scholarly journals Cultural Adaptation of a Brief Intervention to Reduce Alcohol Use Among Injury Patients in Tanzania

2021 ◽  
Author(s):  
Armand Zimmerman ◽  
Msafiri Pesambili ◽  
Ashley J. Phillips ◽  
Judith Boshe ◽  
Blandina T. Mmbaga ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Low Income ◽  
Cultural Adaptation ◽  
Standard Of Care ◽  
High Income ◽  
Harmful Alcohol ◽  
Culturally Adapted ◽  
Increased Risk ◽  
Intervention Protocol ◽  
Kilimanjaro Region

Abstract Background Harmful alcohol use is a leading risk factor for injury-related death and disability in low- and middle-income countries (LMICs). Brief negotiational interventions (BNIs) administered in emergency departments (EDs) to injury patients with alcohol use disorders (AUDs) are effective in reducing post-hospital alcohol intake and re-injury rates. However, most BNIs to date have been developed and implemented in high-income countries. The efficacy of BNIs in LMICs is largely unknown as few studies have undertaken the rigorous task of culturally adapting these interventions to new settings. Given the high prevalence of alcohol-related injury in the Kilimanjaro region of Tanzania, we culturally adapted a BNI to reduce post-injury alcohol use for implementation in this patient population. Methods We used an iterative, multiphase process to culturally adapt a high-income country standard of care BNI to the Tanzanian setting using the Intervention Mapping ADAPT framework. Our team consisted of local healthcare professionals with extensive experience in counseling patients who use alcohol, as well as an international team of academic and clinical professionals. Focus groups were used to inform culturally appropriate changes to the standard of care BNI protocol. Objective assessment of BNI delivery was performed to ensure adherence to the FRAMES model of motivational interviewing. Results We developed the Punguza Pombe Kwa Afya Yako (PPKAY); a one-time, 15-minute nurse-led BNI that encourages safe alcohol use and motivates change in alcohol use behaviors among injury patients in the Kilimanjaro region of Tanzania. Adaptations to the original intervention protocol include changes regarding the interventionist, how a patient is greeted, how the topic of alcohol use is raised, how a patient is informed of their harmful alcohol use, how graphics are visualized within the intervention protocol, how behavior change is motivated, and which behavior changes are encouraged. Conclusions The PPKAY intervention is the first BNI to be culturally adapted for delivery to injury patients in an LMIC population. Our study demonstrates a unique approach to adapting substance use interventions for use in LMICs, and shows that cultural adaptation of alcohol use interventions is feasible even in settings where community knowledge regarding harmful alcohol use is limited. Our study prompts the need for further research and cultural adaptation of BNIs for other low-income communities at increased risk of alcohol-related harm.

scholarly journals Income and Marital Status Interact on Obesity Among Black and White Men

2019 ◽  
Vol 13 (1) ◽  
pp. 155798831982995 ◽  
Author(s):  
Caryn N. Bell ◽  
Roland J. Thorpe
Keyword(s):  
Marital Status ◽  
Black Men ◽  
Low Income ◽  
Positive Association ◽  
White Men ◽  
Poverty Line ◽  
High Income ◽  
Never Married ◽  
Black And White ◽  
Increased Risk

Racial disparities in obesity among men are accompanied by positive associations between income and obesity among Black men only. Race also moderates the positive association between marital status and obesity. This study sought to determine how race, income, and marital status interact on obesity among men. Using data from the 2007 to 2014 National Health and Nutrition Examination Survey, obesity was measured as body mass index ≥30 kg/m2 among 6,145 Black and White men. Income was measured by percentage of the federal poverty line and marital status was categorized as currently, formerly, or never married. Using logistic regression and interaction terms, the associations between income and obesity were assessed by race and marital status categories adjusted for covariates. Black compared to White (OR = 1.19, 95% CI [1.03, 1.38]), currently married compared to never married (OR = 1.45, 95% CI [1.24, 1.69]), and high-income men compared to low income men (OR = 1.26, 95% CI [1.06, 1.50]) had higher odds of obesity. A three-way interaction was significant and analyses identified that income was positively associated with obesity among currently married Black men and never married White men with the highest and lowest probabilities of obesity, respectively. High-income, currently married Black men had higher obesity rates and may be at increased risk for obesity-related morbidities.

scholarly journals Husband’s Alcohol Use, Intimate Partner Violence, and Family Maltreatment of Low-Income Postpartum Women in Mumbai, India

2016 ◽  
Vol 33 (14) ◽  
pp. 2241-2267 ◽  
Author(s):  
Jennifer A. Wagman ◽  
Balaiah Donta ◽  
Julie Ritter ◽  
D. D. Naik ◽  
Saritha Nair ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Alcohol Use ◽  
Low Income ◽  
Partner Violence ◽  
Access To Health Care ◽  
Scale Up ◽  
Intimate Partner ◽  
Design Strategies ◽  
Cross Sectional ◽  
Increased Risk

Husbands’ alcohol use has been associated with family-level stress and intimate partner violence (IPV) against women in India. Joint family systems are common in India and IPV often co-occurs with non-violent family maltreatment of wives (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care). Alcohol use increases for some parents following the birth of a child. This study examined 1,038 postpartum women’s reports of their husbands’ alcohol use and their own experiences of IPV (by husband) and non-violent maltreatment from husbands and/or in-laws. We analyzed cross-sectional, quantitative data collected in 2008, from women (ages 15-35) seeking immunizations for their infants <6 months at three large urban health centers in Mumbai, India. Crude and adjusted logistic regression models estimated associations between the independent variable (husbands’ past month use of alcohol) and two dependent variables (postpartum IPV and maltreatment). Overall, 15% of husbands used alcohol, ranging from daily drinkers (10%) to those who drank one to two times per week (54%). Prevalence of postpartum IPV and family maltreatment was 18% and 42%, respectively. Prevalence of IPV among women married to alcohol users was 27%. Most abused women’s husbands always (27%) or sometimes (37%) drank during violent episodes. Risk for IPV increased with a man’s increasing frequency of consumption. Women who lived with a husband who drank alcohol, relative to non-drinkers, were more likely to report postpartum IPV, aOR = 2.0, 95% confidence interval (CI) = [1.3, 3.1]. Husbands’ drinking was marginally associated with increased risk for family maltreatment, aOR = 1.4, 95% CI = [1.0, 2.1]. Our findings suggest that men’s alcohol use is an important risk factor for postpartum IPV and maltreatment. Targeted services for Indian women contending with these issues are implicated. Postpartum care offers an ideal opportunity to screen for IPV, household maltreatment, and other health risks, such as husband’s use of alcohol. There is need to scale up proven successful interventions for reducing men’s alcohol use and design strategies that provide at-risk women protection from alcohol-related IPV.

Alcohol-related problems among college and university students in Norway: extent of the problem

2019 ◽  
pp. 140349481986351 ◽  
Author(s):  
Ove Heradstveit ◽  
Jens Christoffer Skogen ◽  
Geir Scott Brunborg ◽  
Kari Jussi Lønning ◽  
Børge Sivertsen
Keyword(s):  
Alcohol Use ◽  
University Students ◽  
National Health Survey ◽  
Health Concern ◽  
Relative Risk Ratio ◽  
Full Time ◽  
College And University ◽  
Harmful Alcohol ◽  
Increased Risk ◽  
Alcohol Related Problems

Aims: The aim of the current study was to provide estimates of the distribution of alcohol-related problems in a large sample of college and university students. We also sought to examine trends in the distribution of alcohol-related problems from 2010 to 2018. Methods: Data stem from a recent national health survey from 2018 for higher education in Norway (the SHoT study) in which 50,054 full-time students (69.1% women; 30.9% men) aged 18–35 years participated. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess potential alcohol-related problems. Data on demographic characteristics were also collected. Results: More than half of the male students (52.8%) and 4 out of 10 of the female students (40.1%) reported risky, harmful or dependent alcohol use. Compared to women, men had an increased risk of risky alcohol use (relative risk ratio (RRR) = 1.57), harmful alcohol use (RRR = 2.45) and dependent alcohol use (RRR = 2.73). Younger students had higher rates of risky and harmful alcohol use compared with older students, while rates of dependent alcohol use were similar across the age span. Several demographic variables were associated with alcohol use. The trend analyses revealed that the rates of risky, harmful and dependent alcohol use, as well as mean AUDIT scores, among the students have remained relatively stable over the past 8 years. Conclusions: Alcohol use remains an important health concern among Norwegian college and university students, and the present study confirms the high rates of alcohol-related problems, and the need to address the issue within this population.

Prevalence and socioeconomic factors in the prescription of concurrent amphetamine and alprazolam

2020 ◽  
pp. 009121742096061
Author(s):  
Paul A Zarkowski ◽  
Alex R Van-Den-Ende ◽  
Jacob A Groen
Keyword(s):  
Socioeconomic Factors ◽  
Low Income ◽  
Household Income ◽  
Monitoring Program ◽  
High Income ◽  
Urban Setting ◽  
Increased Risk ◽  
Prescription Rates ◽  
Zip Code ◽  
Low Income Households

Objective Goals were to determine the prevalence of concurrent prescription of amphetamine and alprazolam, and examine variation by socioeconomic factors. Methods Washington State’s Prescription Monitoring Program was reviewed for calendar years 2013 through 2017. Individuals receiving more than 180 days of amphetamine, alprazolam or both were tabulated for each zip code. Prescription rates were compared between zip codes with variation in rural/urban setting and fraction of low and high income households using a multiple regression. Results One in 3920 individuals in the general population of Washington State were taking a combination of alprazolam and amphetamine. The statewide prevalence of this combination increased 40.2% between 2013 and 2017. The prevalence of the combination in each zip code is significantly positively correlated with the fraction of high income households, p < 0.001, and urban area, p < 0.05. In contrast, the prevalence of amphetamine increased with both the fraction of high income, p < 0.001, and low income households, p < 0.01, with an incremental increase over twice as large with fraction of high income (b = 232 (25)) than low income households (b = 102 (38)). In contrast, alprazolam decreased in prevalence with the fraction of high income households, p < 0.05. Conclusions The prevalence of concurrent prescription of alprazolam and amphetamine correlates with local socioeconomic factors, including greater household income, instead of the prevalence of FDA indications, including anxiety disorders or ADHD. More clinical studies are required to establish efficacy and guidelines for safe use to mitigate the increased risk of accidents in patients taking concurrent amphetamine and alprazolam.

scholarly journals Factors associated with different forms of alcohol use behaviors among college students in Bhutan: a cross-sectional study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Tandin Dorji ◽  
Peeradone Srichan ◽  
Tawatchai Apidechkul ◽  
Rachanee Sunsern ◽  
Wipob Suttana
Keyword(s):  
College Students ◽  
Alcohol Use ◽  
Binge Drinking ◽  
Low Income ◽  
High Income ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Significance Level ◽  
Factors Associated ◽  
Binge Drinkers

Abstract Background Alcohol use has impacts on several dimensions of health, including physical health and mental health, particularly in college-age populations. Therefore, this study aimed to estimate the prevalence and to determine factors associated with alcohol use behaviors among college students in Bhutan. Methods A cross-sectional design was applied to collect data from the participants. A simple random method was used to select the participants from the lists of students who were attending the four selected colleges in Bhutan in the academic year of 2019. A questionnaire was developed, and validity and reliability were verified before use. Descriptive statistics were applied to describe the general characteristics of participants, while logistic regression was used to detect the associations between variables at the significance level of α = 0.05. Results A total of 432 college students were recruited into the study, of whom 62.0% were females. The average age was 20.0 years, 40.7% were the third-year students, and 79.9% lived in college dormitories. The prevalence of current drinking was 51.6% and that of binge drinking was 19.4%. After controlling for all potential confounder factors, three variables were found to be associated with current drinking: students who had low income were more likely to be current drinkers than those who had high income (AOR = 2.59, 95% CI = 1.29–5.21); students who did not use tobacco were more likely to be current drinkers than those students who used tobacco (AOR = 6.99, 95% CI = 2.90–16.81); and students who had close friends who did not use alcohol were more likely to be current drinkers than those who had close friends who used alcohol (AOR = 5.14, 95% CI = 3.04–8.69). Four factors were found to be associated with binge drinking after controlling for all possible confounder factors: students who had high income were more likely to be binge drinkers than those who had low income (AOR = 3.03, 95% CI = 1.72–5.31); students who used tobacco were more likely to be binge drinkers than those students who did not use tobacco (AOR = 2.28, 95% CI = 1.35–3.87); students whose parents used alcohol were more likely to be binge drinkers than those students whose parents did not use alcohol (AOR = 1.75, 95% CI = 1.02–3.01); and students whose close friends used alcohol were more likely to be binge drinkers than those who had close friends who did not use alcohol (AOR = 2.26, 95% CI = 1.05–4.87). Conclusions There is a high prevalence in alcohol use among the college students in Bhutan. Effective health promotion programs should be implemented by focusing on reducing the alcohol consumption among college students.

scholarly journals The dark side of helping behaviors: Partner support increases daily alcohol use in outpatients with a history of alcohol dependence

2020 ◽  
Vol 37 (5) ◽  
pp. 1389-1404
Author(s):  
Frances C. Calkins ◽  
Rebecca L. Brock
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Low Income ◽  
Alcohol Use Disorders ◽  
Partner Support ◽  
Dark Side ◽  
Increased Risk ◽  
History Of ◽  
Helping Behaviors ◽  
Ecological Momentary

The primary goal of the present study was to systematically investigate the role of intimate partner support in alcohol use and to examine whether partner support serves a maladaptive function among individuals with a history of alcohol dependence. This goal was pursued in a sample of low-income outpatients because of increased risk for chronic stress and alcohol use disorders among this population. We implemented a comprehensive, multi-method assessment of partner support and ecological momentary assessments of alcohol use over 14 consecutive days. Results demonstrate the potential “dark side” of helping behaviors that has been proposed in recent literature. Specifically, in a sample of low-income outpatients, we found that receiving more frequent and higher quality support from one’s partner put individuals meeting criteria for alcohol dependence at greater risk for consuming alcohol. Findings converge with research suggesting that helping behaviors might function to enable maladaptive coping mechanisms in the context of alcohol use disorders.

scholarly journals Representative estimates of COVID-19 infection fatality rates from four locations in India: cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050920
Author(s):  
Rebecca Cai ◽  
Paul Novosad ◽  
Vaidehi Tandel ◽  
Sam Asher ◽  
Anup Malani
Keyword(s):  
Low Income ◽  
Tamil Nadu ◽  
Large Population ◽  
Cross Sectional Study ◽  
High Income ◽  
Income Country ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk

ObjectivesTo estimate age-specific and sex-specific mortality risk among all SARS-CoV-2 infections in four settings in India, a major lower-middle-income country and to compare age trends in mortality with similar estimates in high-income countries.DesignCross-sectional study.SettingIndia, multiple regions representing combined population >150 million.ParticipantsAggregate infection counts were drawn from four large population-representative prevalence/seroprevalence surveys. Data on corresponding number of deaths were drawn from official government reports of confirmed SARS-CoV-2 deaths.Primary and secondary outcome measuresThe primary outcome was age-specific and sex-specific infection fatality rate (IFR), estimated as the number of confirmed deaths per infection. The secondary outcome was the slope of the IFR-by-age function, representing increased risk associated with age.ResultsAmong males aged 50–89, measured IFR was 0.12% in Karnataka (95% CI 0.09% to 0.15%), 0.42% in Tamil Nadu (95% CI 0.39% to 0.45%), 0.53% in Mumbai (95% CI 0.52% to 0.54%) and an imprecise 5.64% (95% CI 0% to 11.16%) among migrants returning to Bihar. Estimated IFR was approximately twice as high for males as for females, heterogeneous across contexts and rose less dramatically at older ages compared with similar studies in high-income countries.ConclusionsEstimated age-specific IFRs during the first wave varied substantially across India. While estimated IFRs in Mumbai, Karnataka and Tamil Nadu were considerably lower than comparable estimates from high-income countries, adjustment for under-reporting based on crude estimates of excess mortality puts them almost exactly equal with higher-income country benchmarks. In a marginalised migrant population, estimated IFRs were much higher than in other contexts around the world. Estimated IFRs suggest that the elderly in India are at an advantage relative to peers in high-income countries. Our findings suggest that the standard estimation approach may substantially underestimate IFR in low-income settings due to under-reporting of COVID-19 deaths, and that COVID-19 IFRs may be similar in low-income and high-income settings.

scholarly journals Participant Satisfaction and Acceptability of a Culturally Adapted Brief Intervention to Reduce Unhealthy Alcohol Use Among Latino Immigrant Men

2020 ◽  
Vol 14 (3) ◽  
pp. 155798832092565
Author(s):  
Vanessa N. Torres ◽  
Emily C. Williams ◽  
Rachel M. Ceballos ◽  
Dennis M. Donovan ◽  
India J. Ornelas
Keyword(s):  
Alcohol Use ◽  
Brief Intervention ◽  
Controlled Trial ◽  
Participant Satisfaction ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
Culturally Adapted ◽  
Increased Risk ◽  
Latino Immigrant ◽  
Immigrant Men

Latino immigrant men are at increased risk for unhealthy alcohol use, yet few interventions have been designed to meet their unique needs. The current study assessed participant satisfaction and acceptability of a culturally adapted brief intervention to reduce unhealthy alcohol use in this population. Adaptations to the brief intervention included delivering it in Spanish by promotores in a community setting. The mixed methods approach included surveys ( N = 73) and in-depth interviews ( N = 20) with participants in a pilot randomized controlled trial. The study drew on Sekhon’s theoretical framework of acceptability to asses affective attitude, burden, and perceived effectiveness of the intervention, along with satisfaction with the content, setting, and promotor. Participants’ survey responses indicated that they were highly satisfied with the content, setting, and delivery of the brief intervention. In interviews participants noted that the brief intervention helped them reflect on their drinking behaviors, that they perceived promotores to be a trusted source of health information, and that they liked receiving personalized feedback via tablets. Some participants found the feedback did not match their own perceptions of their alcohol use and wanted clearer advice on how to reduce their drinking. Men felt they would benefit from more contact with promotores. These findings suggest that Latino immigrant men in this study were receptive to the culturally adapted brief intervention. Future interventions may be more effective if they include multiple contacts with promotores and more directive guidance on strategies to reduce drinking.

An Analysis on Harmful Alcohol Use and Comparison between One-Person Households and Age Groups

2018 ◽  
Vol 19 (2) ◽  
pp. 39-52 ◽  
Author(s):  
Yerjin Park ◽  
◽  
Areum Oh ◽  
Yumi Oh ◽  
Yuseon Yang
Keyword(s):  
Alcohol Use ◽  
Age Groups ◽  
Harmful Alcohol

SATUAN TIMBULAN DAN KOMPOSISI SAMPAH DOMESTIK KABUPATEN TANAH DATAR

Jurnal Dampak ◽  
2014 ◽  
Vol 11 (1) ◽  
pp. 28 ◽  
Author(s):  
Yommi Dewilda ◽  
Yeggi Darnas
Keyword(s):  
Low Income ◽  
High Income ◽  
Income Data

Penelitian ini bertujuan untuk mendapatkan data timbulan dan komposisi sampah domestik di Kabupaten Tanah Datar serta dapat membandingkan perbedaan timbulan dan komposisi sampah yang dihasilkan berdasarkan tingkat pendapatan masyarakat (High income, Medium income dan Low income). Data timbulan dan komposisi sampah diperlukan dalam perencanaan dan pengembangan sistem pengelolaan sampah. Sampling timbulan dan jumlah sampling dilakukan berdasarkan SNI 19-3964-1994. Hasil penelitian timbulan sampah domestik dalam satuan berat 0,232 kg/o/h dan dalam satuan volume 3,646 l/o/h. Berdasarkan tingkat pendapatan dalam satuan berat High Income (HI) 0,308 kg/o/h, Medium Income (MI) 0,198 kg/o/h dan Low Income (LI) 0,190 kg/o/h dalam satuan volume HI 4,269 l/o/h, MI 3,835 l/o/h dan LI 2,835 l/o/h. Timbulan sampah yang dihasilkan penduduk dengan High Incame lebih besar dibandingkan dengan penduduk dengan pendapatan Medium Income dan Low Income. Komposisi sampah domestik untuk sampah basah 75,5%; sampah plastik 16,6%; sampah kertas 5,3%; sampah tekstil 0,8%; sampah kayu 0,3%; sampah kaca 0,7%; sampah logam ferrous 0,2%; sampah logam non ferrous 0,1%; dan sampah lain-lain 0,5%.Kata kunci: sampah domestik, komposisi sampah, timbulan Sampah

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