scholarly journals Motivational network intervention to reduce substance use and increase supportive connections among formerly homeless emerging adults transitioning to housing: study protocol for a pilot randomized controlled trial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Joan S. Tucker ◽  
David P. Kennedy ◽  
Karen Chan Osilla ◽  
Daniela Golinelli
Keyword(s):  
Substance Use ◽  
Los Angeles ◽  
Transition Period ◽  
Case Manager ◽  
Case Managers ◽  
Transitional Period ◽  
Computer Assisted ◽  
Housing Program ◽  
Manager Support ◽  
Network Intervention

Abstract Background Studies indicate high rates of substance use among youth experiencing homelessness (YEH). Further, the social networks of YEH, although multi-dimensional in composition, are largely comprised of other YEH, substance users, and individuals who do not provide the youth with tangible or emotional support. For YEH who have the opportunity to enter a housing program, helping them to reduce their substance use and strengthen their prosocial supportive connections during this critical transition period may increase their stability and reduce their risk of re-entering homelessness. The goal of this study is to pilot test a brief motivational network intervention (MNI), delivered by case managers, to help former YEH who have recently transitioned to a housing program reduce their substance use and strengthen their prosocial supportive connections. Methods/design Up to 60 residents of housing programs in the Los Angeles area will be randomized to receive four sessions of usual case manager support or four sessions of case manager support + MNI. Each MNI session consists of three parts: (1) identifying two goals that are most important for the resident over the next year (e.g., get or keep a job, finish or stay in school, reduce substance use); (2) a network interview with the resident to capture network data pertaining to their interactions in the past 2 weeks; and (3) a discussion between the case manager and the resident of the resulting network visualizations, conducted in a Motivational Interviewing (MI) style, and what role the resident’s network may play in reaching their most important goals over the next year. Discussion This study addresses a critical gap by pilot testing a computer-assisted MNI, delivered using MI techniques, that can help case managers work with recent YEH to reduce substance use and increase permanent supportive connections during the critical transitional period from homelessness to housing. Trial registration ClinicalTrials.gov Identifier: NCT04637815. Registered November 10, 2020.

scholarly journals Methamphetamine Injection Among Young Men Who Have Sex With Men: Risk for Human Immunodeficiency Virus Transmission in a Los Angeles Cohort

2020 ◽  
Vol 222 (Supplement_5) ◽  
pp. S471-S476
Author(s):  
Pamina M Gorbach ◽  
Marjan Javanbakht ◽  
Amy Ragsdale ◽  
Robert B Bolan ◽  
Risa Flynn ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Substance Use ◽  
Los Angeles ◽  
Sexually Transmitted Infections ◽  
Repeated Measures ◽  
Virus Transmission ◽  
Computer Assisted ◽  
Sexually Transmitted ◽  
Immunodeficiency Virus ◽  
Sex With Men

Abstract Background Prevalence of methamphetamine (meth) injection and associated human immunodeficiency virus (HIV) risks among men who have sex with men (MSM) are unclear. Methods A total of 532 MSM completed 1880 mSTUDY study visits between August 2014 and June 2018 in Los Angeles, California. Assessments every 6 months included computer-assisted self-interviews and testing for sexually transmitted infections. Analyses by person and across visits adjusted for repeated measures. Results Of 532 participants, 51% (n = 276) reported meth use (past 6 months). Across 1880 visits, mutually exclusive substance use categories were as follows: 5% meth injection (5%), meth use without injection (33%), other substance use excluding meth (36%), and no substance use (26%). Comparisons across these categories respectively found that meth injectors reported higher prevalence of new sex partners (89%, 70%, 68%, and 51%, respectively), more were HIV positive (83%, 65%, 34%, and 50%), fewer were virally suppressed (53%, 48%, 61%, and 67%), and more had sexually transmitted infections (31%, 22%, 15%, and 15% (all P <.01). Conclusions Among the young MSM reporting meth injection in this Los Angeles cohort, elevated risks of acquiring or transmitting HIV suggest that they contribute significantly to sustaining the local HIV epidemic. Preventing transition to injection use has potential for HIV prevention.

Case Management in Occupational Rehabilitation: Would the Real Case Manager Please Stand Up?

1995 ◽  
Vol 1 (2) ◽  
pp. 104-117 ◽  
Author(s):  
Dianna T. Kenny
Keyword(s):  
Case Management ◽  
Case Manager ◽  
Occupational Rehabilitation ◽  
Case Managers ◽  
Injured Workers ◽  
Policy And Practice ◽  
Post Injury ◽  
Proper Role ◽  
Key Stakeholders ◽  
Successful Case

Key stakeholders (injured workers, rehabilitation co-ordinators, rehabilitation providers, treating doctors and insurers) in the occupational rehabilitation process were interviewed to gain their perspective concerning the degree to which case management was viewed as the organising principle of post-injury management and to whom this role was most frequently assigned. Findings indicated that there were differences in stakeholder perceptions about who should fill this role for the injured worker, with the majority of each group claiming case management as their proper role. In contrast, 35% of the injured workers interviewed stated that they either did not have a case manager or that they case managed themselves. Although it was argued that rehabilitation co-ordinators are suitably placed to act as case managers, they were nominated least by injured workers. Three vignettes of successful case management were presented and recommendations for policy and practice were made.

scholarly journals A Randomized Pilot Study Comparing the Efficacy of a Therapist-Delivered Motivational Interview to a Brief Computer-Delivered Intervention

2019 ◽  
Vol 8 (1) ◽  
pp. 29-36
Author(s):  
Lynn Hernandez ◽  
Mary Kathryn Cancilliere ◽  
Hannah Graves ◽  
Anthony Spirito
Keyword(s):  
Substance Use ◽  
Marijuana Use ◽  
Family Court ◽  
Adolescent Substance Use ◽  
Computer Assisted ◽  
Adolescent Substance ◽  
Significant Time ◽  
High Degree ◽  
Review Session

Aims: The purpose of this study was to compare the preliminary efficacy of a computer-assisted intervention (CAI), in which a computer-delivered intervention was immediately followed up with a brief therapist review session, to a therapist-delivered intervention (TDI) for adolescent substance use. Design, Setting, and Participants: Both conditions were examined in a pilot randomized clinical trial. All participants were recruited from a family court in the northeast United States. The sample included a total of 36 adolescents court-referred for an adolescent substance-related offense.Measures: Measures included adolescent alcohol and marijuana-use frequency, quantity, and problems as well as self-efficacy to resist the urge to use.Findings: While no significant time-by-condition differences were noted between the CAI and TDI conditions, significant time effects were found for both the TDI and CAI indicating a decrease in the total number of alcohol- or marijuana-use days over the six-month follow-up period.Conclusions: Given that CAIs are inexpensive, require minimal training, can be implemented with a high degree of fidelity, and are portable when compared to some TDIs, their use for decreasing substance use and related problems, particularly among adolescents with low access to substance-use interventions, seems promising. A fully powered trial of CAI efficacy is indicated.

VA Health Service use for homeless and low-income veterans: A spotlight on Los Angeles’ VA Supportive Housing program

2015 ◽  
Vol 146 ◽  
pp. e118-e119
Author(s):  
Sonya Gabrielian ◽  
Anita H. Yuan ◽  
Ronald Andersen ◽  
Lisa Rubenstein ◽  
Lillian Gelberg
Keyword(s):  
Los Angeles ◽  
Health Service ◽  
Low Income ◽  
Service Use ◽  
Supportive Housing ◽  
Health Service Use ◽  
Housing Program

Preparing Nurses for the Acute Care Case Manager Role: Educational Needs Identified by Existing Case Managers

1998 ◽  
Vol 29 (3) ◽  
pp. 130-134
Author(s):  
Marie T Nolan ◽  
Alexandra Harris ◽  
Amanda Kufta ◽  
Nancy Opfer ◽  
Holley Turner
Keyword(s):  
Acute Care ◽  
Case Manager ◽  
Educational Needs ◽  
Case Managers ◽  
Manager Role

Client Outcomes and the Working Alliance in Assertive Community Treatment Programs

2004 ◽  
Vol 5 (4) ◽  
pp. 199-202 ◽  
Author(s):  
Robert J. Calsyn ◽  
Gary A. Morse ◽  
W. Dean Klinkenberg ◽  
Matthew R. Lemming
Keyword(s):  
Substance Use ◽  
Working Alliance ◽  
Assertive Community Treatment ◽  
Psychiatric Symptoms ◽  
Case Manager ◽  
Self Report ◽  
Community Treatment ◽  
Treatment Programs ◽  
Client Outcome ◽  
Abuse Treatment

This study examined the relationship between outcomes and the working alliance in clients who were receiving assertive community treatment only or integrated assertive community treatment (assertive community treatment plus substance abuse treatment). All 98 participants had a severe mental illness and a substance use disorder. The Working Alliance Inventory assessed the alliance from the perspective of both the client and the case manager at 3 and 15 months into treatment. The six outcome measures were stable housing, client rating of psychiatric distress, interviewer rating of psychiatric symptoms, self-report of days used alcohol or drugs, and interviewer rating of substance use. Only 4 of 24 correlations were significant, indicating little relationship between the strength of the working alliance and client outcome.

scholarly journals Weighing up Work Willingness in Social Assistance: A Balancing Act on Multiple Levels

2019 ◽  
Vol 35 (5) ◽  
pp. 718-737 ◽  
Author(s):  
Marjolijn De Wilde ◽  
Sarah Marchal
Keyword(s):  
Political Ideology ◽  
Social Assistance ◽  
Case Manager ◽  
Individual Case ◽  
Case Managers ◽  
Unintended Consequences ◽  
Organizational Setting ◽  
Multiple Levels ◽  
Vignette Experiment ◽  
Welfare Agencies

Abstract In all European countries, social assistance legislation specifies that the receipt of benefits is conditional upon the willingness to work. Nevertheless, the manner in which such policies are implemented in practice has remained a black box. From the literature on social policy, social work, and social administration, we know that implementation is the result of decisions at multiple levels. To our knowledge, however, this study is the first quantitative attempt to bring together the insights from these various strands of literature into a combined assessment of factors that determine willingness-to-work assessments. We build on an innovative and purpose-designed survey of social workers in Belgium. We identified factors determining the perceptions of 584 case managers, clustered in 89 municipalities, with regard to sanction decisions upon job refusal, based on almost 5,000 experimentally varied client cases (vignette experiment). These unique data make it possible to distinguish between the effects of case managers who assess individual cases and characteristics of the local welfare agencies and municipalities in which they operate. The results reveal relatively little variation between municipalities, which can be largely explained by characteristics of the municipalities (e.g. political ideology and organizational setting). Surprisingly, however, we find extensive variation at the case-manager level. Although some of this variation remains unexplained, a substantial share can be explained by characteristics of individual case managers (e.g. age and attitudes concerning the welfare state). This finding raises concerns about the unintended consequences of the broad discretion granted to case managers within contemporary social assistance schemes.

scholarly journals Process and implementation of Audio Computer Assisted Self-Interviewing (ACASI) assessments in low resource settings: a case example from Zambia

2016 ◽  
Vol 3 ◽  
Author(s):  
J. C. Kane ◽  
L. K. Murray ◽  
S. Sughrue ◽  
J. DeMulder ◽  
S. Skavenski van Wyk ◽  
...  
Keyword(s):  
Substance Use ◽  
Risk Behaviors ◽  
Controlled Trial ◽  
Lessons Learned ◽  
Self Report ◽  
Computer Assisted ◽  
Middle Income ◽  
Orphans And Vulnerable Children ◽  
Barriers And Challenges ◽  
Audio Computer

Background.Studies from low- and middle-income countries (LMIC) indicate that the use of audio computer-assisted self-interviewing (ACASI) is associated with more accurate reporting of sensitive behaviors (e.g. substance use and sexual risk behaviors) compared with interviewer-administered questionnaires. There is a lack of published information on the process of designing, developing, and implementing ACASI in LMIC. In this paper we describe our experience implementing an ACASI system for use with a population of orphans and vulnerable children in Zambia.Methods.A questionnaire of mental health, substance use, and HIV risk behaviors was converted into an ACASI system, tested in pilot and validity studies, and implemented for use in a randomized controlled trial. Successes, barriers, and challenges associated with each stage in the development and implementation of ACASI are described.Results.We were able to convert a lengthy and complex survey into an ACASI system that was feasible for use in Zambia. Lessons learned include the importance of: (1) piloting the written and electronic versions; (2) proper and extensive training for study assessors to use ACASI and for those doing voice recordings; and (3) attention to logistics such as appropriate space, internet, and power.Conclusions.We found that ACASI was feasible and acceptable in Zambia with proper planning, training, and supervision. Given mounting evidence indicating that ACASI provides more accurate self-report data and immediate data download compared with interview-administered measures, it may be an effective and economical alternative for behavioral health research studies in LMIC.

scholarly journals Preliminary results from Brazil's first recovery housing program

2018 ◽  
Vol 40 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Dhione Almeida do Carmo ◽  
Sonia Maria Motta Palma ◽  
Ariadne Ribeiro ◽  
Alisson Paulino Trevizol ◽  
Elisa Brietzke ◽  
...  
Keyword(s):  
Substance Use ◽  
Outpatient Treatment ◽  
Positive Impact ◽  
Adherence To Treatment ◽  
Housing Program ◽  
Permanent Disability ◽  
End Of Treatment ◽  
Governmental Support ◽  
Recovery Housing ◽  
To Receive

Abstract Introduction: The recovery housing (RH) program was initiated in São Paulo with the objective of providing treatment for substance use disorders and addressing users’ housing and employment problems. The purpose of this study was to describe the model based on its first 11 months of operation, it was launched in June 2016 in Brazil. Method: We carried out a retrospective analysis of the records of all subjects treated in the RH of the Restart Program (Programa Recomeço) since its creation, from June 2016 to May 2017. Results: Sixty-nine subjects were included. Thirty-five (51%) remained in the household until the end of treatment or were reinserted in society. Thirty-four (49%) presented recurrence during their stay, of which 16 (47%) volunteered for treatment in a therapeutic community or psychiatric hospital, 8 (23.5%) chose to continue with outpatient treatment only, 6 (17.7%) returned to their families and continued to receive outpatient treatment, and 4 (11.8%) discontinued the treatment. Of the 35 subjects who completed the RH program, 28 (80%) were in employment and 7 (20%) received governmental support for permanent disability on medical or psychiatric grounds. Conclusion: RH can be an important component of integrated care and is used in several countries. Although controversial, the use of urine tests to control relapse seems to have a positive impact on adherence to treatment and maintenance of abstinence. These preliminary findings corroborate, with clear limitations, the evidence available in the literature showing that RH programs are effective for the treatment of addictions.

Sign in / Sign up

Export Citation Format

Share Document