Barriers to Entry into 12-Step Mutual Help Groups among Justice-Involved Women with Alcohol Use Disorders.
Ontology highlight
ABSTRACT:
SUBMITTER: Schonbrun YC
PROVIDER: S-EPMC7518285 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
Publications
Barriers to Entry into 12-Step Mutual Help Groups among Justice-Involved Women with Alcohol Use Disorders.
Schonbrun Yael Chatav YC Anderson Bradley J BJ Johnson Jennifer E JE Kurth Megan M Timko Christine C Stein Michael D MD
Alcoholism treatment quarterly 20180124 1
Although involvement in twelve step mutual help groups (TMGs) is an accessible and effective means of addressing alcohol problems, many justice-involved women do not attend. This study examined barriers to TMG attendance for 135 justice-involved women with alcohol use disorders. TMG attenders were more likely than non-attenders to say their past contacts with people in TMGs were not helpful (χ<sup>2</sup> = 4.91, p =.027); non-attenders were more likely to report that they did not want to change ...[more]
Similar Datasets
Project description:BackgroundMany studies suggest that participation in 12-step groups contributes to better recovery outcomes, but people often object to such groups and most do not sustain regular involvement. Yet, research on alternatives to 12-step groups is very sparse. The present study aimed to extend the knowledge base on mutual help group alternatives for those with an alcohol use disorder (AUD), sampling from large, active, abstinence-focused groups including Women for Sobriety (WFS), LifeRing, and SMART Recovery (SMART). This paper presents a cross-sectional analysis of this longitudinal study, using baseline data to describe the profile and participation characteristics of attendees of these groups in comparison to 12-step members.MethodsData from participants 18 and over with a lifetime AUD (N=651) were collected using Web-based surveys. Members of alternative 12-step groups were recruited in collaboration with group directors, who helped publicize the study by emailing meeting conveners and attendees and posting announcements on social media. A comparison group of current (past-30-day) 12-step attendees was recruited from an online meeting hub for recovering persons. Interested parties were directed to a Webpage where they were screened, and eligible participants completed an online survey assessing demographic and clinical variables; in-person and online mutual help involvement; and group satisfaction and cohesion. Analyses involved comparing those identifying WFS, SMART, and LifeRing as their primary group to 12-step members on the above characteristics.ResultsCompared to 12-step members, members of the mutual help alternatives were less religious and generally higher on education and income. WFS and LifeRing members were also older, more likely to be married, and lower on lifetime drug and psychiatric severity; meanwhile, LifeRing and SMART members were less likely to endorse the most stringent abstinence goal. Finally, despite lower levels of in-person meeting attendance, members of all the 12-step alternatives showed equivalent activity involvement and higher levels of satisfaction and cohesion, compared to 12-step members.ConclusionsResults suggest differences across 12-step groups and their alternatives that may be relevant when advising clients on a choice of mutual help group. Meanwhile, findings for high levels of participation, satisfaction, and cohesion among members of the mutual help alternatives suggest promise for these groups in addressing addiction problems.
| S-EPMC5193234 | biostudies-literature
Project description: Not available
| S-EPMC7065341 | biostudies-literature
Project description:OBJECTIVE:The purpose of this study was to determine whether vocational supports for emerging adults with serious mental health conditions who are at high risk for rearrest are more effectively served within Multisystemic Therapy for Emerging Adults (MST-EA) through vocationally enhanced MST-EA Coaches or through referral to state vocational rehabilitation services. METHOD:A pilot randomized controlled trial examined two MST-EA Coaching approaches. In the Standard Coach + VR condition (n = 16), MST-EA Coaches delivered standard skills curricula to participants and referred them to state vocational rehabilitation (VR) services for vocational supports. In the Vocational Coach (VC) condition (n = 16), MST-EA Coaches delivered the standard skills curricula enhanced with extensive education/employment components. Analyses included pre- to posttreatment comparisons of vocational outcomes, and between groups comparisons of fidelity, satisfaction, and services utilization. RESULTS:Those in the VC condition had a 12-fold increase in the odds of posttreatment vocational activity compared with those in the Standard Coach + VR condition (92.9 vs. 57.1% employed or in school, respectively). Subgroup analyses of those who engaged in Coaching showed that there was specifically an increase in the odds of posttreatment educational engagement among those in the VC condition compared with those in Standard Coach + VR. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE:Based on the strength of the findings in this small pilot study the VC should be included in future clinical trials of MST-EA to maximize treatment impact for supporting emerging adult vocational functioning and thus reducing antisocial behavior. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
| S-EPMC6776998 | biostudies-literature
Project description:BACKGROUND:Over half of veterans in the criminal justice system have mental health or substance use disorders. However, there is a critical lack of information about female veterans in the criminal justice system and how diagnosis prevalence and treatment entry differ by sex. OBJECTIVES:To document prevalence of mental health and substance use disorder diagnoses and treatment entry rates among female veterans compared with male veterans in the justice system. RESEARCH DESIGN:Retrospective cohort study using national Veterans Health Administration clinical/administrative data from veterans seen by Veterans Justice Outreach Specialists in fiscal years 2010-2012. SUBJECTS:A total of 1535 females and 30,478 male veterans were included. MEASURES:Demographic characteristics (eg, sex, age, residence, homeless status), mental health disorders (eg, depression, post-traumatic stress disorder), substance use disorders (eg, alcohol and opioid use disorders), and treatment entry (eg, outpatient, residential, pharmacotherapy). RESULTS:Among female veterans, prevalence of mental health and substance use disorders was 88% and 58%, respectively, compared with 76% and 72% among male veterans. Women had higher odds of being diagnosed with a mental health disorder [adjusted odds ratio (AOR)=1.98; 95% confidence interval (CI), 1.68-2.34] and lower odds of being diagnosed with a substance use disorder (AOR=0.50; 95% CI, 0.45-0.56) compared with men. Women had lower odds of entering mental health residential treatment (AOR=0.69; 95% CI, 0.57-0.83). CONCLUSIONS:Female veterans involved in the justice system have a high burden of mental health disorders (88%) and more than half have substance use disorders (58%). Entry to mental health residential treatment for women is an important quality improvement target.
| S-EPMC5764085 | biostudies-literature
Project description:IntroductionReadiness to change is a key component of substance use behavioral change; yet little is known about readiness to change among justice-involved young adults. This study 1) describes readiness to change alcohol and drug use and 2) examines predictors of readiness to change alcohol and drug use among justice-involved young adults.MethodJustice-involved young adults (18-24 years; n = 137) who were positive on a validated alcohol and/or drug screening tool completed an interview assessing substance use, readiness to change, and reasons to quit. A multivariable linear regression model examined whether reasons to change and substance use severity, and interactions between these, predicted readiness.ResultsMore than half of participants were contemplating or had decided to quit/cut down substance use. Personal reasons to quit were positively related to readiness to change; interpersonal reasons were negatively associated.ConclusionsThis study contributes information needed to design motivational interventions for substance use among justice-involved young adults. Personal reasons to quit using drugs are a potential intervention target.
| S-EPMC9485898 | biostudies-literature
Project description:BACKGROUND:Alcohol use disorder (AUD) constitutes a major public health problem and is associated with a substantial amount of disability and premature death worldwide. Several treatment and self-help options including Alcoholics Anonymous (AA) meetings are available. Nevertheless, factors associated with AA affiliation in some disadvantaged groups such as justice-involved women are not well understood. The purpose of this study is to report on previously unexamined correlates of past year AA affiliation among women in pretrial jail detention. METHODS:The current study used cross-sectional data from 168 women with DSM-5 diagnosis of AUD in pretrial jail detention. The study examined factors related to women's concept of self and others (i.e., disbelief that others are trustworthy, lack of autonomy to choose who they interact with, experience of violent victimization, low investment in self-care, higher stress levels, and homelessness) as correlates of past-year AA affiliation, controlling for severity of AUD and demographic factors. RESULTS:Women who believe that others are inherently trustworthy, women who met less AUD criteria, and women who are older reported more past-year AA affiliation in both univariate and multivariate analyses. CONCLUSION:Introducing AA outreach and alternative interventions for younger, less severely addicted women might improve AUD outcomes. Moreover, designing more individualized treatment plan for women who believe others are not trust worthy might help AUD treatment engagement in this population. TRIAL REGISTRATION:NCT01970293 , 10/28/2013.
| S-EPMC6042328 | biostudies-literature
Project description:BackgroundLone-mother led families are at increased risk of psychosocial disadvantage, social isolation and mental health morbidity. Community-based programs are more accessible for families seeking assistance. We examine the experiences of eight lone mothers participating in a larger randomized controlled trial (RCT) of a community-based education/support group program using mixed methods.MethodsA purposeful sample of eight mothers participating in the intervention arm of an RCT of community-based support/education groups was selected for the qualitative study. Individual interviews asked mothers about themselves and their relationships with their children before and after the group. Interviews were taped, transcribed and content analysis was used to code and interpret the data. Quantitative data collected in the RCT were used to describe these mothers.ResultsMothers participating in the RCT and qualitative study experienced multiple difficulties, including financial and mood problems. These mothers reported that before participating in the group, they had shared experiences of social isolation, stigma, a sense of failure, poor relationships with their children and difficulties with financial management. After the group, mothers identified improved self-esteem, support from other mothers, improved parenting skills and improved communication with their children as outcomes of group participation.ConclusionsThe qualitative data revealed mothers' perceptions of specific areas that improved by participating in the group. The utility of complementary information provided by qualitative and quantitative methods in understanding program impact, as well as the need for broader assistance is noted.
| S-EPMC2820475 | biostudies-literature
Project description:ObjectiveResearch exploring the enablers and barriers that exist for military veterans seeking to address their poor mental health has produced ambiguous results. To identify the enablers and barriers correctly, this study systematically reviews the literature, including research that included alcohol and had a clearly defined veteran population.MethodsSix databases were searched. Inclusion criteria specified that empirical studies related to veterans that had ceased military service and were seeking help for poor mental health and/or alcohol difficulties. Critical Appraisal Skills Programme and AXIS appraisal tools were used to assess quality and bias. A narrative synthesis approach was adopted for analysis. From 2044 studies screened, 12 were included featuring 5501 participants.ResultsForty-four enablers and barriers were identified, with thirty-two being statistically significant. Post-traumatic stress disorder had the greatest number of enabler/barrier endorsements to veterans seeking help. Depression, anxiety, experience and attitudes also acted as enablers/barriers. Most studies were of fair methodological quality. Limitations included that samples were skewed towards US army veterans. Little research exists concerning those that have ceased military service.ConclusionsVeteran help-seeking is likely enabled by poor mental health symptomology and comorbidity, which suggests veterans reach a crisis point before they seek help. Further research on alcohol misuse and attitude formation is required. The field would also benefit from alternative study designs including qualitative studies with non-US participants.
| S-EPMC10363942 | biostudies-literature
Project description:Does representative hazardous-waste-site testing tend to follow or to violate government technical guidance? This is an important question, because following such guidance promotes reliable risk analysis, adequate remediation, and environmental-justice and -health protection. Yet only government documents typically address this question, usually only when it is too late, when citizens have already exhibited health harm, allegedly from living or working near current/former hazardous-waste sites. Because no systematic, representative, scientific analyses have answered the preceding question, this article begins to investigate it by posing a narrower part of the question: Does representative US testing of volatile-organic-compound (VOC) waste sites tend to follow or to violate government technical requirements? The article (i) outlines US/state-government technical guidance for VOC testing; (ii) develops criteria for discovering representative US cases of VOC testing; (iii) uses the dominant US Environmental Protection Agency method to assess whether these representative cases follow such guidance; (iv) employs the results of (iii) to begin to answer the preceding question; then (v) discusses the degree to which, if any, these results suggest threats to environmental health or justice. Our initial, but representative, results show that almost all US VOC-waste-site testing (that we investigated) violates government technical requirements and systematically underestimates risks, and this may help justify less expensive, potentially health-threatening cleanups, mostly in environmental justice communities. We outline needed future research and suggest two strategies to promote following government technical guidance for hazardous-waste testing.
| S-EPMC9265884 | biostudies-literature
Project description:The influence of the alcohol industry, also known as "corporate political activity" (CPA), is documented as one of the main barriers in implementing effective alcohol control policies. In Portugal, despite an alcohol consumption above the European average, alcohol control does not feature in the current National Health Plan. The present research aimed to identify and describe the CPA of the alcohol industry in Portugal. Publicly-available data published between January 2018 and April 2019 was extracted from the main websites and social media accounts of alcohol industry trade associations, charities funded by the industry, government, and media. A "Policy Dystopia" framework, used to describe the CPA strategies of the tobacco industry, was adapted and used to perform a qualitative thematic analysis. Both instrumental and discursive strategies were found. The industry works in partnership with health authorities, belonging to the national task force responsible for planning alcohol control policies. Additionally, it emphasizes the role alcohol plays in Portuguese culture as a way to disregard evidence on control policies from other countries. This paper presents the first description of CPA by the alcohol industry in Portugal and provides evidence for the adoption of stricter control policies in the country.
| S-EPMC6888387 | biostudies-literature