Examining the Impact of Individual, Community, and Market Factors on Methamphetamine Use: A Tale of Two Cities

2005 ◽  
Vol 35 (4) ◽  
pp. 665-693 ◽  
Author(s):  
Nancy Rodriguez ◽  
Charles Katz ◽  
Vincent J. Webb ◽  
David R. Schaefer
Keyword(s):  
Drug Market ◽  
Community Level ◽  
Policy Implications ◽  
Individual Level ◽  
Methamphetamine Use ◽  
Level Data ◽  
Two Cities ◽  
Market Factors ◽  
The Individual ◽  
The Impact

Although prior studies have monitored the trends in methamphetamine use and reported its increase over the years, few studies have considered how community-level characteristics affect the use of methamphetamine. In this study, we utilize data from the Arrestee Drug Abuse Monitoring (ADAM) program from two cities to examine how individual-level, community-level, and drug market factors influence methamphetamine use. Results indicate that both individual and community-level data significantly influence methamphetamine use. Also, findings show that predictors of methamphetamine use (at the individual and community-level) differ significantly from marijuana, cocaine, and opiate use. Policy implications regarding law enforcement suppression and the treatment of methamphetamine users are discussed.

Area-level relative deprivation and alcohol use in Denmark: Is there a relationship?

2018 ◽  
Vol 47 (4) ◽  
pp. 428-438 ◽  
Author(s):  
Kim Bloomfield ◽  
Gabriele Berg-Beckhoff ◽  
Abdu Kedir Seid ◽  
Christiane Stock
Keyword(s):  
Alcohol Use ◽  
Relative Deprivation ◽  
Health Behaviours ◽  
Area Deprivation ◽  
Individual Level ◽  
Level Data ◽  
Housing Component ◽  
Disorder Identification ◽  
The Individual ◽  
The Impact

Aims: Greater area-level relative deprivation has been related to poorer health behaviours, but studies specifically on alcohol use and abuse have been equivocal. The main purpose of the present study was to investigate how area-level relative deprivation in Denmark relates to alcohol use and misuse in the country. Methods: As individual-level data, we used the national alcohol and drug survey of 2011 ( n= 5133). Data were procured from Statistics Denmark to construct an index of relative deprivation at the parish level ( n=2119). The deprivation index has two components, which were divided into quintiles. Multilevel linear and logistic regressions analysed the influence of area deprivation on mean alcohol use and hazardous drinking, as measured by the Alcohol Use Disorder Identification Test. Results: Men who lived in parishes designated as ‘very deprived’ on the socioeconomic component were more likely to consume less alcohol; women who lived in parishes designated as ‘deprived’ on the housing component were less likely to drink hazardously. But at the individual level, education was positively related to mean alcohol consumption, and higher individual income was positively related to mean consumption for women. Higher-educated men were more likely to drink hazardously. Conclusions: Area-level measures of relative deprivation were not strongly related to alcohol use, yet in the same models individual-level socioeconomic variables had a more noticeable influence. This suggests that in a stronger welfare state, the impact of area-level relative deprivation may not be as great. Further work is needed to develop more sensitive measures of relative deprivation.

scholarly journals Development and Validation of a Multivariable Prediction Model for Missed HIV Healthcare Provider Visits in a Large United States Clinical Cohort

2021 ◽  
Author(s):  
April C Pettit ◽  
Aihua Bian ◽  
Cassandra O Schember ◽  
Peter F Rebeiro ◽  
Jeanne C Keruly ◽  
...  
Keyword(s):  
Prediction Models ◽  
Community Level ◽  
Research Network ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Individual Level ◽  
Visit Adherence ◽  
Level Data ◽  
Missed Visits ◽  
The Individual

Abstract Background Identifying individuals at high risk of missing HIV care provider visits could support proactive intervention. Previous prediction models for missed visits have not incorporated data beyond the individual-level. Methods We developed prediction models for missed visits among people living with HIV (PLWH) with ≥1 follow-up visit in the Center for AIDS Research Network of Integrated Clinical Systems from 2010-2016. Individual-level (medical record data and patient-reported outcomes), community-level (American Community Survey), HIV care site-level (standardized clinic leadership survey), and structural-level (HIV criminalization laws, Medicaid expansion, and state AIDS Drug Assistance Program budget) predictors were included. Models were developed using random forests with 10-fold cross-validation; candidate models with highest area under the curve (AUC) were identified. Results Data from 382,432 visits among 20,807 PLWH followed for a median of 3.8 years were included; median age was 44 years, 81% were male, 37% were Black, 15% reported injection drug use, and 57% reported male-to-male sexual contact. The highest AUC was 0.76 and strongest predictors were at the individual-level (prior visit adherence, age, CD4+ count) and community-level (proportion living in poverty, unemployed, and of Black race). A simplified model, including readily accessible variables available in a web-based calculator, had a slightly lower AUC of 0.700. Conclusions Prediction models validated using multi-level data had a similar AUC to previous models developed using only individual-level data. Strongest predictors were individual-level variables, particularly prior visit adherence, though community-level variables were also predictive. Absent additional data, PLWH with previous missed visits should be prioritized by interventions to improve visit adherence.

scholarly journals Individual-, household- and community-level determinants of infant mortality in Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248501
Author(s):  
Girmay Tsegay Kiross ◽  
Catherine Chojenta ◽  
Daniel Barker ◽  
Deborah Loxton
Keyword(s):  
Infant Mortality ◽  
Health Behaviours ◽  
Community Level ◽  
Family Characteristics ◽  
P Value ◽  
Community Based Interventions ◽  
Individual Level ◽  
Individual Household ◽  
The Individual ◽  
The Impact

Introduction People living in the same area share similar determinants of infant mortality, such as access to healthcare. The community’s prevailing norms and attitudes about health behaviours could also influence the health care decisions made by individuals. In diversified communities like Ethiopia, differences in child health outcomes might not be due to variation in individual and family characteristics alone, but also due to differences in the socioeconomic characteristics of the community where the child lives. While individual level characteristics have been examined to some extent, almost all studies into infant mortality conducted in Ethiopia have failed to consider the impact of community-level characteristics. Therefore, this study aims to identify individual and community level determinants of infant mortality in Ethiopia. Method Data from the Ethiopian Demographic and Health Survey in 2016 were used for this study. A total of 10641 live births were included in this analysis. A multi-level logistic regression analysis was used to examine both individual and community level determinants while accounting for the hierarchal structure of the data. Results Individual-level characteristics such as infant sex have a statistically significant association with infant mortality. The odds of infant death before one year was 50% higher for males than females (AOR = 1.66; 95% CI: 1.25–2.20; p-value <0.001). At the community level, infants from pastoralist areas (Somali and Afar regions) were 1.4 more likely die compared with infants living in the Agrarian area such as Amhara, Tigray, and Oromia regions; AOR = 1.44; 95% CI; 1.02–2.06; p-value = 0.039). Conclusion Individual, household and community level characteristics have a statistically significant association with infant mortality. In addition to the individual based interventions already in place, household and community-based interventions such as focusing on socially and economically disadvantaged regions in Ethiopia could help to reduce infant mortality.

scholarly journals Natural History of NAFLD

2021 ◽  
Vol 10 (6) ◽  
pp. 1161
Author(s):  
Raluca Pais ◽  
Thomas Maurel
Keyword(s):  
Liver Disease ◽  
Natural History ◽  
Disease Progression ◽  
Specific Treatment ◽  
Alcoholic Fatty Liver ◽  
Individual Level ◽  
Close Relationship ◽  
History Of ◽  
The Individual ◽  
The Impact

The epidemiology and the current burden of chronic liver disease are changing globally, with non-alcoholic fatty liver disease (NAFLD) becoming the most frequent cause of liver disease in close relationship with the global epidemics of obesity, type 2 diabetes and metabolic syndrome. The clinical phenotypes of NAFLD are very heterogeneous in relationship with multiple pathways involved in the disease progression. In the absence of a specific treatment for non-alcoholic steatohepatitis (NASH), it is important to understand the natural history of the disease, to identify and to optimize the control of factors that are involved in disease progression. In this paper we propose a critical analysis of factors that are involved in the progression of the liver damage and the occurrence of extra-hepatic complications (cardiovascular diseases, extra hepatic cancer) in patients with NAFLD. We also briefly discuss the impact of the heterogeneity of the clinical phenotype of NAFLD on the clinical practice globally and at the individual level.

Missing Data in Research on Youth and Family Programs

2021 ◽  
pp. 003329412110268
Author(s):  
Jaime Ballard ◽  
Adeya Richmond ◽  
Suzanne van den Hoogenhof ◽  
Lynne Borden ◽  
Daniel Francis Perkins
Keyword(s):  
Missing Data ◽  
Statistical Methods ◽  
Self Report ◽  
Program Participation ◽  
Multilevel Data ◽  
Individual Level ◽  
Level Data ◽  
Before And After ◽  
Post Test ◽  
The Individual

Background Multilevel data can be missing at the individual level or at a nested level, such as family, classroom, or program site. Increased knowledge of higher-level missing data is necessary to develop evaluation design and statistical methods to address it. Methods Participants included 9,514 individuals participating in 47 youth and family programs nationwide who completed multiple self-report measures before and after program participation. Data were marked as missing or not missing at the item, scale, and wave levels for both individuals and program sites. Results Site-level missing data represented a substantial portion of missing data, ranging from 0–46% of missing data at pre-test and 35–71% of missing data at post-test. Youth were the most likely to be missing data, although site-level data did not differ by the age of participants served. In this dataset youth had the most surveys to complete, so their missing data could be due to survey fatigue. Conclusions Much of the missing data for individuals can be explained by the site not administering those questions or scales. These results suggest a need for statistical methods that account for site-level missing data, and for research design methods to reduce the prevalence of site-level missing data or reduce its impact. Researchers can generate buy-in with sites during the community collaboration stage, assessing problematic items for revision or removal and need for ongoing site support, particularly at post-test. We recommend that researchers conducting multilevel data report the amount and mechanism of missing data at each level.

scholarly journals How does area-level deprivation depress an individual’s self-rated health and life satisfaction? Evidence from a nationwide population-based survey in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takashi Oshio ◽  
Hiromi Kimura ◽  
Toshimi Nishizaki ◽  
Takashi Omori
Keyword(s):  
Life Satisfaction ◽  
Health Behavior ◽  
Well Being ◽  
Population Based ◽  
Internet Survey ◽  
Subjective Well Being ◽  
Individual Level ◽  
Self Rated Health ◽  
Level Data ◽  
The Impact

Abstract Background Area-level deprivation is well known to have an adverse impact on mortality, morbidity, or other specific health outcomes. This study examined how area-level deprivation may affect self-rated health (SRH) and life satisfaction (LS), an issue that is largely understudied. Methods We used individual-level data obtained from a nationwide population-based internet survey conducted between 2019 and 2020, as well as municipality-level data obtained from a Japanese government database (N = 12,461 living in 366 municipalities). We developed multilevel regression models to explain an individual’s SRH and LS scores using four alternative measures of municipality-level deprivation, controlling for individual-level deprivation and covariates. We also examined how health behavior and interactions with others mediated the impact of area-level deprivation on SRH and LS. Results Participants in highly deprived municipalities tended to report poorer SRH and lower LS. For example, when living in municipalities falling in the highest tertile of municipality-level deprivation as measured by the z-scoring method, SRH and LS scores worsened by a standard deviation of 0.05 (p < 0.05) when compared with those living in municipalities falling in the lowest tertile of deprivation. In addition, health behavior mediated between 17.6 and 33.1% of the impact of municipality-level deprivation on SRH and LS, depending on model specifications. Conclusion Results showed that area-level deprivation modestly decreased an individual’s general health conditions and subjective well-being, underscoring the need for public health policies to improve area-level socioeconomic conditions.

scholarly journals Less than one-fifth of the mothers practised exclusive breastfeeding in the emerging regions of Ethiopia: a multilevel analysis of the 2016 Ethiopian demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu
Keyword(s):  
Health Survey ◽  
Exclusive Breastfeeding ◽  
Household Wealth ◽  
Community Level ◽  
Wealth Status ◽  
Individual Level ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
The Individual ◽  
Low Coverage

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.

scholarly journals Harnessing testing strategies and public health measures to avert COVID-19 outbreaks during ocean cruises

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gerardo Chowell ◽  
Sushma Dahal ◽  
Raquel Bono ◽  
Kenji Mizumoto
Keyword(s):  
Public Health ◽  
Cost Effective ◽  
Contact Network ◽  
Social Distancing ◽  
Individual Level ◽  
Health Measures ◽  
Testing Strategies ◽  
Novel Coronavirus ◽  
The Individual ◽  
The Impact

AbstractTo ensure the safe operation of schools, workplaces, nursing homes, and other businesses during COVID-19 pandemic there is an urgent need to develop cost-effective public health strategies. Here we focus on the cruise industry which was hit early by the COVID-19 pandemic, with more than 40 cruise ships reporting COVID-19 infections. We apply mathematical modeling to assess the impact of testing strategies together with social distancing protocols on the spread of the novel coronavirus during ocean cruises using an individual-level stochastic model of the transmission dynamics of COVID-19. We model the contact network, the potential importation of cases arising during shore excursions, the temporal course of infectivity at the individual level, the effects of social distancing strategies, different testing scenarios characterized by the test’s sensitivity profile, and testing frequency. Our findings indicate that PCR testing at embarkation and daily testing of all individuals aboard, together with increased social distancing and other public health measures, should allow for rapid detection and isolation of COVID-19 infections and dramatically reducing the probability of onboard COVID-19 community spread. In contrast, relying only on PCR testing at embarkation would not be sufficient to avert outbreaks, even when implementing substantial levels of social distancing measures.

scholarly journals The potential impacts of community drug checking within the overdose crisis: qualitative study exploring the perspective of prospective service users

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bruce Wallace ◽  
Thea van Roode ◽  
Flora Pagan ◽  
Dennis Hore ◽  
Bernadette Pauly
Keyword(s):  
Harm Reduction ◽  
Drug Market ◽  
Pilot Project ◽  
Service Users ◽  
Socioecological Model ◽  
Individual Level ◽  
Universal Approach ◽  
Drug Checking ◽  
Potential Benefits ◽  
The Individual

Abstract Background As drug checking becomes more integrated within public health responses to the overdose crisis, and potentially more institutionalized, there is value in critically questioning the impacts of drug checking as a harm reduction response. Methods As part of a pilot project to implement community drug checking in Victoria, BC, Canada, in-depth interviews (N = 27) were held with people who use or have used substances, family or friends of people who use substances, and/or people who make or distribute substances. Critical harm reduction and social justice perspectives and a socioecological model guided our analysis to understand the potential role of drug checking within the overdose crisis, from the perspective of prospective service users. Results Participants provided insight into who might benefit from community drug checking and potential benefits. They indicated drug checking addresses a “shared need” that could benefit people who use substances, people who care for people who use substances, and people who sell substances. Using a socioecological model, we identified four overarching themes corresponding to benefits at each level: “drug checking to improve health and wellbeing of people who use substances”, “drug checking to increase quality control in an unregulated market”, “drug checking to create healthier environments”, and “drug checking to mediate policies around substance use”. Conclusions Drug checking requires a universal approach to meet the needs of diverse populations who use substances, and must not be focused on abstinence based outcomes. As a harm reduction response, community drug checking has potential impacts beyond the individual level. These include increasing power and accountability within the illicit drug market, improving the health of communities, supporting safer supply initiatives and regulation of substances, and mitigating harms of criminalization. Evaluation of drug checking should consider potential impacts that extend beyond individual behaviour change and recognize lived realities and structural conditions.

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