This study investigated the relationship between selected adolescent characteristics and treatment completion in a large, national sample of adolescents receiving substance misuse treatment in 2011. Participants were de-identified adolescent entries between the ages of 12 and 17 in the Treatment Episode Dataset- Discharges (TEDS-D), which is a national census data system including persons discharged from public and private substance abuse treatment programs that received public funding. Chi-square tests of independence and logistic regressions were used to examine the relationships between adolescent characteristics and treatment completion. The results showed significant relationships between selected variables (sex, gender, primary substance problem, principal source of referral, frequency of use) and treatment completion, but with small to medium effect sizes. Implications, limitations and directions for future research are discussed. / School Psychology

Magister Public Health - MPH / Background: TB is one of the most common opportunistic infections in the HIV infected population. In 2014, of the 9.6 million people estimated to have TB globally, 1.2 million were also infected with HIV. In the same year WHO reported 400 000 TB deaths in HIV infected people worldwide. TB Prevention strategies include ensuring HIV infected people take ART, TB infection control, treatment of TB cases and pharmacological prevention of primary TB infection or progression of latent TB into active TB. Isoniazid preventive therapy for a minimum of six months has been recommended to reduce the risk of TB in people living with HIV. Aim: The study’s aim was to determine the programmatic outcomes of isoniazid preventive therapy (IPT) and factors associated with treatment completion among people living with HIV aged 15 years and above at the AIDS Healthcare Foundation LaMvelase clinic in Manzini Swaziland, who were enrolled for IPT during the period March to December 2014. Methodology: This was a quantitative retrospective analytical cohort study that reviewed 3642 patient care records. IBM SPSS 20 was used for descriptive and statistical analysis of the data. Descriptive statistics were calculated and reported as frequencies and percentages. Bivariate statistics were carried out to test independent associations between socio-demographic and clinical characteristics, and IPT completion. Further multiple logistic regression analysis was done to determine the nature of association between the dependent and independent variables which had p < 0.1.

Latent tuberculosis infection (LTBI), a product of exposure to Mycobacterium tuberculosis (Mtb), can lead to tuberculosis (TB) and further cause death if untreated. Fortunately, TB can be prevented with LTBI treatment. Targeting newly arrived visa holders for LTBI screening and treatment is an effective strategy for decreasing future TB burden. However, LTBI treatment completion rates are low, and researches had primarily focused on the nonrural U.S. setting. This study, using a retrospective cohort design under the epidemiological disease triangle framework evaluated (a) the treatment completion rates for 2 cohorts of visa holders (i.e., immigrants, N = 31 and refugees, N = 109) with LTBI residing in the rural setting using Pearson's chi-square analysis, (b) mean times on LTBI treatment using Kaplan-Meier survival analysis, and (c) predictors of time on treatment using Cox proportional hazard regression. Study findings revealed immigrants had higher treatment noncompletion rates over refugees (25.6% and 19.3%). The potential risk factors for noncompletion were being older than 24 years of age (HR = 0.18, p = 0.01). There were also significant interactions for the time on treatment between (a) being < 25 years old and visa type (HR = 0.23, p = 0.04), (b) being < 25 years and traveling longer (miles) to treatment facility (HR = 0.25, p = 0.03), or (c) being < 25 years and Mtb blood-test positive (HR = 0.35, p = 0.05). These findings suggest interventions targeting visa holders older than 24 years may increase the rate of treatment completion and decrease the future TB cases. Therefore, the study promotes social change by providing actionable, rural-population-specific information for the prioritization of visa holders at increased risk of experiencing LTBI treatment noncompletion.

The purpose of the study was to investigate the problem of defaulting of tuberculosis (TB) treatment in the Khomas region of Namibia. A quantitative, descriptive research approach was used to investigate the reasons for defaulting of TB treatment under the DOTS strategy in Khomas Region of Namibia. Data was collected by using a structured interview schedule with 54 participants who were on DOTS strategy and defaulted. Data were analysed by using the Epi info computer program. The major findings from the data obtained, revealed that the respondents did not have an in-depth knowledge of TB and the health education was not successful. This contributed to the defaulting of their treatment. Based on the study findings nurses should improve health education to TB patients on DOTS and also educate members of the community to address the stigmatisation of TB. Recommendations for further improvement in the compliance of TB treatment were made. / Public Health / M.A. (Public Health)

The purpose of the study was to investigate the problem of defaulting of tuberculosis (TB) treatment in the Khomas region of Namibia. A quantitative, descriptive research approach was used to investigate the reasons for defaulting of TB treatment under the DOTS strategy in Khomas Region of Namibia. Data was collected by using a structured interview schedule with 54 participants who were on DOTS strategy and defaulted. Data were analysed by using the Epi info computer program. The major findings from the data obtained, revealed that the respondents did not have an in-depth knowledge of TB and the health education was not successful. This contributed to the defaulting of their treatment. Based on the study findings nurses should improve health education to TB patients on DOTS and also educate members of the community to address the stigmatisation of TB. Recommendations for further improvement in the compliance of TB treatment were made. / Public Health / M.A. (Public Health)

Dual diagnosis clients continue to have low treatment completion rates. The purpose of the current study was to understand if motivational interviewing helped to increase completion rates for clients receiving cognitive behavioral therapy (CBT). Studying the problem was necessary for identifying an evidenced-based model for mental health counselors to help clients with dual diagnoses complete CBT treatment. There were no studies available for understanding the effectiveness of motivational interviewing as a tool for improving treatment completion rates for dual diagnoses clients in intensive outpatient programs. The research question examined if motivational interviewing was effective for improving treatment completion rates for the dual diagnosis population. A quantitative methodology with a quasi-experimental design used for this study and included a paired samples t test, a chi-square test, and a logistic regression analysis. The results showed a statistically significant association between receiving the motivational interviewing techniques and completing CBT. Clients who received motivational interviewing were 4 times more likely to complete CBT treatment compared to clients who did not receive the technique. Clients with increased self-efficacy levels were 2 times more likely to complete treatment, thus addressing the problem of dual diagnosis clients having low treatment completion rates. The overall results demonstrated that clients reduced substance use relapse and recidivism improved. Completing treatment helped to reduce crimes related to drug use; it also prepared substance users for return to society as productive citizens, which promoted positive social change.

Despite decades of the implementation of the directly observed therapy short-course (DOTS), Sierra Leone is ranked among the 30 highest TB-burdened countries. Several factors account for unfavorable treatment outcomes, among which are patient characteristics. Previous studies have only focused on treatment compliance without any consideration for the factors that lead to noncompliance to treatment. The purpose of this study was to investigate patient characteristics that are associated with treatment noncompliance (treatment not completed) among TB patients undergoing the DOTS program in Sierra Leone. A retrospective longitudinal quantitative design was used to analyze secondary data from the completed records of 1,633 TB patients, using the Andersen's behavioral model of health services utilization as a theoretical framework work. Descriptive statistics and bivariate and multivariate logistic regressions were used to analyze the data. The results show that there was no significant association between treatment completion and age, gender, and TB-case category. On the other hand, being HIV-positive decreases the odds of treatment completion. Also, the educational level, geographic location, and year of treatment were significantly associated with treatment completion. Overall, program performance improved as the number of dropouts decreased significantly between 2013 and 2015. The social change implication of this study was that it identified HIV-positive patients and rural communities as areas needing specific attention such as the assignment of case managers to ensure compliance thereby improve DOTS program performance, thereby reducing the incidence and transmission of TB

Drivers under the influence of alcohol cause nearly one third of all fatal motor vehicle accidents. Ambulatory outpatient alcohol abuse treatment has been clinically shown to increase abstinence, which could decrease the chance of subsequent DWI offences. A barrier to successful completion is extended waiting periods prior to treatment engagement. The theory of patient waiting supports the longer a patient waits to begin treatment the lower the likelihood of successful completion. By exploring the impact of waiting times on DWI court mandated clients, referral courts and treatment facilities can work together to create a successful completion strategy for offenders. The research question focused on if days waiting can predict successful outpatient treatment completion in court mandated adults. The TEDS-D archival data set was used, consisting of data collected between 2006-€”2011 from federally funded substance abuse treatment centers throughout the USA. The variables time awaiting treatment, treatment level, gender, race, employment status, and age were used as controls. A logistic regression using a random sample of 4,947 participants determined days waiting was significant but weak in nature. The variables of employment status and age are stronger predictors of treatment completion. An interaction effect analysis of days waiting and age results in clients over 45 years old being significantly impacted by days waiting while younger clients are not. Court and treatment agencies can use this information to give priority intake appointments to older clients to increase chances of treatment completion.

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Magister Psychologiae - MPsych / Cape Town is suffering from high rates of alcohol and other drug (AOD) problems. Despite the need for effective treatment, there are insufficient AOD treatment facilities available, with barriers to AOD treatment being particularly pronounced among historically disadvantaged communities (HDCs). In addition, the high drop-out rate of patients from AOD treatment, and the finding that retention in treatment is predictive of positive outcomes, increases the necessity of retaining people who enter AOD treatment.This study therefore aimed to identify those patient-level factors impacting on the successful completion of and retention in AOD treatment. In particular, the study aimed to describe the relationship between treatment process factors (therapeutic alliance,motivation, treatment satisfaction, social support), demographic and psychological variables, and treatment completion and retention. The Texas Christian University (TCU) Treatment Model, which conceptualises the AOD treatment process, provided the theoretical framework for the study. Using a quantitative design, secondary data analysis was conducted on a section of data that was originally collected by the Medical Research Council (MRC) via a cross-sectional survey. The sample consisted of 434 individuals from HDCs who had previously entered AOD treatment. Multiple regression analyses revealed that the therapeutic alliance, treatment satisfaction, abstinence-specific social support and depression were significant predictors of treatment completion, while race,therapeutic alliance, abstinence-specific social support and anxiety were predictive of the time spent in treatment. These predictors were positively associated with treatment completion and time in treatment. Black Africans spent significantly less days in treatment than Coloured individuals, although both groups were equally likely to complete treatment. The results suggest that by strengthening the therapeutic alliance,social support and treatment satisfaction, treatment completion and retention can be improved. This can be achieved by training, ongoing monitoring of these factors during treatment, and greater involvement of supportive social networks in a patient’s recovery. The findings also point towards the need for improved service delivery for Black Africans, who confront many barriers to accessing inpatient AOD treatment.