scholarly journals Gender Differences in Smoking Among an Urban Emergency Department Sample

2019 ◽  
Vol 12 ◽  
pp. 1179173X1987913 ◽  
Author(s):  
Carol B Cunradi ◽  
Juliet Lee ◽  
Anna Pagano ◽  
Raul Caetano ◽  
Harrison J Alter
Keyword(s):  
Gender Differences ◽  
Emergency Department ◽  
Substance Use ◽  
Partner Violence ◽  
Regression Models ◽  
Food Insufficiency ◽  
Polysubstance Use ◽  
Same Gender ◽  
The Impact ◽  
Urban Emergency Department

Background: Urban emergency department (ED) patients have elevated smoking and substance use compared with the general population. We analyzed gender differences in smoking among an urban ED sample and assessed the contribution of substance use, demographic, and couple factors. Methods: We conducted a secondary analysis of data obtained from a cross-sectional, observational survey (N = 1037 participants) on drinking, drug use, and intimate partner violence (IPV). Gender-specific logistic regression models for current (past 30-day) smoking and multinomial regression models for smoking intensity (light: ⩽5 cigarettes per day [CPD]; moderate: 6 to 10 CPD; heavier: >10 CPD) were estimated. Results: Smoking prevalence was higher among men than women (35.5% vs 18.9%; P < .001). Substance use (frequency of intoxication, marijuana, amphetamine, and cocaine use), demographic (food insufficiency, unemployment), and couple-related factors (having a spouse/partner who smoked, IPV involvement, being in a same-gender couple) were differentially associated with current smoking and level of intensity among men and women. Conclusions: Emergency department staff should consider the impact of polysubstance use, food insufficiency, unemployment, and whether both partners in the couple smoke when screening patients for smoking and formulating cessation treatment plans. Women in same-gender relationships and those who have experienced IPV involvement may require additional referral.

scholarly journals Frequency of Intimate Partner Violence among an Urban Emergency Department Sample: A Multilevel Analysis

2020 ◽  
Vol 18 (1) ◽  
pp. 222
Author(s):  
Carol B. Cunradi ◽  
William R. Ponicki ◽  
Raul Caetano ◽  
Harrison J. Alter
Keyword(s):  
Emergency Department ◽  
Intimate Partner Violence ◽  
Substance Use ◽  
Partner Violence ◽  
Safety Net ◽  
Intimate Partner ◽  
Socially Disadvantaged ◽  
Safety Net Hospital ◽  
Individual Household ◽  
Urban Emergency Department

Intimate partner violence (IPV) is a pervasive public health problem. Within the U.S., urban emergency department (ED) patients have elevated prevalence of IPV, substance use, and other social problems compared to those in the general household population. Using a social-ecological framework, this cross-sectional study analyzes the extent to which individual, household, and neighborhood factors are associated with the frequency of IPV among a socially disadvantaged sample of urban ED patients. Confidential survey interviews were conducted with 1037 married/partnered study participants (46% male; 50% Hispanic; 29% African American) at a public safety-net hospital. Gender-stratified multilevel Tobit regression models were estimated for frequency of past-year physical IPV (perpetration and victimization) and frequency of severe IPV. Approximately 23% of participants reported IPV. Among men and women, impulsivity, adverse childhood experiences, substance use, and their spouse/partner’s hazardous drinking were associated with IPV frequency. Additionally, household food insufficiency, being fired or laid off from their job, perceived neighborhood disorder, and neighborhood demographic characteristics were associated with IPV frequency among women. Similar patterns were observed in models of severe IPV frequency. IPV prevention strategies implemented in urban ED settings should address the individual, household, and neighborhood risk factors that are linked with partner aggression among socially disadvantaged couples.

scholarly journals The Impact of a Concierge Medicine Model on Door to Doctor Time and Patient Flow in an Urban Emergency Department

2020 ◽  
Vol Volume 12 ◽  
pp. 13-18
Author(s):  
Asher L Mandel ◽  
Thomas Bove ◽  
Amisha D Parekh ◽  
Paris Datillo ◽  
Joseph Bove Jr ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
The Impact ◽  
Urban Emergency Department

scholarly journals Individual and poly-substance use and condomless sex among HIV-uninfected adults reporting heterosexual sex in a multi-site cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. J. Fredericksen ◽  
B. M. Whitney ◽  
E. Trejo ◽  
R. M. Nance ◽  
E. Fitzsimmons ◽  
...  
Keyword(s):  
Substance Use ◽  
Fixed Effects ◽  
Hiv Status ◽  
Anal Sex ◽  
Condomless Sex ◽  
Polysubstance Use ◽  
Vaginal Sex ◽  
Heterosexual Sex ◽  
The Impact ◽  
Hiv Negative

Abstract Background We analyzed the association between substance use (SU) and condomless sex (CS) among HIV-negative adults reporting heterosexual sex in the Seek, Test, Treat, and Retain (STTR) consortium. We describe the impact of SU as well as person/partner and context-related factors on CS, identifying combinations of factors that indicate the highest likelihood of CS. Methods We analyzed data from four US-based STTR studies to examine the effect of SU on CS using two SU exposures: 1) recent SU (within 3 months) and 2) SU before/during sex. Behavioral data were collected via 1:1 or self-administered computerized interviews. Adjusted individual-study, multivariable relative risk regression was used to examine the relationship between CS and SU. We also examined interactions with type of sex and partner HIV status. Pooled effect estimates were calculated using traditional fixed-effects meta-analysis. We analyzed data for recent SU (n = 6781; 82% men, median age = 33 years) and SU before/during sex (n = 2915; 69% men, median age = 40 years). Results For both exposure classifications, any SU other than cannabis increased the likelihood of CS relative to non-SU (8–16%, p-values< 0.001). In the recent SU group, however, polysubstance use did not increase the likelihood of CS compared to single-substance use. Cannabis use did not increase the likelihood of CS, regardless of frequency of use. Type of sex was associated with CS; those reporting vaginal and anal sex had a higher likelihood of CS compared to vaginal sex only for both exposure classifications (18–21%, p < 0.001). Recent SU increased likelihood of CS among those reporting vaginal sex only (9–10%, p < 0.001); results were similar for those reporting vaginal and anal sex (5–8%, p < 0.01). SU before/during sex increased the likelihood of CS among those reporting vaginal sex only (20%; p < 0.001) and among those reporting vaginal and anal sex (7%; p = 0.002). Single- and poly-SU before/during sex increased the likelihood of CS for those with exclusively HIV-negative partners (7–8%, p ≤ 0.02), and for those reporting HIV-negative and HIV-status unknown partners (9–13%, p ≤ 0.03). Conclusion Except for cannabis, any SU increased the likelihood of CS. CS was associated with having perceived HIV-negative partners and with having had both anal/vaginal sex.

scholarly journals Intimate Partner Violence Documentation and Awareness in an Urban Emergency Department

Cureus ◽  
2019 ◽  
Author(s):  
Janeske Vonkeman ◽  
Paul Atkinson ◽  
Jacqueline Fraser ◽  
Rose McCloskey ◽  
Adrian Boyle
Keyword(s):  
Emergency Department ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Intimate Partner ◽  
Urban Emergency Department

Military Cohorts, Substance Use, and Male-Perpetrated Intimate Partner Violence

2020 ◽  
pp. 107780121989347
Author(s):  
Roberto Cancio
Keyword(s):  
Intimate Partner Violence ◽  
Substance Use ◽  
Partner Violence ◽  
Military Families ◽  
Intimate Partner ◽  
Adult Health ◽  
National Longitudinal Study ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

This study considers variations of intimate partner violence (IPV) from the point of the perpetrator to test the impact of demographic factors on the type of IPV most prevalent among pre-9/11 and post-9/11 military families from the National Longitudinal Study of Adolescent to Adult Health (1994–2008): Waves I and IV in-home interviews ( N = 499). Study findings indicate that the perpetration of physical and sexual IPV depends on the context of veteran cohort and race/ethnicity. Models for substance use and IPV patterns were not similar across military cohorts and/or racial/ethnic groups.

scholarly journals “That's Where the Arguments Come in”: A Qualitative Analysis of Booster Sessions following a Brief Intervention for Drug Use and Intimate Partner Violence in the Emergency Department

2016 ◽  
Vol 10 ◽  
pp. SART.S33388 ◽  
Author(s):  
Esther K. Choo ◽  
Chantal Tapé ◽  
Kimberly M. Glerum ◽  
Michael J. Mello ◽  
Caron Zlotnick ◽  
...  
Keyword(s):  
Emergency Department ◽  
Intimate Partner Violence ◽  
Substance Use ◽  
Drug Use ◽  
Qualitative Analysis ◽  
Brief Intervention ◽  
Partner Violence ◽  
Intimate Partner ◽  
Abusive Relationships ◽  
Booster Sessions

Although booster phone calls have been used to enhance the impact of brief interventions in the emergency department, there has been less number of studies describing the content of these boosters. We conducted a qualitative analysis of booster calls occurring two weeks after an initial Web-based intervention for drug use and intimate partner violence (IPV) among women presenting for emergency care, with the objective of identifying the following: progress toward goals set during the initial emergency department visit, barriers to positive change, and additional resources and services needed in order to inform improvements in future booster sessions. The initial thematic framework was developed by summarizing codes by major themes and subthemes; the study team collaboratively decided on a final thematic framework. Eighteen participants completed the booster call. Most of them described a therapeutic purpose for their drug use. Altering the social milieu was the primary means of drug use change; this seemed to increase isolation of women already in abusive relationships. Women described IPV as interwoven with drug use. Participants identified challenges in attending substance use treatment service and domestic violence agencies. Women with substance use disorders and in abusive relationships face specific barriers to reducing drug use and to seeking help after a brief intervention.

scholarly journals Substance use and HIV stage at entry into care among people with HIV

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Canada Parrish ◽  
Bridget M. Whitney ◽  
Robin M. Nance ◽  
Nancy Puttkammer ◽  
Paul Fishman ◽  
...  
Keyword(s):  
Substance Use ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Regression Models ◽  
Hiv Care ◽  
Hiv Disease ◽  
Methamphetamine Use ◽  
Early Entry ◽  
Timing Of Entry ◽  
The Impact

Abstract Background Information regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage. Methods We examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site. Results We found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances. Conclusion Early entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.

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