scholarly journals The Financial Lives and Capabilities of Women Engaged in Sex Work: Can Paradoxical Autonomy Inform Intervention Strategies?

2021 ◽  
Vol 13 (6) ◽  
pp. 69
Author(s):  
Lyla S. Yang ◽  
Susan S. Witte ◽  
Carolina Vélez-Grau ◽  
Tara McCrimmon ◽  
Assel Terlikbayeva ◽  
...  
Keyword(s):  
Drug Use ◽  
Hiv Prevention ◽  
Food Insecurity ◽  
Sex Work ◽  
Controlled Trial ◽  
Well Being ◽  
Poverty Line ◽  
Computer Assisted ◽  
Daily Lives ◽  
Cluster Randomized

INTRODUCTION: Despite growing attention to structural approaches to HIV prevention, including economic empowerment interventions for key populations, few studies examine the financial lives of women engaged in sex work (WESW) and even fewer examine the financial lives of those who also use drugs. The purpose of this paper is to examine the financial status, sex work involvement, and individual and structural vulnerabilities of women involved in sex work and drug use in Kazakhstan. METHODS: We used baseline data from Project Nova, a cluster-randomized controlled trial that tested the efficacy of a combined HIV risk reduction and microfinance intervention for WESW in two cities in Kazakhstan. We collected data on income, savings, debt, sex work, drug use, homelessness, food insecurity, HIV status, attitudes towards safety, and financial knowledge from 400 participants through computer-assisted self-interview techniques. Descriptive statistics were utilized to describe and characterize the sample and aforementioned measures. RESULTS: Findings illustrate the paradoxical nature of sex work, wherein women may achieve economic independence despite the great adversities they encounter in their daily lives and work. The majority of women (65%) in this study reported being the highest income earner in the household, caring for up to 3 dependents, and demonstrated entrepreneurial characteristics and aspirations for the future. However, many were still living below the poverty line (72.5%), as well as experiencing high levels of homelessness (58%) and food insecurity (89.5%). CONCLUSION: Study findings underscore the need for better understanding of the existing capabilities of WESW and those who use drugs, including financial autonomy and community supports, that may guide the design of programs that most effectively promote women’s economic well-being and ensure that it is not at the expense of wellness and safety. Designing such programs requires incorporating a social justice lens into social work and public health interventions, including HIV prevention, and attention to the human rights of the most marginalized and highest risk populations, including WESW and those who use drugs.

scholarly journals Does #Tamojunto alter the dynamic between drug use and school violence among youth? Secondary analysis from a large cluster-randomized trial

2021 ◽  
Author(s):  
Hugo Cogo-Moreira ◽  
Julia D. Gusmões ◽  
Juliana Y. Valente ◽  
Michael Eid ◽  
Zila M. Sanchez
Keyword(s):  
Drug Use ◽  
School Violence ◽  
Causal Effect ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Cluster Randomized Trial ◽  
Random Intercept ◽  
Carry Over ◽  
Cluster Randomized ◽  
Use Behavior

AbstractThe present study investigated how intervention might alter the relationship between perpetrating violence and later drug use. A cluster-randomized controlled trial design involving 72 schools (38 intervention, 34 control) and 6390 students attending grades 7 and 8 was employed in Brazil. Drug use and violence were assessed at three points. A random-intercept cross-lagged panel model examined the reciprocal association between drug use and school violence domains across the three data collection waves. For both groups, we found that the cross-lagged effect of perpetration on further drug use in adolescents was stronger than the reverse, but the interrelationship was not statistically significant between #Tamojunto and control schools. The carry-over effects of drug use and violence were also not significantly different between groups. There is a lack of evidence showing that #Tamojunto can modify the dynamics between drug use and school violence across the 21-month period. The direction of the causal effect (i.e., the more perpetration behavior, the more subsequent drug use behavior) is present, but weak in both groups. The trial registration protocol at the national Brazilian Register of Clinical Trials (REBEC) is #RBR-4mnv5g.

scholarly journals Evaluation of the Intensive Treatment and Rehabilitation Program for Residential Treatment and Rehabilitation Centers (INTREPRET) in the Philippines: a study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Takayuki Harada ◽  
Toshiaki Baba ◽  
Tomohiro Shirasaka ◽  
Shogo Kanamori
Keyword(s):  
Randomized Controlled Trial ◽  
Drug Use ◽  
Treatment Program ◽  
Drug Users ◽  
Controlled Trial ◽  
Well Being ◽  
The Philippines ◽  
Consent Form ◽  
Comprehensive Treatment ◽  
Randomized Controlled

Abstract Background The Philippines has been severely affected by the methamphetamine crisis. The government has launched a policy war against drug use, although the severe sanctions imposed on drug users have been criticized internationally. To help implement a more effective and humane approach to drug use, this study aimed to introduce a comprehensive treatment program for methamphetamine users based on cognitive-behavioral therapy (CBT) whose effectiveness will be evaluated through a randomized controlled trial. Methods Methamphetamine users admitted into government-run rehabilitation facilities are recruited and randomly assigned to either a CBT-based treatment program or existing therapeutic community (TC)-based treatment. The CBT treatment program was developed based on the Matrix Model that considers cultural and social factors in the Philippines. After 6 months of treatment, there will be a three-month follow-up, when the participants’ drug use (tested through urine testing) and other psychological variables, including craving, coping skills, and well-being, will be compared. Potential participants are given a summary of the study and a consent form. The consent form is signed and dated by participants prior to their study participation. Ethical approval was obtained prior to the commencement of the study. Discussion This is the first randomized controlled trial to compare the residential CBT program and the TC model for methamphetamine users in the Philippines. The study aims to fill the current knowledge and capacity gaps by introducing a CBT-based treatment program to improve the psychosocial well-being of drug users in the Philippines. Moreover, if the effectiveness of the treatment program is demonstrated, anti-drug campaigns and severe sanctions against drug users may be reconsidered. Trial registration UMIN Clinical Trials Registry JPRN-UMIN000038597. Registered on 15 November 2019. Protocol version October 17, 2021 ver.2

scholarly journals Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-Being, Engagement, and Recovery: Protocol for a Feasibility Cluster Randomized Controlled Trial Harnessing Mobile Phone Technology Blended With Peer Support

10.2196/15058 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e15058 ◽  
Author(s):  
Andrew Gumley ◽  
Simon Bradstreet ◽  
John Ainsworth ◽  
Stephanie Allan ◽  
Mario Alvarez-Jimenez ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Digital Health ◽  
Controlled Trial ◽  
Well Being ◽  
Service Users ◽  
Main Trial ◽  
Definitive Trial ◽  
Randomized Controlled ◽  
Cluster Randomized

Background Relapse in schizophrenia is a major cause of distress and disability and is predicted by changes in symptoms such as anxiety, depression, and suspiciousness (early warning signs [EWSs]). These can be used as the basis for timely interventions to prevent relapse. However, there is considerable uncertainty regarding the implementation of EWS interventions. Objective This study was designed to establish the feasibility of conducting a definitive cluster randomized controlled trial comparing Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER) against treatment as usual (TAU). Our primary outcomes are establishing parameters of feasibility, acceptability, usability, safety, and outcome signals of a digital health intervention as an adjunct to usual care that is deliverable in the UK National Health Service and Australian community mental health service (CMHS) settings. We will assess the feasibility of candidate primary outcomes, candidate secondary outcomes, and candidate mechanisms for a definitive trial. Methods We will randomize CMHSs to EMPOWER or TAU. We aim to recruit up to 120 service user participants from 8 CMHSs and follow them for 12 months. Eligible service users will (1) be aged 16 years and above, (2) be in contact with local CMHSs, (3) have either been admitted to a psychiatric inpatient service or received crisis intervention at least once in the previous 2 years for a relapse, and (4) have an International Classification of Diseases-10 diagnosis of a schizophrenia-related disorder. Service users will also be invited to nominate a carer to participate. We will identify the feasibility of the main trial in terms of recruitment and retention to the study and the acceptability, usability, safety, and outcome signals of the EMPOWER intervention. EMPOWER is a mobile phone app that enables the monitoring of well-being and possible EWSs of relapse on a daily basis. An algorithm calculates changes in well-being based on participants’ own baseline to enable tailoring of well-being messaging and clinical triage of possible EWSs. Use of the app is blended with ongoing peer support. Results Recruitment to the trial began September 2018, and follow-up of participants was completed in July 2019. Data collection is continuing. The database was locked in July 2019, followed by analysis and disclosing of group allocation. Conclusions The knowledge gained from the study will inform the design of a definitive trial including finalizing the delivery of our digital health intervention, sample size estimation, methods to ensure successful identification, consent, randomization, and follow-up of participants, and the primary and secondary outcomes. The trial will also inform the final health economic model to be applied in the main trial. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 99559262; http://isrctn.com/ISRCTN99559262 International Registered Report Identifier (IRRID) DERR1-10.2196/15058

scholarly journals Early Signs Monitoring to Prevent Relapse in Psychosis and Promote Well-Being, Engagement, and Recovery: Protocol for a Feasibility Cluster Randomized Controlled Trial Harnessing Mobile Phone Technology Blended With Peer Support (Preprint)

2019 ◽  
Author(s):  
Andrew Gumley ◽  
Simon Bradstreet ◽  
John Ainsworth ◽  
Stephanie Allan ◽  
Mario Alvarez-Jimenez ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Digital Health ◽  
Controlled Trial ◽  
Well Being ◽  
Service Users ◽  
Main Trial ◽  
Definitive Trial ◽  
Randomized Controlled ◽  
Cluster Randomized

BACKGROUND Relapse in schizophrenia is a major cause of distress and disability and is predicted by changes in symptoms such as anxiety, depression, and suspiciousness (early warning signs [EWSs]). These can be used as the basis for timely interventions to prevent relapse. However, there is considerable uncertainty regarding the implementation of EWS interventions. OBJECTIVE This study was designed to establish the feasibility of conducting a definitive cluster randomized controlled trial comparing Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery (EMPOWER) against treatment as usual (TAU). Our primary outcomes are establishing parameters of feasibility, acceptability, usability, safety, and outcome signals of a digital health intervention as an adjunct to usual care that is deliverable in the UK National Health Service and Australian community mental health service (CMHS) settings. We will assess the feasibility of candidate primary outcomes, candidate secondary outcomes, and candidate mechanisms for a definitive trial. METHODS We will randomize CMHSs to EMPOWER or TAU. We aim to recruit up to 120 service user participants from 8 CMHSs and follow them for 12 months. Eligible service users will (1) be aged 16 years and above, (2) be in contact with local CMHSs, (3) have either been admitted to a psychiatric inpatient service or received crisis intervention at least once in the previous 2 years for a relapse, and (4) have an International Classification of Diseases-10 diagnosis of a schizophrenia-related disorder. Service users will also be invited to nominate a carer to participate. We will identify the feasibility of the main trial in terms of recruitment and retention to the study and the acceptability, usability, safety, and outcome signals of the EMPOWER intervention. EMPOWER is a mobile phone app that enables the monitoring of well-being and possible EWSs of relapse on a daily basis. An algorithm calculates changes in well-being based on participants’ own baseline to enable tailoring of well-being messaging and clinical triage of possible EWSs. Use of the app is blended with ongoing peer support. RESULTS Recruitment to the trial began September 2018, and follow-up of participants was completed in July 2019. Data collection is continuing. The database was locked in July 2019, followed by analysis and disclosing of group allocation. CONCLUSIONS The knowledge gained from the study will inform the design of a definitive trial including finalizing the delivery of our digital health intervention, sample size estimation, methods to ensure successful identification, consent, randomization, and follow-up of participants, and the primary and secondary outcomes. The trial will also inform the final health economic model to be applied in the main trial. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN): 99559262; http://isrctn.com/ISRCTN99559262

scholarly journals Norms and Social Network–Centric Behavior Change Intervention (Nam Nalavazhvu) for Improved Toilet Usage in Peri-Urban Communities of Tamil Nadu: Protocol for a Cluster-Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Sania Ashraf ◽  
Cristina Bicchieri ◽  
Maryann G Delea ◽  
Upasak Das ◽  
Kavita Chauhan ◽  
...  
Keyword(s):  
Behavior Change ◽  
Low Income ◽  
Tamil Nadu ◽  
Controlled Trial ◽  
Well Being ◽  
Baseline Survey ◽  
Behavior Change Intervention ◽  
Behavior Change Interventions ◽  
Cluster Randomized ◽  
The Impact

BACKGROUND Inconsistent toilet usage is a continuing challenge in India. Despite the impact of social expectations on toilet usage, few programs and studies have developed theoretically grounded norm-centric behavior change interventions to increase toilet use in low-income settings. OBJECTIVE The objective of this paper is to detail the rationale and design of an ex ante, parallel cluster-randomized trial evaluating the impact of a demand-side, norm-centric behavior change intervention on exclusive toilet use and maintenance in peri-urban Tamil Nadu, India. METHODS Following formative research, we developed an evidence-based norm-centric behavior change intervention called Nam Nalavazhvu (Tamil for “our well-being”). The multilevel intervention aims to improve toilet usage by shifting empirical expectations or beliefs about other relevant people’s sanitation practices. It also provides action-oriented information to aid individuals to set goals and overcome barriers to own, consistently use, and maintain their toilets. This trial includes 76 wards in the Pudukkottai and Karur districts, where half were randomly assigned to receive the intervention and the remaining served as counterfactuals. RESULTS We enrolled wards and conducted a baseline survey among randomly selected individuals in all 76 wards. The 1-year behavior change intervention is currently ongoing. At the endline, we will collect relevant data and compare results between study arms to determine the impacts of the Nam Nalavazhvu intervention on sanitation-related behavioral, health, and well-being outcomes and potential moderators. This study is powered to detect differences in the prevalence of exclusive toilet use between study arms. We are also conducting a process evaluation to understand the extent to which the intervention was implemented as designed, given the special pandemic context. CONCLUSIONS Findings from this trial will inform norm-centric behavior change strategies to improve exclusive toilet usage. CLINICALTRIAL ClinicalTrials.gov NCT04269824; https://www.clinicaltrials.gov/ct2/show/NCT04269824 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24407

scholarly journals Positive Youth Development and Mental Well-Being in Late Adolescence: The Role of Body Appreciation. Findings From a Prospective Study in Norway

2021 ◽  
Vol 12 ◽  
Author(s):  
Helga Bjørnøy Urke ◽  
Ingrid Holsen ◽  
Torill Larsen
Keyword(s):  
Youth Development ◽  
Positive Youth Development ◽  
Controlled Trial ◽  
Well Being ◽  
The Body ◽  
Body Appreciation ◽  
Healthy Development ◽  
Cluster Randomized ◽  
A Prospective Study ◽  
Mental Well Being

Although a vulnerable period, adolescence is a time of great potential for healthy development. Understanding factors that contribute to mental well-being in this period is of great importance to facilitate for healthy development. During the adolescence period the body goes through rapid and considerable changes, and the focus on body appearance and perfection is substantial at societal, media, and peer level. In this study, we investigated the association between dimensions characterizing positive youth development, and mental well-being among Norwegian adolescents 16–17 years 1 year later, and whether this association was mediated by degree of body appreciation. We further tested whether the indirect and direct paths between positive youth development dimensions and mental well-being were moderated by gender. We used data from the first and second follow-up of the control arm of the COMPLETE study, a cluster randomized controlled trial in upper secondary schools in Norway. Findings showed that positive youth development in grade 1, as measured by both a combined global PYD and the dimensions competence, and connection were significantly associated with mental well-being in grade 2 in models adjusted for mental well-being in grade 1, gender and perceived family affluence. Also, body appreciation in grade 1 significantly predicted mental well-being in grade 2 in models including each of global PYD, competence, connection, character, and caring dimensions. Contrary to our hypothesis, no mediating effects of body appreciation were observed, and no moderation of indirect effects by gender were observed.

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