses have become more prevalent in the Maori population than New Zealand's general population. The aim of the present research was to investigate smoking from a Maori perspective. It was hoped this information would provide a better understanding of how Maori can become smokefree. The present research also investigated a number of possible benefits that could be obtained by Maori through becoming smokefree. These benefits were analysed through Mason Durie's Whare Tapa Wha model, a Maori holistic health model. Semi-structured in-depth interviews were conducted with four Maori people, two of whom were current smokers and two who were ex-smokers. Common themes emerged from these interviews including the social aspect of smoking for Maori and the influence of the enviroment on smoking behaviour. Suggestions were given to illustrate how the social aspect of smoking and the cycle that subsequently develops can be broken. Using the Whare Tapa Wha model and the personal accounts given, the benefits of breaking such a cycle were discussed. Lastly, the importance of nurturing smokefree environments, especially Maori environments, was outlined. The notion of being positive about becoming smokefree and the need to celebrate giving up smoking were highlighted throughout this research.
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M'Buka, Attlee Charles. "Methamphetamine addiction : towards a prevention strategy in a ministerial approach to substance abuse during mid-adolescence within the Lavender Hill setting." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86356.
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Thesis (MTh)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Motivated by the observation that children living in the Western Cape face challenges relating to methamphetamine (tik) abuse, this research attempts to develop and propose a strategy that can be used in preventing mid-adolescents from engaging in tik use. To develop this strategy, a contextual analysis and hermeneutical process of the life of mid- adolescents and the environment in which tik abuse is occurring was initially undertaken. Through a contextual analysis of children living in Lavender Hill and surrounding areas, it was discovered that most children were attracted to tik due to the influence of modern technology, rampant poverty, the cheap cost of the drug, dysfunctionality of families, influence of gangs and lack of recreation facilities. Acknowledging that adolescence is an important stage in the formation of the character of any individual, this research attests that adolescents who use and abuse tik are those who do not have an enabling family and societal environment. It is suggested in this research that the Church can play a pivotal role in creating a socio-spiritual environment that would enable adolescents to develop themselves in such a manner that they do not need to use tik, or any other drug for that matter. This research thus develops a prevention strategy for dealing with tik abuse during mid- adolescence. This preventive strategy centres on the Church being of service to others. Based on a literature research conducted on the Lavender Hill community of the Cape Flats, this research proposes practical recommendations that could help different Christian churches in the fight against methamphetamine use by mid-adolescents. These recommendations attempt to involve different members of the community in the spirit that John Mbiti encapsulates in the proverb ―We are therefore I am‖. In this all- inclusive endeavour, this research supposes that if a community is properly functioning, it is possible for it to weed out unwanted elements in a manner that protects all its members, particularly the young.
AFRIKAANSE OPSOMMING: Die studie fokus op die vraagstuk van Metamfetamien-verslawing onder jeuggroepe binne die konteks van die Kaapse Vlakte met ‘n besondere fokus op die Lavender Hill- area. Daar is besluit om op middel-adolessensie te fokus omdat dit die fase is waarin jongmense uiters broos is en veral vatbaar is vir buite-invloede. Dit is ook die fase waarin vaste gedragspatrone binne identiteitsvorming vasgelê word. Die oogmerk was om veral op voorkomingstrategieë binne gemeentelike verband te fokus ten einde die pastorale bediening van die problematiek bewus te maak. Omdat verslawing ingebed is binne plaaslike kultuurkontekste, is besluit om aan te sluit by ‘n sosiaal-kontekstuele analise. Metamfetamien (of tik) raak betekenisraamwerke asook die mens se soeke na erkenning en aanvaarding. Vandaar die keuse vir ‘n kwalitatiewe benadering in aansuiting by ‘n pastoraal-hermeneutiese metodologie. Die sosiaal-kontekstuele analise in die Lavender Hill-area het aangetoon dat veral die sopsiale media en tegnologie ‘n groot rol speel in die gebruik van tik onder kinders. Binne ‘n armoedekultuur en die impak van gesinsverbrokkeling op jongmense se identiteitsontwikkeling, veral binne die bruingemeenskap, word ‘n teelaarde vir dwelmisbruik geskep. Tik is bekostigbaar en die situasie word deur bendes (gangsters) uitgebuit. Daar is ook bevind dat omgewingsfaktore ‘n bydraende rol speel, veral die gebrek aan doeltreffende ontspanningsgeriewe. As gevolg van die gebrek aan voldoende sosiale en familiale ondersteuningstrukture, word persoonslikheidsontwikkeling en karaktervorming hierdeur nadelig beïnvloed. Teen hierdie agtergrond stel die studie voor dat die kerk binne gemeenteverband as ‘n soort ‘familie‘ gestruktureer moet word. Die kerk is die skakel tussen die sosiale dimensie en spirituele raamwerke. Die gemeentelike bediening moet derhalwe by identiteitsontwikkeling betrokke wees ten einde voorkomend op te tree. Kerklike voorkomingstrategieë moet gekoppel wees aan die ekklesiale modus van diakonale uitreik ondanks religieuse and kulturele grense. In dié verband moet verskillende denomenasies hande vat en ook intensief saaamwerk met plaaslike gemeenskapsleiers. Dit is hier waar die Afrika-spiritualiteit , soos onder andere deur John Mbiti geformuleer, ‘n deurslaggewende rol kan speel, naamlik: ons bestaan vir mekaar, daarom leef ek as individu en bestaan ek as mens. Hierdeur word ‘n inklusiewe benadering geprofileer wat die gemeenskap inskakel ten einde die euwel van tik doeltreffend te bestry.
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Roberts, C., A. Caliano, Nicholas E. Hagemeier, A. Salwan, Kelly N. Foster, Arsham Alamian, J. Arnold, and Robert P. Pack. "Pharmacists’ Prescription Drug Abuse Prevention Communication Behaviors: Prevalence and Correlates." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5428.
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Ohlsson, Claiborne Beth. "Traditional Story as a Tool in Substance Abuse Prevention and Treatment." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etd/1326.
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This qualitative study examined the viability of traditional stories in substance abuse treatment. The subjects for this study were young women ages 18-30 who were in substance abuse treatment in a small, rural, health department. During the 4-week study, 4 traditional stories were used in group sessions that gave the women a common reference point and a common language to frame discussions. Using story in the IOP sessions helped to create a safe, supportive environment as well as creating an opening for discussions about trauma and abuse, and other significant issues. Principles of 12 Step Recovery were woven into the discussion to help the participants deal with and reframe their experiences.
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Flippin, Heather, Joan Hagy, Raneem Mubaslat, Arsham Alamian, and Nicholas E. Hagemeier. "Factors Associated with Provision of Addiction Treatment Facility Information by Tennessee Community Pharmacists." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1399.
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Introduction: Community pharmacists in the United States routinely serve as intermediaries in the process of providing (i.e., dispensing) prescription opioids (POs) to patients for whom they are prescribed. Similar to most states, Tennessee (TN) has experienced exponential increases in PO dispensing, abuse and overdose deaths over the past decade. A multifaceted approach has been put forth by the United States National Drug Control Strategy to combat PO abuse, one aspect of which is expanding the extent to which health care professionals detect and address substance use disorders. Despite little exploration of pharmacist provided PO abuse/misuse interventions, our previous research reveals that 26% of TN community pharmacists have provided addiction treatment facility information to one or more patients in the past, and 13% of pharmacists have addiction treatment facility information in their pharmacies. The objective of this study is to investigate the associations between community pharmacist and community pharmacy characteristics and the provision of addiction treatment facility information to pharmacy patients. Methods: A survey was administered to a stratified random sample of licensed TN pharmacists in 2012 using Dillman’s Tailored Design Method. The survey instrument assessed community pharmacists’ attitudes, beliefs and behaviors specific to prescription drug abuse communication. Logistic regression techniques were used to identify correlates of provision of addiction facility information by pharmacists. Results: A response rate of 40% was obtained. Univariate logistic regression analysis indicated the provision of addiction treatment information was associated with being male, increased average number of hours worked per week, having addiction treatment information readily available in the pharmacy, higher self-efficacy beliefs regarding ability to discuss addiction treatment facility options, discuss perceived PO abuse, and discuss perceived PO addiction with patients, participation in PO abuse specific continuing education (CE), and employment in an independent pharmacy setting. Multiple logistic regression analysis indicated that being male (OR = 2.2; 95% CI = 1.4-3.6), having high task-specific self-efficacy beliefs (OR = 4.2; 95% CI = 2.7-6.5), working more hours (OR = 1.00; 95% CI = 1.02-1.05), participating in prescription drug abuse-related CE (OR = 2.9; 95% CI = 1.7-5.0), and having treatment facility information in the practice setting (OR = 8.2; 95% CI = 4.4-15.4) were statistically significant predictors of information provision. Implications: As interventions and models are developed that expand prevention and treatment efforts, factors should be considered that influence health care providers’ prescription drug abuse/misusedeterrent behaviors. Our research has the potential to inform these interventions and thereby expand the extent to which community pharmacists engage in the detection and care of patients with substance use disorders.
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Nieto, Faye Lotta. "A drug prevention education program serving East Los Angeles youth: Program outcome evaluation." CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/431.
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Hagemeier, Nicholas E. "Public Health Minute: Prescription Drug Abuse Prevention and the Community Pharmacist." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1486.
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Pack, Robert P. "Opioid Use Disorder." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1335.
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Pack, Robert P. "Lessons Learned a Decade into the Opioid Epidemic." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1338.
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Van, Scoyoc Amanda. "Pathways to Substance Abuse Treatment Success in Pregnancy." Thesis, University of Oregon, 2017. http://hdl.handle.net/1794/22616.
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This mixed-methods dissertation considers the experiences of women who used substances during pregnancy. Retrospective interviews with 15 women, currently accessing inpatient substance abuse treatment, identify trends in women’s experiences prior to accessing these services. Women report being concerned about the impact of their substance use on the developing baby, seeking information, reducing substance use outside of accessing treatment services, and engaging in healthy behaviors to protect the baby from harm. Trends related to trying to reduce harm to the baby during pregnancy are then further explored through quantitative analyses.
Data on harm reduction behaviors prior to accessing treatment were collected from an additional 54 women. A clinical and research tool for visually tracking patterns of maternal substance use over the course of pregnancy was developed. This tool identifies the high prevalence of women who decrease their substance use during pregnancy outside of accessing treatment services. Clinical use of this tool is considered.
In addition, a questionnaire, designed to identify engagement in harm reduction and health promoting behaviors, was administered. Data suggests that harm reduction and health promotion behaviors are common and tend to begin early on in pregnancy. Women report beginning to decrease their substance use, on average, beginning at the end of the first trimester. The timing of beginning to reduce substance use is not associated with the timing of entering substance abuse treatment in relation to a given pregnancy. However, maternal mental health and perceived barriers to accessing services do predict when, in relation to pregnancy, women enter treatment.
As a whole, this research suggests that continued use of substances during pregnancy is not due to indifference towards the developing baby. Instead, women report being concerned about their babies and being engaged in the process of positive self-change. There are public health and clinical implications to these findings. This research suggests the opportunity to build upon the motivation that women have to decrease their substance use. In addition, this research suggests the importance of focusing policy and intervention efforts on addressing perceived barriers to accessing treatment services.
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Cotton, Julie-Christine. "Expérimentation de l'adaptation culturelle d’un programme de prévention des dépendances pour des élèves innus du Québec." Thèse, Université de Sherbrooke, 2016. http://hdl.handle.net/11143/10135.
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Chaque année, de nombreux programmes de prévention des dépendances sont implantés dans les écoles québécoises. L'efficacité de ces programmes peut être minée par différents facteurs, dont le manque d’adaptation du programme aux caractéristiques de la population ciblée (Grover, 2010; Grover, Cram et Bowman, 2007; McKennitt, 2007) et les problèmes d'implantation (Janosz, 2010; Joly, Tourigny et Thibaudeau, 2005). Ainsi, un programme probant pourrait s'avérer peu efficace s’il est mal adapté ou mal implanté (Botvin, Baker, Dusenbury, Tortu et Botvin, 1990; Chen, 2015; Dumas, Lynch, Laughlin, Smith et Prinz, 2001; Dusenbury, Brannigan, Falco et Hansen, 2003; Janosz, 2010; Rohrbach, Graham et Hansen, 1993; Rossi, Lipsey et Freeman, 2004) ou encore créer des effets iatrogènes chez la population ciblée (Botvin et Griffin, 2007; Craplet, 2006; Sohn, 2000; Werch et Owen, 2002).
Au Québec, si l’étude de l'adaptation et de l’implantation des programmes de prévention en milieu scolaire apparait limitée pour la population générale (Janosz, 2010; Roberge, Choinière et Laverdure, 2009), elle semble absente chez la population autochtone. Or, dans certaines communautés autochtones québécoises, des taux élevés de consommation de psychotropes sont rapportés, sans compter que l'initiation à l’alcool et aux drogues survient à un âge précoce (Cotton et Laventure, 2013; Pronovost, Plourde, Alain, Eveno et Laperrière, 2009). Les particularités culturelles et la dispersion géographique de certaines communautés d'une même Nation peuvent complexifier l'implantation des programmes (Dell et al., 2012; Grover, 2010; Grover et al., 2007; McKennitt, 2007; Whitbeck, Walls et Welch, 2012). Pour offrir des programmes de prévention qui répondent aux besoins des jeunes autochtones, leur adaptation et l’évaluation de leur implantation apparaissent alors essentielles (Kumpfer, Pinyuchon, de Melo et Henry, 2008; McKleroy et al., 2006; Ringwalt et Bliss, 2006; Wingood et DiClemente, 2008).
Cette thèse par articles a pour but d’expérimenter l'adaptation culturelle d'un programme de prévention. À cette fin, le premier article vise à identifier les facteurs facilitant ou entravant l’implantation initiale d’un programme de prévention des dépendances (Système d) chez les élèves innus du Québec d'âge scolaire primaire. Le second article vise à illustrer le processus d’adaptation de ce même programme, puis à vérifier la fidélité de son implantation en ce qui a trait à l'adhérence au contenu.
Cette thèse comporte un devis de recherche mixte incorporé. Dans le volet qualitatif, différents répondants ont été rencontrés afin de documenter leur satisfaction et d’identifier les facteurs ayant facilité et entravé l'implantation: les animateurs du programme (n=6), les intervenants scolaires (n=2), les enseignants (n=2), la direction de l'école (n=1) et les parents des élèves ayant participé à la version initiale du programme (n=9). Dans le volet quantitatif, des journaux de bord ont permis de compléter l'identification des facteurs, en plus de mesurer l'adhérence au contenu de la version initiale du programme puis de sa version adaptée.
Les résultats obtenus ont permis d’identifier différents facteurs entravant l'implantation du programme (manque de disponibilité des membres du personnel scolaire, complexité de certains concepts). D’autres facteurs ont toutefois facilité l’implantation du programme (adaptation en cours d’animation, capacité de résolution de problèmes des animateurs et des enseignants). Si certains de ces facteurs (formation au programme, aptitudes des personnes qui implantent) sont également observés en milieu scolaire non autochtone, d'autres facteurs (implication de membres du Conseil de bande, barrières de la langue et de la culture) apparaissent plus spécifiques au contexte communautaire autochtone. L’identification de ces facteurs, bien qu'elle ne concerne qu'une communauté autochtone, pourrait être transposée à d’autres communautés afin optimiser l’implantation et l'adaptation des programmes de prévention dans leurs écoles. Les principales adaptations apportées au programme Système d concernent la restructuration du protocole d'intervention (réduction de la durée des ateliers, ajout d'un cinquième atelier ainsi que d'un volet communautaire), la diversification des méthodes pédagogiques utilisées et l’intégration de références culturelles autochtones dans le contenu du programme. Il semble toutefois que l'adaptation du programme, bien que nécessaire pour correspondre à la réalité des élèves innus, se soit avérée insuffisante pour augmenter l'adhérence à son contenu.
L'ensemble des résultats obtenus dans cette thèse permet de sensibiliser les différents praticiens des milieux scolaires autochtones, dont les psychoéducateurs, sur l'importance de sélectionner, implanter et adapter avec soin des programmes afin de prévenir adéquatement les dépendances auprès des jeunes autochtones.
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Davis, Andrew J. "A Mixed-Method Study of the Effects of a Mindfulness-Based Relapse Prevention Aftercare Program on Clients with Opioid Addiction in a Court-Ordered Population." University of Akron / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=akron1596059927076454.
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Pack, Robert P. "Opioid Use in Tennessee: Lessons Learned." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1342.
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Pack, Robert P., Angela Hagaman, S. Loyd, S. Livesay, and A. McAffrey. "Prescription Drug Abuse: The Present Situation & Local Data and Services." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1350.
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Gray, Jeffrey A., Nicholas E. Hagemeier, and Sarah Melton. "Prescription Drug Abuse Prevention in East Tennessee: Engaging Communities to Impact an Epidemic." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1457.
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Prescription drug abuse (PDA) is an epidemic nationwide and has disproportionally impacted the Southern Appalachian region. Situated within a geographic area known for pervasive PDA and its consequences, The Gatton College of Pharmacy and Academic Health Sciences Center (AHSC) at East Tennessee State University are proactively engaging the Region and its health professions students to address the problem. Over the College’s six-year history of community engagement in PDA, efforts have focused on primary prevention activities, PDA treatment, awareness, education, and interprofessional collaboration as the key impact sectors. Notable programs include Generation Rx, Operation Rx Disposal, continuing education (CE) programming, and establishment of the ETSU Diversity-promoting Institutions Drug Abuse Research Program. In 2013-2014, 3 faculty and 38 Generation Rx pharmacy students engaged 4000 children and adolescents in PDA prevention education. Operation Rx Disposal employed 5 faculty members and 35 student pharmacists to assist more than 1000 households in removing unwanted medication from their homes through conduction of drug take-back events. Over 2000 health care providers from regional communities participated in PDA CE events conducted by 3 pharmacy faculty members. Additionally, 3 externally funded, PDA-specific grants totaling $2.26 million were awarded to pharmacy faculty members to engage communities, health care professionals, and students in innovative PDA prevention research. The College’s efforts have been nationally recognized by peers, professional organizations, state boards of pharmacy and within the evidentiary literature.
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Mathis, Stephanie M., Nicholas Hagemeier, Angela Hagaman, John Dreyzehner, and Robert P. Pack. "A Dissemination and Implementation Science Approach to the Epidemic of Opioid Use Disorder in the United States." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2780.
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Purpose of Review: This review aims to (1) conceptualize the complexity of the opioid use disorder epidemic using a conceptual model grounded in the disease continuum and corresponding levels of prevention and (2) summarize a select set of interventions for the prevention and treatment of opioid use disorder.
Recent Findings: Epidemiologic data indicate non-medical prescription and illicit opioid use have reached unprecedented levels, fueling an opioid use disorder epidemic in the USA. A problem of this magnitude is rooted in multiple supply- and demand-side drivers, the combined effect of which outweighs current prevention and treatment efforts. Multiple primary, secondary, and tertiary prevention interventions, both evidence-informed and evidence-based, are available to address each point along the disease continuum—non-use, initiation, dependence, addiction, and death.
Summary: If interventions grounded in the best available evidence are disseminated and implemented across the disease continuum in a coordinated and collaborative manner, public health systems could be increasingly effective in responding to the epidemic./p>
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Hagemeier, Nicholas E., and S. T. Melton. "The Center for Prescription Drug Abuse Prevention and Treatment: A Community-University Partnership." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5423.
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Choi, Young Soo. "Social policy for users of information technology : young people and internet addiction in Korea." Thesis, University of Birmingham, 2005. http://etheses.bham.ac.uk//id/eprint/887/.
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The Internet has conferred many benefits, but it also has negative effects including addiction patterns termed “Internet addiction”. Many studies have been inclined to focus on discovering psychological symptoms. However, they have not usually considered young people’s relationships, which can themselves lead to Internet addiction. This study gathers the life experiences of young people with an ‘Internet addiction pattern’ in order to understand better their relationships and circumstances. South Korea was chosen as the main focus of this study. From the Foucauldian perspective, the relationships produce power in new ways, wherever they meet and whenever they talk, with knowledge through their abilities, topics or information. This knowledge may categorise peers according to status and ability to use the Internet. These factors activate a ‘power network’ in ‘their own world’. As a result, Internet addiction situation is interpreted as a loss of balance in using the Internet and the research findings demonstrate how this process is influenced by the development of a set of power relations between young people within ‘their own world’. The recommendations are included, mainly ways to participate in the young people’s concerns and to relate to their lives so as to understand the real situation and reduce the problems.
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Pack, Robert P., Angela Hagaman, and Nicholas Hagemeier. "Forum hosts: Tennessee State Task Force on Opioids." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1340.
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Brewster, S., Fred Tudiver, E. Hagy, Angela Hagaman, Robert E. Pack, and Nicholas E. Hagemeier. "Prescriber and Pharmacist Prescription Drug Abuse Communication Perceptions." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1358.
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Pack, Robert P. "Prescription Drug Abuse a Decade into the Epidemic: Lessons learned in Tennessee." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1345.
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Dr. Robert Pack is Professor of Community and Behavioral Health, Associate Dean for Academic Affairs in the College of Public Health at East Tennessee State University (ETSU), and Director of the new ETSU Center for Prescription Drug Abuse Prevention and Treatment. The Center grew out of a university and community collaborative that was started in 2012 to address the regional problem of prescription opioid abuse. At least five funded projects and dozens of other academic products have grown out of the Working Group. Dr. Pack is currently PI of the NIH/NIDA-funded Diversity Promoting Institutions Drug Abuse Research Program at ETSU, the research component of which is the fiveyear set of three studies titled Inter-professional Communication to Prevent Prescription Drug Abuse and Misuse. He was trained in health education/health promotion at the UAB Ryals School of Public Health and is experienced in designing, running and disseminating theory-based intervention studies. In 2014, he was trained at the NIH-funded Training Institute for Dissemination and Implementation Research in Health.
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Pack, Robert P. "Ethical Considerations Concerning Methadone and Suboxone Treatments." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1339.
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Hagemeier, Nicholas E. "The Role of Community Pharmacy in Addressing and Preventing Opioid Use Disorder." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/5433.
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Hagaman, Angela M., Jeffery A. Gray, Nicholas Hagemeier, Billy Brooks, Stephanie M. Mathis, Karilynn Dowling, and Robert P. Pack. "Impact of an Organized Marketing Campaign on Drug Take Back Event Outcomes in South Central Appalachia." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/3195.
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Background: Prescription drug abuse is a major public health concern in the United States, associated with dramatic increases in morbidity and mortality over the past two decades. In recent years, disposal of unwanted, unused, and expired medications has been a pillar of national prevention efforts. Acknowledging increased policy and advocacy emphasis on improving prescription drug disposal behaviors of consumers, the purpose of this study was to evaluate the impacts of a targeted promotional campaign on participation in community-based drug take back events (TBE) in NE Tennessee. Methods: Between October 2013 and October 2017, 45 drug take-back events were held in 5 municipalities across NE Tennessee. A region-wide, promotional campaign including direct to consumer advertising (television, print, radio, etc) initiated spring 2014. Two methods of data collection were implemented: 1) donor surveys; and 2) drug donation weights (pounds) and dosage units collected. Controlled substance (CS) donations with identifiable dispensing dates were used to calculate donors’ possession time in months. One-way ANOVA, paired t-tests, and chi-square procedures were utilized to assess trends in donation weights, time to donation, and donor characteristics across the study period. Results: Total Disposal donations increased by 2.35 times (CS 2.61 times) from baseline after the initial promotional campaign. A total of 2300 CS donations were collected, with a spike in total pounds collected observed in spring of 2014 following initial marketing interventions. Donor possession time hdecreased by approximately one year during the length of the study (62.01 to 50.5 months). More than 1500 donor surveys were administered during the study. Half of all participants reported hearing about TBE through television promotions. Participants at urban events were 52.6% more likely than rural participants to hear about the event through newspaper promotion. Conclusion: Collaborative marketing across a TBE concentrated region increases CS disposal weight and decreases donor possession time.
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Hagemeier, Nicholas E., Fred T. Tudiver, S. Brewster, E. J. Hagy, Angela Hagaman, and Robert P. Pack. "Prescriber and Dispenser Prescription Drug Abuse Communication andPrescribing/Dispensing Behaviors: A Qualitative Analysis." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1360.
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Context: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and dispenser health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research is lacking on HCP PDA communicative behavioral engagement and factors that influence it. Objective: To describe PDA-related communicative behaviors and perceptions of primary care prescribers and community pharmacists. Design: Qualitative, semi-structured interprofessional and profession-specific focus groups were conducted, transcribed, coded, and thematically analyzed by two researchers. Established communication domains (communication apprehension, self-perceived communication competence, and willingness to communicate) guided focus group interviews. Setting: Appalachian Research Network (AppNET) PBRN clinics and communities. Participants: AppNET primary care prescribers (N=19) and community pharmacists (N=16). Main and Secondary Outcome Measures: Inductively derived themes resulting from focus groups. Results: Twelve themes were noted across two communication domains: HCP-patient communication (N=6) and HCP-HCP communication (N=6). HCP-patient communication engagement was influenced by multiple patient factors, with objective data (e.g., urine drug screens, distance travelled to practice) weighed heavily. Multiple practice barriers to communication were noted, including time pressures and a lack of screening resources. Difficult or uncomfortable conversations were often avoided by HCPs and substituted with simplified prescribing/dispensing conversations or policies. Dispenser to prescriber and prescriber to dispenser communication was described as rare and often perceived to be ineffective. Counter-intuitively, prescriber to dispenser communication was reported to have decreased after implementation of state prescription drug monitoring programs. Dispensers reported not being perceived as colleagues or teammates to prescribers in prescription drug abuse prevention and treatment. Prescribing behaviors were often questioned by dispensers, and some prescribers questioned dispensing behaviors. Conclusions: HCP prescription drug abuse communication is situational and influenced by patient, practice, and HCP characteristics. Identified themes will inform development of PDA-specific communication assessments that can be used to target and evaluate PDA communication interventions.
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Faulkner, Briar Lee. "Chemical dependency treatment: An examination of following continuing care recommendations." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2145.
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The purpose of this study was to determine what influence scheduled phone contacts would have on the extent of follow-through of continuing care recommednations by participants after treatment. Continuing care recommendations associated with ongoing sobriety include going to another level of care (individual therapy, group therapy, outpatient treatment), attending twelve-step meetings and communicating with a sponsor. Continuing care recommendations are typically written and referred to as a continuing care plan.
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Palmer, Sarah Morgando, and Tracy Lee Inman. "Perceived effects of a substance abuse prevention science program among fourth and fifth grade children: A qualitative study." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2418.
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This project explores the perceptions of fourth and fifth grade students who participated in a substance abuse prevention program. Risk and protective factors are presented to assist the reader in understanding this project.
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Hagemeier, Nicholas E., Fred Tudiver, Scott Brewster, Elizabeth J. Hagy, Brittany Ratliff, Angela Hagaman, and Robert P. Pack. "Interprofessional Prescription Opioid Abuse Communication Among Prescribers and Pharmacists: A Qualitative Analysis." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1323.
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Background: Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed support for interventions that improve interprofessional communication and reduce prescription opioid abuse. The objective of this study was to describe prescription opioid abuse-related communication among and between prescribers and community pharmacists in South Central Appalachia. Methods: The investigators conducted five focus groups with 35 Appalachian Research Network practice-based research network providers between February and October, 2014. Two prescriber-specific, two pharmacist-specific, and one interprofessional (prescribers and pharmacists) focus groups were conducted, recorded, and transcribed. Data collection and analysis occurred iteratively. Emerging themes were inductively derived and refined. Five member-checking interviews were conducted to validate themes. Results: Providers noted several factors that influence intraprofessional and interprofessional communication, including level of trust, role perceptions, conflict history and avoidance, personal relationships, and prescription monitoring program use. Indirect communication approaches via patients, office staff, and voicemail systems were common. Direct pharmacist to prescriber and prescriber to pharmacist communication was described as rare and often perceived to be ineffective. Prescriber to pharmacist communication was reported by prescribers to have decreased after implementation of state prescription monitoring programs. Difficult or uncomfortable conversations were often avoided by providers. Conclusions: Interprofessional and intraprofessional prescription opioid abuse communication is situational and influenced by multiple factors. Indirect communication and communication avoidance are common. Themes identified in this study can inform development of interventions that improve providers' intra- and interprofessional communication skills.
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Pack, Robert P., and Samantha A. Mathis. "Substance Use Disorder in Central Appalachia: Challenges for Cultural Competency." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1344.
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Dr. Robert Pack is Professor of Community and Behavioral Health, Associate Dean for Academic Affairs in the College of Public Health at East Tennessee State University, and Director of the new ETSU Center for Prescription Drug Abuse Prevention and Treatment. The Center grew out of a university and community collaborative that was started in 2012 to address the regional problem of prescription opioid abuse. At least five funded projects and dozens of other academic products have grown out of the Working Group. Dr. Pack is currently PI of the NIH/NIDA-funded Diversity Promoting Institutions Drug Abuse Research Program at ETSU, the research component of which is the five-year set of three studies titled Inter-professional Communication to Prevent Prescription Drug Abuse and Misuse. He was trained in health education/health promotion at the UAB Royals School of Public Health and is experienced in designing, running and disseminating theory-based intervention studies. In 2014, he was trained at the NIH-funded Training Institute for Dissemination and Implementation Research in Health (TIDIRH, Boston, 2014).
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Polaha, J. P., and Robert P. Public Health Pack. "Substance Use Disorder in Appalachia: Challenges for Cultural Competency." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1341.
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Pack, Robert P. "Prescription Drug Abuse/Misuse in Appalachia." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/1365.
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Dowling, Karilynn, Taylor Riedley, MacKenzie Broome, and Nicholas E. Hagemeier. "Stopping the Spread by Using Sterile Needles Instead: A Rural Community Pharmacy Hepatitis C/HIV Prevention Feasibility Study." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5432.
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Purpose: Prescription and illicit opioid abuse have disproportionately impacted the Central Appalachian Region. Centers for Disease Control and Prevention (CDC) data indicate the region is home to many of the 220 counties most vulnerable to rapid dissemination of Hepatitis C Virus (HCV) and HIV related to injection drug use. Growing evidence supports the role of community pharmacies in HCV/HIV prevention by providing access to non-prescription sterile syringes; however, research has largely been confined to major metropolitan areas. The objective of this study is to evaluate the feasibility of community pharmacies in Central Appalachia serving as access points for sterile syringes. Methods: This study was approved by the Institutional Review Board. Using state directories of health professionals, community pharmacists from Northeast Tennessee, Western North Carolina, and Southwest Virginia were randomly selected to participate in key informant interviews to inform understanding of the impact of attitudes, beliefs, and state-level policies on pharmacists’ syringe dispensing behaviors (N=15). Informed consent was obtained prior to initiating the interviews and participants were provided modest compensation for their time. The semi-structured interviews were guided by Theory of Planned Behavior constructs to focus the interview on evidence-based predictors of behaviors. Interviews were audio-recorded, de-identified, transcribed, and are currently being thematically analyzed by the research team with NVivo software. The results of this study are expected to inform development of a survey instrument for a larger quantitative evaluation of pharmacists' perceptions on syringe dispensing in the region. Results: Not applicableConclusion: Not applicable
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Ross, A., A. Dinh, J. A. Basden, Ivy Click, and Nicholas E. Hagemeier. "Neonatal Abstinence Syndrome Prevention Behaviors Among Primary Care Prescribers, Buprenorphine Prescribers, and Pain Management Clinic Directors." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1441.
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Hagaman, Angela M., and Stephanie M. Mathis. "Interprofessional Working Group Addresses Prescription Drug Abuse." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/3198.
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Northeast Tennessee has been disproportionately burdened by a high prevalence of opioid prescribing, prescription drug abuse, addiction, overdose, and Neonatal Abstinence Syndrome. The East Tennessee State University Prescription Drug Abuse and Misuse Working Group (PDAMWG) formed upon recognizing an urgent need for a collaborative, multi-faceted response to reduce prescription drug abuse. Composed of over 100 members from various agencies, organizations, and institutions, members of this highly interprofessional, university-sponsored working group include academic scholars, healthcare providers, pharmacists, elected officials, students, community members, and more. This collaboration has successfully generated multiple funded research projects and numerous evidence- and community-based initiatives targeting prescription drug abuse. This seminar will focus on substance abuse prevention, specifically the prevention of prescription drug abuse. In addition to providing a data supported summary of the epidemic in the region, this seminar will outline the historical development of the PDAMWG and describe past and present research and community-based initiatives. An emphasis will be on the continuous commitment of the PDAMWG to the development, dissemination, and implementation of evidence-based practices to reduce prescription drug abuse and improve population health in the region. This seminar will also document research as well as community-based outcomes of PDAMWG efforts. Consequently, participants will recognize the effectiveness of strong, cross-sector partnerships for population health improvement. Relatedly, participants will develop a concrete understanding of a collaborative approach that bridges academic research and community-based practice. Perhaps most importantly, participants will discover its potential for replication in other communities to support the achievement of maximum, evidence-based outcomes for various health concerns. Lastly, participants will be introduced to the underlying model of the PDAMWG, which visually depicts evidence-based strategies along the disease continuum. As a result, participants will appreciate the complexity of public health problems and the subsequent importance of a multi-pronged, evidence-based response to addressing them