Suchergebnisse

Rising rates of overdose mortality underscore the importance of understanding and preventing overdose. We developed a seven-item scale for the assessment of nonfatal opioid-related overdose experiences, adding items on others' perceptions of whether the participant had overdosed and whether an intervention was attempted to frequently used criteria. We administered the scale to 240 primarily male and minority veterans, recruited using venue-based and chain-referral sampling, who separated from the military post-9/11 and reported current opioid use. The items were internally consistent, and correlated well with overdose risk behaviors ( r = .13-.45). The new scale detected overdose events in a significantly higher proportion of participants (36.5%) than that using either self-report criterion (18.2%) or difficulty breathing and losing consciousness criteria (23.8%). These experiences or perceptions should be investigated to inform and better tailor the development of more effective overdose prevention and response programs.

Rising rates of overdose mortality underscore the importance of understanding and preventing overdose. We developed a seven-item scale for the assessment of nonfatal opioid-related overdose experiences, adding items on others' perceptions of whether the participant had overdosed and whether an intervention was attempted to frequently used criteria. We administered the scale to 240 primarily male and minority veterans, recruited using venue-based and chain-referral sampling, who separated from the military post-9/11 and reported current opioid use. The items were internally consistent, and correlated well with overdose risk behaviors (r = .13–.45). The new scale detected overdose events in a significantly higher proportion of participants (36.5%) than that using either self-report criterion (18.2%) or difficulty breathing and losing consciousness criteria (23.8%). These experiences or perceptions should be investigated to inform and better tailor the development of more effective overdose prevention and response programs.

City-specific studies have suggested the quality of the local environment and economic circumstances are associated with greater risk of injection drug use (IDU). No studies have assessed the relation among the quality of the local environment, economic circumstances, and IDU over time across US metropolitan areas. Annual numbers of IDUs in the 88 largest US metropolitan statistical areas (MSAs) were estimated by extrapolating, adjusting, and allocating existing estimates using various data sources. Generalized estimating equations were used to assess the relation among the quality of the local environment, metropolitan political economy, and IDU prevalence using lagged models taking into account potential confounders. MSAs with a worse local environment (measured as a one standard deviation difference) had a greater risk of IDU (relative risk [RR] = 1.03, 95% confidence interval [CI]: 1.01, 1.06); similarly, a one-percentage point worsening of the political economy for an MSA was associated with greater risk of IDU (RR=1.04 to 1.10). Final models stratified by region indicated heterogeneity of effect by region whereby the quality of the local environment was associated with IDU strongest in the South (RR=1.12, CI: 1.05, 1.12) followed by the West (RR=1.04, CI: 1.01, 1.07) and Midwest (RR=1.03, CI: 1.00, 1.06), and the metropolitan political economy was associated with IDU in the West (RR=1.03 to 1.09) and Northeast (RR=1.04 to 1.12). Our results underscore the importance of sociopolitical factors as determinants of IDU in MSAs. Structural solutions targeted at improving environmental conditions and economic circumstances should be considered as drug use interventions.

Objective: To adapt and apply the Nutri­tion Environment Measures Survey for Res­taurants (NEMS-R) to Hispanic Caribbean (HC) restaurants and examine associations between restaurant characteristics and nutrition environment measures.Methods: We adapted the NEMS-R for HC cuisines (Cuban, Puerto Rican, Dominican) and cardiovascular health-promoting fac­tors, and applied the instrument (NEMS-HCR) to a random sample of HC restau­rants in New York City (NYC) (N=89). Multivariable linear regression was used to assess independent associations between NEMS-HCR score and restaurant charac­teristics (cuisine, size, type [counter-style vs sit-down] and price).Results: None of the menus in the res­taurants studied listed any main dishes as "healthy" or "light." More than half (52%) offered mostly (>75%) nonfried main dishes, and 76% offered at least one vegetarian option. The most common facilitator to healthy eating was offering reduced portion sizes (21%) and the most common barrier was having salt shak­ers on tables (40%). NEMS-HCR scores (100-point scale) ranged from 24.1-55.2 (mean=39.7). In multivariable analyses, scores were significantly related to cuisine (with Puerto Rican cuisine scoring lower than Cuban and Dominican cuisines), and size (with small [<22 seats] restaurants scoring lower than larger restaurants). We found a significant quadratic association with midpoint price, suggesting that scores increased with increasing price in the low­est price range, did not vary in the middle range, and decreased with increasing price in the highest range.Conclusions: Our application of the NEMS-R to HC restaurants in NYC revealed areas for potential future interventions to improve food offerings and environmental cues to encourage healthful choices. Ethn Dis. 2020;30(4):583-592; doi:10.18865/ed.30.4.592

Drug use involves social interactions. Therefore, norms in the proximal environment of people who inject drugs (PWID) can favor behaviors that may result in HIV transmission. This work aimed at studying drug injection-related norms and their potential association with risky behaviors among PWID in Athens, Greece, in the context of economic recession and political activism that followed the fiscal crisis and soon after a recent HIV outbreak had leveled off. The Transmission Reduction Intervention Project (TRIP) was a social network-based approach (June 2013 to July 2015) that involved two groups of PWID seeds—with recent HIV infection and with long-term HIV infection and one control group of HIV-negative PWID. Network contacts of seeds were also enrolled. TRIP participants answered a questionnaire that included items on injection-related norms and behaviors. TRIP recruited 320 PWID (HIV positive, 44.4%). TRIP participants, especially those without HIV, often recalled or perceived as normative among their partners and in their networks some behaviors that can lead to HIV transmission. TRIP participants who recalled that they were encouraged by their regular drug partners to use an unclean syringe were almost twice as likely to report that they share syringes [odds ratio (OR) = 2.03; 95% confidence interval (CI) = 1.86–2.21], or give syringes to someone else (OR = 1.70; 95% CI = 1.42–2.04) as those who did not recall such an encouragement. Associations were modified by HIV status. HIV negatives, who were reportedly encouraged to share nonsyringe injecting equipment, were almost 4.5 times as likely to share that material as HIV-negative participants who were not encouraged (OR = 4.59, 95% CI = 4.12–5.11). Further research is needed on the multiple determinants (social, economic, and political) of norms in the social environments of PWID. Since peer norms are associated with risky behaviors, interventions should be developed to encourage norms and peer pressure against the sharing of injection equipment.