Pacific Institute For Research and Evaluation

ObjectiveParticipation in 12-step groups (TS), such as Alcoholics Anonymous, confers benefits among individuals with alcohol use disorder (AUD), and one candidate mechanism underlying these effects is reductions in impulsivity. Using a multidimensional assessment of impulsivity, the current study examined impulsive personality and action in a longitudinal cohort of adults with AUD initiating a significant recovery attempt.MethodsA prospective matched-sample cohort study design compared participants who reported a clinically meaningful increase in TS attendance (i.e., increase of ≥ 1 meetings/week; n = 74) from enrollment to 6 weeks to a matched control group who did not increase attendance (n = 74). Drinking was assessed using the Timeline Followback (% drinking days [%DD], % heavy drinking days [%HDD]); impulsivity was assessed using delay discounting (DD) and five UPPS-P subscales. Mediation models evaluated whether impulsivity explained the relationship between increased TS attendance and alcohol outcomes.ResultsCompared to matched controls, participants who increased TS significantly differentially reduced %DD, %HDD (p < 0.001), as well as Negative Urgency (i.e., acting out due to negative emotions) and Lack of Perseverance (i.e., failure to persist in tasks; ps = 0.03) after their recovery attempt. Reductions in impulsivity, however, did not mediate the association between increased TS attendance and drinking.ConclusionsIncreased TS attendance was associated with significant reductions in drinking and certain impulsivity traits. However, while the changes were contemporaneous, impulsivity did not explain the benefits of TS effects in early AUD recovery process. Future research should evaluate this hypothesis in larger samples and over longer follow-up periods.

Reducing behavioral health risks requires a comprehensive range of prevention and treatment services delivered by professionals who are ‘housed’ within various community-based provider silos. Law enforcement constitutes an important silo that has not been closely associated with prevention, and particularly with evidence-based prevention programs and practices. Yet within communities there are well-defined prevention roles that law enforcement can play to support and enhance ongoing prevention programming. These roles, as informed by police science, are very much related to the overall role of law enforcement in the communities that officers serve. In this paper we discuss these roles and guidelines and make recommendations as to the training and functioning of law enforcement officers within a prevention framework.

Individuals with intellectual or developmental disabilities (IDD) often experience more negative oral health outcomes. We implemented and tested a comprehensive strategy in 39 IDD group homes to examine whether skills-based training for direct support professionals (DSP) and individualized oral health planning for residents could improve DSP assistance and provision of oral health care for residents and oral health status. Our sample comprised 19 intervention homes and 20 control group homes, with 61 residents with IDD and 77 DSP. The strategy involved providing didactic and experiential skills-based training, combined with in-home coaching to DSP with resident participation over the course of 16 weeks. DSP in control homes received educational brochures. DSP attitudes, skills, and behaviors; and resident oral health outcomes were measured at baseline, 4 months later (post-intervention), and 12 months after baseline. Analyses compared the intervention and control conditions at 4-months and 12-months. Results suggest that the intervention influenced DSP skills and behaviors. Among residents, results showed improved outcomes for teeth in the lower anterior sextant only; intervention effects largely abated by 12-month follow-up. Findings demonstrate that skills-based, experiential training with coaching can be effective in enhancing skill sets and increasing behaviors about oral health among DSP. In addition, results showed that the strategy used can improve oral health outcomes for residents. However, given that there were only improved outcomes in residents' lower anterior sextant, more research is needed to determine how to adequately assess and improve resident outcomes.

Medication misuse is a threat to public health and patient safety, and strategies to prevent medication misuse should be incorporated in nursing education. An interdisciplinary nursing and pharmacy team collaborated on a pilot project with graduate FNP students to adapt and evaluate a training program for pharmacy students on the prevention of medication misuse for nursing based on the publicly available online program Generation Rx. Of 39 students who participated in the training, 74% (n = 29) completed pre- and posttest surveys. Results showed the training program effectively improved participants' perceived skills and abilities related to Generation Rx and improved knowledge in certain areas about medication misuse. Interdisciplinary collaboration brings new concepts and skills to nursing. This pilot project highlights the importance of addressing medication misuse in nursing education and serves as an example with lessons learned for future interdisciplinary educational efforts.

This study investigated the prevalence and potential factors of problem gambling among adults in New Mexico. The state has a diverse population and a well-established gambling industry. The study used data from a survey of 19,202 adults in 2018 and 2019 and found that problem gambling rates (3.1-3.9%) were significantly higher than the national average. The study revealed significant differences in problem gambling prevalence based on sociodemographic factors, with higher rates among males, younger adults, and racial/ethnic minorities, particularly Native American/American Indian respondents. Substance use behaviors and adverse childhood experiences (ACEs) showed strong associations with problem gambling. Logistic regression analyses showed that being male, identifying as Latinx or Native American/American Indian, having lower educational attainment, experiencing housing instability, engaging in substance use, and reporting multiple ACEs significantly increased the odds of problem gambling. A risk score index indicated that the likelihood of problem gambling increased considerably with the accumulation of risk factors. These findings highlight the complex and multifaceted nature of problem gambling in New Mexico, underscoring the need for culturally sensitive interventions. The study offers valuable insights for policymakers, healthcare providers, and community organizations to develop evidence-based strategies to address problem gambling in this specific demographic context.

The COVID-19 pandemic has disproportionately affected Latino/a communities in the U.S., with limited research on vulnerable subgroups like recent Latino/a immigrants (RLIs). RLIs encounter various challenges including employment instability, healthcare access issues, limited social support, language barriers, and fears tied to immigration status, potentially hindering COVID-19 vaccine acceptance. This study, utilizing cross-sectional data from an NIH-funded project, examines COVID-19 vaccination status among RLIs who migrated to South Florida ~ 3 years prior. An eco-developmental framework is applied to analyze associations between sociocultural factors and vaccination status using hierarchical multiple logistic regression models. The sample comprised of 325 RLIs (43.4% females; M age = 27.4; SD = 5.09), of which approximately 72% received COVID-19 vaccinations. Seeking COVID-19 information from family/friends correlated with lower vaccination likelihood (aOR = 0.35, 95% CI: [0.14, 0.83], p = .018). Conversely, relying on religious coping moderately or significantly increased vaccination likelihood (aOR = 2.60, 95% CI: [1.02, 6.57], p = .046), as did experiencing COVID-19 related stigma (aOR = 6.04, 95% CI: [2.00, 18.21], p = .001) and adhering to traditional gender norms (aOR = 1.51, 95% CI: [1.03, 2.21], p = .034). Additionally, demographic factors such as immigration status and country of origin correlated with vaccination status. Findings from the present study allows us to understand the impact of sociocultural factors on vaccination status among young adult RLIs and is critical to informing culturally relevant public health efforts aimed at reducing COVID-19-related health inequities.

IntroductionCocreation, a collaborative process of key interested partners working alongside researchers, is fundamental to community-engaged research. However, the field of community-engaged research is currently grappling with a significant gap: the lack of a pragmatic and validated measure to assess the quality of this process. This protocol addresses this significant gap by developing and testing a pragmatic cocreation measure with diverse community and research partners involved in participatory health-related research. A valid measure for evaluating the quality of the cocreation process can significantly promote inclusive research practices and outcomes.Methods and analysisThe measure consists of two components: (1) an iterative group assessment to prioritise cocreation principles and identify specific activities for achieving those principles and (2) a survey assessing individual partner experience. An expert panel of 16–20 patients, community, healthcare providers and research partners, will participate in a modified Delphi process to assist in construct delineation and assess content validity using group discussions and rating exercises. We will compute survey items using an Item-Level Content Validity Index and a modified kappa statistic to adjust for chance agreement with panel members’ ratings. We will then conduct cognitive interviews with a new group of 40 participants to assess survey item comprehension and interpretation, applying an iterative coding process to analyse the data. Finally, we will assess the measure’s psychometric and pragmatic characteristics with a convenience sample of 300 participants and use the Psychometric and Pragmatic Evidence Rating Scale. Construct validity will be assessed by examining survey data using confirmatory and exploratory factor analysis.Ethics and disseminationThis funded study (years 2024–2025) has been approved by the Institutional Review Board at the University of Colorado, Denver. The team will share the study findings online, with key partners, and by publishing results in a peer-reviewed journal.

Background and Objectives: We examined associations between sources of social influence (i.e. close friends, other underage people present) within specific settings with the number of drinks underage youth consumed. Methods: Data were collected through a cross-sectional survey with 422 underage youth in California (14 to 19 years old) who reported past-6-month alcohol use. Participants were asked to think about the last time they drank alcohol in the past 6 months at: restaurants, bars/nightclubs, own home, another’s home, outdoors, and fraternities/sororities. Outcomes were the number of whole drinks participants drank the last time in each setting. Independent measures were social characteristics of these drinking events including number of people <21 years old present, number of close friends present, number of <21 years old who consumed alcohol, and number of close friends who consumed alcohol. We also assessed socio-demographics and accounted for the overall exposure to each setting in the past 6 months. Results: Using negative binomial regression models, the number of close friends was positively associated with number of drinks consumed at restaurants, another’s home, and outdoors. The number of close friends drinking was positively associated with the number of drinks at restaurants, own home, another’s home, and outdoors. Number of people <21 years old was positively associated with number of drinks at own home, and number of people <21 years old who consumed alcohol was positivity associated with number of drinks consumed at restaurants, own home, another’s home, and outdoors. Conclusions: Results suggest that social influence from close friends and from other underage youth are context-specific.