Dataset Information

Independent and Interactive Effects of Neighborhood Disadvantage and Social Network Characteristics on Problem Drinking after Treatment.

ABSTRACT: Socioecological approaches to public health problems like addiction emphasize the importance of person-environment interactions. Neighborhood and social network characteristics may influence the likelihood of relapse among individuals in recovery, but these factors have been understudied, particularly with respect to conceptualizing social network characteristics as moderators of neighborhood disadvantage. Drawing from a larger prospective study of individuals recruited from outpatient treatment (N=451) and interviewed 1, 3, 5, and 7 years later, the aim of this study was to examine the independent and interactive effects of neighborhood and social network characteristics on continued problem drinking after treatment. Models using generalized estimating equations controlling for demographic and other risk factors found the number of heavy drinkers in one's network increases risk of relapse, with the effects being significantly stronger among those living in disadvantaged neighborhoods than among those in non-disadvantaged neighborhoods. No independent effects were found for neighborhood disadvantage or for the number of network members supporting reduced drinking. Future research is needed to examine potential protective factors in neighborhoods which may offset socioeconomic disadvantage as well as to investigate the functions that network members serve in helping to improve long-term treatment outcomes.

SUBMITTER: Mericle AA

PROVIDER: S-EPMC5894881 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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Independent and Interactive Effects of Neighborhood Disadvantage and Social Network Characteristics on Problem Drinking after Treatment.

Mericle Amy A AA Kaskutas Lee A LA Polcin Doug L DL Karriker-Jaffe Katherine J KJ

Journal of social and clinical psychology 20180101 1

Socioecological approaches to public health problems like addiction emphasize the importance of person-environment interactions. Neighborhood and social network characteristics may influence the likelihood of relapse among individuals in recovery, but these factors have been understudied, particularly with respect to conceptualizing social network characteristics as moderators of neighborhood disadvantage. Drawing from a larger prospective study of individuals recruited from outpatient treatment ...[more]

PMID: 29657357

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Project description:ObjectiveRecent studies have highlighted socioeconomic disparities in the severity and management of abdominal aortic aneurysm (AAA) disease. However, these studies focus on individual measures of social disadvantage such as income and insurance status. The area deprivation index (ADI), a validated measure of neighborhood deprivation, provides a more comprehensive assessment of social disadvantage. Therefore, we examined the impact of ADI on AAA severity and its management.MethodsWe identified all patients who underwent endovascular or open repair of an AAA in the Vascular Quality Initiative registry between 2003 and 2020. An ADI score of 1 to 100 was assigned to each patient based on their residential zip code, with higher ADI scores corresponding with increasing deprivation. Patients were categorized by ADI quintiles. Outcomes of interest included rates of ruptured AAA (rAAA) repair versus an intact AAA repair and rates of endovascular repair (EVAR) versus the open approach. Logistic regression was used to evaluate for an independent association between ADI quintile and these outcomes.ResultsAmong 55,931 patients who underwent AAA repair, 6649 (12%) were in the lowest ADI quintile, 11,692 (21%) in the second, 15,958 (29%) in the third, 15,035 (27%) in the fourth, and 6597 (12%) in the highest ADI quintile. Patients in the two highest ADI quintiles had a higher proportion of rAAA repair (vs intact repair) compared with those in the lowest ADI quintile (8.8% and 9.1% vs 6.2%; P < .001). They were also less likely to undergo EVAR (vs open approach) when compared with the lowest ADI quintile (81% and 81% vs 88%; P < .001). There was an overall trend toward increasing rAAA and decreasing EVAR rates with increasing ADI quintiles (P < .001). In adjusted analyses, when compared with patients in the lowest ADI quintile, patients in the highest ADI quintile had higher odds of rAAA repair (odds ratio, 1.4; 95% confidence interval, 1.2-1.8; P < .001) and lower odds of undergoing EVAR (odds ratio, 0.54; 95% confidence interval, 0.45-0.65; P < .001).ConclusionsAmong patients who underwent AAA repair in the Vascular Quality Initiative, those with higher neighborhood deprivation had significantly higher rates of rAAA repair (vs intact repair) and lower rates of EVAR (vs open approach). Further work is needed to better understand neighborhood factors that are contributing to these disparities to identify community-level targets for improvement.

Project description:Although alcohol is socially accepted in most Western societies, studies are clear about its associated negative consequences, especially among university and college students. Studies on the relationship between alcohol-related consequences and both beverage type and drinking onset, however, are scarce, especially in a European context. The aim of this research was, therefore, twofold: (1) What is the relationship between beverage type and the negative consequences experienced by students? and (2) Are these consequences determined by early drinking onset? We will examine these questions within the context of a wide range of alcohol-related consequences.The analyses are based on data collected by the inter-university project 'Head in the clouds?', measuring alcohol use among students in Flanders (Belgium). In total, a large dataset consisting of information from 19,253 anonymously participating students was available. Negative consequences were measured using a shortened version of the Core Alcohol and Drug Survey (CADS_D). Data were analysed using negative binomial regression.Results vary depending on the type of alcohol-related consequences: Personal negative consequences occur frequently among daily beer drinkers. However, a high rate of social negative consequences was recorded for both daily beer drinkers and daily spirits drinkers. Finally, early drinking onset was significantly associated with both personal and social negative consequences, and this association was especially strong between beer and spirits drinking onset and social negative consequences.Numerous negative consequences, both personal and social, are related to frequent beer and spirits drinking. Our findings indicate a close association between drinking beer and personal negative consequences as well as between drinking beer and/or spirits and social negative consequences. Similarly, early drinking onset has a major influence on the rates of both personal and social negative consequences. The earlier students started drinking, the more negative consequences they experienced during college or university. Several (policy) interventions are discussed. This study is the first to incorporate detailed information on both beverage type and drinking onset, and its associated negative consequences, as measured by the CADS_D, in a large student population.

Dataset Information

Independent and Interactive Effects of Neighborhood Disadvantage and Social Network Characteristics on Problem Drinking after Treatment.

Publications

Independent and Interactive Effects of Neighborhood Disadvantage and Social Network Characteristics on Problem Drinking after Treatment.

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