The purpose of this study was to determine what influence scheduled phone contacts would have on the extent of follow-through of continuing care recommednations by participants after treatment. Continuing care recommendations associated with ongoing sobriety include going to another level of care (individual therapy, group therapy, outpatient treatment), attending twelve-step meetings and communicating with a sponsor. Continuing care recommendations are typically written and referred to as a continuing care plan.

No description available.

In an effort to bridge the gap between public health practice and academia, the Health Resources and Services Administration (HRSA)-funded Tennessee Public Health Training Center (LIFEPATH) has supported establishment of an Academic Health Department (AHD) involving the East Tennessee State University (ETSU) College of Public Health (COPH) and the Sullivan County Regional Health Department (SCRHD). The SCRHD identified a need to increase internal capacity to conduct ongoing community health assessments and community-oriented practice. Similarly, the COPH recognized the need to expand field-based public health practice opportunities for students. Personnel from SCRHD, LIFEPATH, and COPH developed a formal AHD memorandum of understanding during the summer of 2012, launching the program in fall 2012. The COPH/SCRHD model addresses financial barriers experienced by other AHDs by competitively awarding the Coordinator position to a Doctor of Public Health (DrPH) student from the COPH, demonstrating investment in the model by the COPH. The DrPH student gains valuable leadership experience through project management, coordination of the local health council, and day-to-day facilitation of undergraduate and master's student interns. SCRHD benefits from formally trained graduate-level interns dedicated to long-term work within the community. This AHD offers a unique opportunity for doctoral-level students to develop practical leadership skills in a functioning health department, while enhancing the capacity of SCRHD and COPH to serve their community and stakeholders.

Maintaining the health of Tennesseans depends heavily on a well-trained, efficient public health workforce that can work effectively in a complex environment. In order to assess the training needs of this group, the Tennessee Public Health Training Center-LIFEPATH administered a survey to all governmental public health employees in Tennessee during the summer of 2012. This instrument was modeled after previous assessments conducted by health agencies outside of Tennessee which utilized as their rubric the Core Competencies for Public Health Professionals developed by the Council on Linkages between Academia and Public Health Practice. The goal of this research was to inform and streamline educational efforts of the Tennessee Department of Health (TDOH), LIFEPATH and their partners across the state by identifying specific competency driven training opportunities within the workforce. Participants were recruited via email and directed to SurveyMonkey, an online survey toolkit, where they could complete the questionnaire. Of the 5178 TDOH employees who received the recruitment email, 3086 individuals completed at least one of the competency questions for a response rate of 59.6%. The survey assigned questions pertinent to the eight core competency areas to respondents based on one of three Tiers – Tier 1: Entry Level, Tier 2: Management Level, Tier 3: Leadership Level. Once the data were collected, responses from all three tiers were dichotomized to generate a “Needs Score” which when summarized represented the percentage of responses indicating a lack of knowledge or proficiency in a competency area. Tier 1 respondents had an average needs score of 60.46% in each of the eight core competency areas. Tier 2 had an average needs score of 49.50%, and Tier 3 respondents had an average needs score of 28.91%. This trend shows that individuals in leadership positions within TDOH were more likely to be knowledgeable or proficient in the eight core competency areas. Prior to administering the survey, TDOH job classifications were submitted to an expert panel within the health department. This body was tasked with assigning tiers to specific job classifications. Previous needs assessments that used the eight core competencies had respondents self-select their tier. As a test of validity the LIFEPATH survey asked TDOH employees to select their job classification in addition to tier. A Kappa test of agreement between self-selection of tier and their actual tier determined by TDOH leadership showed moderate agreement (Kappa=0.5089), suggesting that while most respondents selected the correct tier; there remained some confusion regarding tier definitions. This must be considered when evaluating the results of previous studies that utilize only the self-selected tiers to drive their survey. This data has already begun to direct training goals at the state, regional and local levels across Tennessee and will serve as a baseline measure for future evaluations of educational programing’s impact on workforce competency.

Opioid use disorder impedes dependent parents' abilities to care for their children. In turn, children may languish in unpredictability and persistent chaos. Societal responses to these children are often guided by a belief that unless the drug dependent parent receives treatment, there is little help for the child. While a preponderance of the drug dependence research is adult-centric, a significant body of research demonstrates the importance of not only addressing the immediate well being of the children of drug dependent caregivers but preventing the continuing cycle of drug dependence. The present commentary demonstrates through a brief review of the US history of drug dependence crises and research from the 1980s and 1990s, a range of “tried and true” family, school, and community interventions centered on children. We already know that these children are at high risk of maladjustment and early onset of drug dependence; early intervention is critical; multiple risk factors are likely to occur simultaneously; comprehensive strategies are optimal; and multiple risk-focused strategies are most protective. Where we need now to turn our efforts is on how to effectively implement and disseminate best practices, many of which we learned in the 1980s and 1990s. The greatest opportunity in both changing the nature of the opioid epidemic at scale and influencing rapid translation of existing research findings into policy and practice is not in asking what to do, but in asking how to do the right things well, and quickly.

The effectiveness of a shor-term prevention program to increase drug refusal behavior in elementary school children was assessed. Fifty-seven third grade children were randomly assigned to one of three groups: rehearsal-plus, traditional, and control. Children in the rehearsal-plus group were taught drug knowledge, assertiveness skills, decision making skills, and specific drug refusal techniques in the context of a skills-based strategy. This procedure included behavioral training and elaborative rehearsal. The traditional group targeted the same components, drug knowledge, assertiveness skills, decision making skills, and drug refusal skills, and employed a general educational-based approach to enhance children's functioning. Training occurred in three socially validated situations corresponding to settings where children are likely to be offered drugs. Assessment was carried out at pre- and post-test phases. It was hypothesized that children in the rehearsal-plus group would outperform those in the traditional and control groups on targeted responses. The results suggest that the rehearsal-plus procedure was most effective in enhancing desired behavior. / Master of Science

O primeiro objetivo do presente estudo, de cunho metodológico, foi verificar a viabilidade da realização de uma pesquisa com usuários de ecstasy via internet. A metodologia desenvolvida para o recrutamento e coleta de dados atingiu os objetivos propostos, demonstrando-se viável e profícua, além de apresentar grandes vantagens em relação à coleta de dados presencial. O segundo objetivo foi oferecer subsídio para futuras intervenções de Redução de Danos para o uso de ecstasy. O questionário on-line foi respondido por 1.140 pessoas, primordialmente jovens, com boa formação escolar, inseridos no mercado de trabalho e/ou estudantes, pertencentes às classes socioeconômicas A e B, e poliusuários de drogas. As respostas dos participantes foram descritas estatisticamente e os dados comparados através dos testes t ou chi-quadrado, e analisados por regressão categórica (CatReg) em que se relacionaram os comportamentos de risco associados ao uso de ecstasy com as variáveis independentes relevantes. Os resultados não fundamentam a elaboração de materiais preventivos com direcionamentos específicos, seja para gêneros, para opções sexuais ou para classes socioeconômicas. Indicam, porém, locais privilegiados para a distribuição de material preventivo: ambientes de lazer noturno, festas e eventos ligados à música eletrônica, eventos como paradas comunitárias, e universidades públicas e privadas. São discutidos os principais conteúdos a serem veiculados, tendo sempre como princípio básico a transmissão de informações cientificamente comprovadas. Os dados mostram ainda que é crescente a disponibilidade de ecstasy no Brasil indicando urgência na implantação de um primeiro programa preventivo brasileiro voltado para essa droga. A acolhida e as declarações de interesse dos participantes demonstraram que o projeto inspirou confiabilidade, que existe demanda por intervenções na área e que uma proposta de Redução de Danos teria grande receptividade dos usuários de ecstasy, embora sua implantação dependa do interesse das autoridades responsáveis pela política pública brasileira em relação às drogas ilegais. / One objective of this study was methodological investigating the feasibility of conducting a Web-based survey with ecstasy users. The method developed for participants recruitment and data collection attained the propose proving feasible and fruitful, as well as showing great advantages as compared to personal data collecting. The second objective was to provide subsidies for future Harm Reduction interventions on the use of ecstasy. Participants (N=1.140) were mostly youngsters, with high schooling levels, and currently employed or studying, of A and B social-economic classes, and polydrug users. The data were analyzed using chi-square or t tests and categorical regression (CatReg). The latter evaluated users’ risk behaviors and related them to relevant independent variables. The results do not set the grounds for the drafting of specially-oriented preventive materials, be it for genders, sexual orientation, or even social-economic classes. They do, however, indicate privileged places for the distribution of preventive materials: evening entertainment places, parties and events related to electronic music, events such as community Parades, and universities. The main contents to be conveyed are discussed, always keeping the communication of scientifically proven information as the basic principle. The data also show that there is increasing availability of ecstasy in Brazil, thus pointing to the urgent need of implementing a first Brazilian ecstasy preventive program. The buy-in and the interested statements from participants demonstrate that the project inspired reliability, that there is a demand for interventions in the area and that a Harm Reduction proposal would be highly accepted amongst ecstasy users, although its implementation depends on the interest of authorities responsible for the Brazilian public policy towards illegal drugs.

Abstract available through Journal of the American Pharmacists Association.

No description available.

No description available.