Engaging Families to Prevent Substance Use Among Latino Youth

Angela Chia-Chen Chen, Bonnie Gance-Cleveland, Albert Kopak, Steven Haas, and Mary Gillmore
Column Editor: Bonnie Gance-Cleveland Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building.     

Attitudes of Homeless and Drug-Using Youth Regarding Barriers and Facilitators in Delivery of Quality and Culturally Sensitive Health Care

PROBLEM:  Major barriers to care included a lack of culturally competent, accessible care despite the proximity of numerous health service agencies serving homeless youth.
METHODS:  A qualitative approach using semistructured focus groups was used to assess the perspectives of 54 homeless and drug-using youth, aged 18–24 years, recruited from street- and shelter-based settings.
FINDINGS:  Substance use was perceived as an adaptive response to psychological pain and survival on the streets as well as a health risk and barrier to care.
CONCLUSIONS:  Facilitators to care and suggestions for improved health delivery and quality of care included utilization of health "mentors" to assist in navigating the medical system, cultural competency enhancements, improved amenities in clinic wait areas, and expanded pharmaceutical services.     

Caring for Street Youth: A Nursing Challenge

The Advocate is a forum for exploring our roles as advocates for the children and families we serve.     

Overweight and Obesity Among Youth Entering Residential Care: Prevalence and Correlates

Little is known about the prevalence of clinical weight problems for youth living in residential care. Therefore, this study examined the prevalence and correlates of overweight and obesity in a large sample of youth (N = 1709) entering a residential care program. Results indicated that 48% of youth were overweight or obese at the time of intake, which is much higher than national pediatric rates. Females had higher rates of overweight/obesity, as did youth referred from moderately restrictive placements such as foster care. Youth who were overweight/obese had greater internalizing symptoms at intake. Clinical and research implications are discussed.     

Sex Differences in Prevalence of Emergency Department Patient Substance Use

Purpose

Substance use and misuse is prevalent in emergency department (ED) populations. While the prevalence of substance use and misuse is reported, sex-specific trends in ED populations have not been documented. We set out to determine the sex-specific prevalence of ED patient substance use during this current epidemic.

Impact of Substance Use on Older Patients With Human Immunodeficiency Virus

As a result of effective antiretroviral treatment, patients with human immunodeficiency virus are living nearly normal life spans and are presenting to primary care nurse practitioners for management of comorbidities. Substance use disorders are common but often unexpected in aging patients due to the misconception that older patients do not abuse drugs. When symptoms of substance use are attributed to the normal aging process and overlooked, the diagnosis can be missed, which leads to high morbidity and mortality rates, especially in patients with human immunodeficiency virus. Through early recognition, nurse practitioners can facilitate timely diagnosis and comprehensive treatment that can improve patient outcomes.     

Substance Use Disorder Treatment via Telemedicine During Coronavirus Disease 2019

Telemedicine has been effective at bridging the gap among patients, providers, and health systems. Authors from a large academic medical center in Baltimore, MD, anecdotally found that digital tools were beneficial in supporting substance use disorder recovery during a global pandemic. Audiovisual tools like Zoom (Zoom Video Communications, Inc, San Jose, CA) and Doximity (Doximity, Inc, San Francisco, CA), as well as increased frequency of communication with patients, have been most helpful to supporting recovery. The barriers noted were related to patient privacy and increased tendency of patients to avoid treatment, similar barriers as when treatment is provided in the clinic. The intent of this narrative is to discuss provider perspectives of benefits and barriers to telemedicine for substance use disorder treatment during the coronavirus disease 2019 pandemic.     

The association of social networks with substance use among homeless men in Los Angeles who have unprotected sex with women

Abstract

This study examined the association between social network characteristics and heavy drinking and crack use among homeless men who had unprotected sex with women. This study focused on network members with whom homeless men used substances. Of 305 randomly selected homeless men in Los Angeles, California, 182 participants who had unprotected sex with women during the previous 6 months were included in the final analysis. To obtain social network data, respondents were asked to provide the first names of 20 individuals they had contact with during the previous 6 months. In the final multivariate logistic regression model, social network characteristics were examined as possible influences on heavy drinking and crack use. The likelihood of heavy drinking was significantly increased by the proportion of network members with whom homeless men used alcohol. Likelihood of crack use was also associated with the proportion of network members with whom the respondent used drugs. Results indicated that using alcohol and drugs with network members increased the odds of heavy drinking and crack use among participants. Interventions to reduce substance use among homeless men who have unprotected sex may help them reduce ties with individuals with whom they drink and use drugs.     

Homeless Parents'Perceptions of Parenting Stress

PURPOSE. To describe homeless parents' perceptions of parenting stress as potential indicators of needs for support in parenting roles.
SAMPLE. Forty-seven homeless parents (30 mothers, 17 fathers).
METHODS. Subjects completed the Parenting Stress Index to measure perceived parenting stress in the areas of child domain, parent domain, and life stress.
FINDINGS. Homeless mothers and homeless fathers both identified the child domain as the most frequent source of stress. T tests showed a significant dierence between groups only in the parent domain sub- scale of competence.
CONCLUSIONS. Findings from this study indicate the need to include parenting stress questions in an initial nursing or health assessment.     

Overuse Injury,Substance Use,and Resilience in Collegiate Female Athlete

BackgroundOveruse injury is a common stressor experienced by female collegiate athletes and is often underreported. In response, athletes may develop negative coping skills such as substance use. Alternatively, resilience is a modifiable trait that may positively influence response to musculoskeletal injuries and substance use.PurposeTo provide an updated epidemiological profile of overuse injury and substance use and examine the relationship between resilience, overuse injury, and substance use among collegiate female athletes.DesignCross-sectional studyMethodsTwo-hundred and thirty female collegiate athletes were classified into overuse injury and resilience groups. Overuse injury, pain, and substance use incidence proportions (IP) were calculated. Kruskal-Wallis analyses were performed to investigate differences in substance use among resilience groups. Analyses of covariance were performed to evaluate differences in overuse injuries, substantial overuse injuries, and time loss injuries, among resilience groups.ResultsIP for pain was 45.0% (95% CI: 38.2-51.9); Overuse injury 52.0% (45.1-58.9); Alcohol use 35.1% (28.6-41.6); Electronic cigarette use 19.5% (14.6-24.9); Cigarette use 2.8% (6-5.1); and Drug use 3.3% (0.9-5.8). No significant differences were found between resilience groups for the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC) variables (Pain: p=0.102; Overuse injury: p=0.331; Substantial overuse injury: p=0.084; Not playing: p=0.058), alcohol (p=0.723), or combined substance use (p=0.069).ConclusionsPain and overuse injury prevalence is high among female collegiate athletes. Alcohol followed by electronic cigarette use were the most commonly utilized substances. No significant differences were identified in substance use or overuse injury presentation between resilience groups, though further investigation is warranted.Level of Evidence3     

Implementing Substance Use Screening in Family Planning

Although substance use has negative health effects on women, especially during the reproductive years, family planning practices in which nurse practitioners are key care providers, generally do not adequately screen and intervene for alcohol and drugs. Screening, brief intervention, and referral to treatment (SBIRT) can limit the effects of substance use on women and families. This study explored barriers and facilitators to SBIRT through qualitative analysis of focus groups with family planning providers. Results suggest family planning providers are favorable to implementation. Barriers include training and organizational support; facilitators include use of electronic health records and setting patient expectations.     

Correlates of Condom Use Among Substance Using Older Seropositive MSM: Implications for Mental Health Practice

The purpose of this study was to describe the correlates of condom use among a sample of N = 60 substance using seropositive men who have sex with (MSM). The mean age of the study participants was 52 ranging 50–75 years of age. Seventy-percent of study participants reporting smoking marijuana, 62% using cocaine, 25% heroin, 37% alcohol, and 30% amphetamines. Among those reporting substance use, 75% reported it was a hassle to use condoms, 42% indicated pleasure decreased with condom use, 72% indicated safer sex is boring, 72% reported the idea of using condoms is unappealing, 78% reported condoms ruined sex, and 71% said condoms interfered with romance. A multiple logistic regression analysis revealed low self-esteem, relationship status, attitudes towards condom use, and depression predicted condom use χ² = 20.79, df = 6, ρ =.002. The study findings have implications for mental health nursing practice with seropositive African American MSM.