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Results of a cluster-randomized trial of a Screening and Brief Intervention for heavy drinkers in dental practice are reported. Data were obtained from 103 heavy drinking patients recruited from randomized intervention (7; n = 50) and control (6; n = 53) practices. Analysis of data revealed that 6-month decreases in total drinks per week were significantly (p < .05) greater for heavy drinking intervention (43%) than control patients (21%)—a 4 drink per week difference. Similar decreases were obtained for quantity and frequency among intervention patients compared to control patients. Despite power limitations, the 6-month results support the effectiveness of the Screening and Brief Intervention. [ABSTRACT FROM AUTHOR]

Confirmatory factor analysis (CFA) techniques are used to evaluate the fit of a seven-dimensional concept mapping-based model of key dimensions of faith-based substance abuse treatment, using data from 310 staff and clients of 12 faith-based Teen Challenge programs. The initial seven-dimensional model fit poorly (fit indices of .62-.64), though, after trimming items with low loadings or redundant item content, model fit was increased substantially (fit indices of .87-.89). Overall, the current analyses provide preliminary support for the meaningfulness of the seven-dimensional model of faith-based treatment programs, despite different statistical approaches. [ABSTRACT FROM AUTHOR]

Analyses of the 2002 U.S. National Health and Examination Survey (1,490 adults) examined relationships between alcohol frequency, quantity, and total weekly consumption and preventive and emergency dental service use during the past 12 months. Logistic regression analyses indicated a significant, small percentage of variance in dental service use explained by alcohol use (1%), controlling for predisposing (19%), enabling (18%), or need (4%) covariates. Preventive and emergency service use were associated with higher frequency drinking, but lower total consumption (significant only for preventive services). Limitations and implications for brief alcohol interventions in dental practice are discussed. [ABSTRACT FROM AUTHOR]

Extant measures of spirituality-religiosity, not developed specifically with substance abuse treatment populations in mind, may not be culturally appropriate in regard to either: (1) the 12-step “culture” found in many treatment programs; or (2) racial-ethnic minority populations overrepresented in publicly funded programs. A 40-item four-dimensional measure was developed, which differentiates “religiosity” (religious practices) from “spirituality” (an individual's relationships with God/higher power, others, and self). Instrument development involved: qualitative focus groups with individuals in seven diverse Texas treatment programs; quantitative exploratory and confirmatory (CFA) analyses to test the four-factor model conducted using data from 237 diverse clients in treatment programs in Tennessee and Virginia. Confirmatory analyses indicate acceptable fit indices (>0.90) for the four-factor model, and acceptable reliability estimates for all subdimensions (≥0.70) provide further support for the measures. Results support the potential usefulness of the measures. [ABSTRACT FROM AUTHOR]

Reliable and valid measures of religiosity and spiritual dimensions appropriate for ethnically diverse groups are needed. I examine the factor structure of the relatively new Fetzer multidimensional measure (Fetzer Institute 1999). Confirmatory factor analyses (CFA) of national data collected in the 1998 General Social Survey are conducted to (1) test the fit of the proposed dimensionality of the Fetzer measure, specifically comparing the Fetzer structure with a simpler single-factor model suggested by preliminary exploratory factor analyses; and (2) evaluate ethnic differences in factor structure of the Fetzer items. Data from 1,201 adults, 1,019 whites and 182 African Americans, are examined to compare the fit of the multidimensional Fetzer model against an alternative single-factor (“unitary spirituality”) model. CFA analyses indicated that only the Fetzer models had acceptable fit indices (NFI and/or NNFI approaching or reaching 0.90). Ethnic differences in loadings, while significant, were not substantively different. These findings suggest that a multidimensional measure like the Fetzer is useful for multiethnic research and that combining the daily spirituality and values/beliefs dimensions into a single factor provides a simpler model overall (compared to the Fetzer model separating these dimensions out) while providing acceptable fit. [ABSTRACT FROM AUTHOR]

Abstract: This article (a) discusses the definition of faith-based substance abuse treatment programs, (b) juxtaposes Durkheim''s theory regarding religion with treatment process model to highlight key dimensions of faith-based and traditional programs, and (c) presents results from a study of seven programs to identify key program dimensions and to identify differences/similarities between program types. Focus group/Concept Mapping techniques yielded a clear “spiritual activities, beliefs, and rituals” dimension, rated as significantly more important to faith-based programs. Faith-based program staff also rated “structure and discipline” as more important and “work readiness” as less important. No differences were found for “group activities/cohesion” and “role modeling/mentoring,” “safe, supportive environment,” and “traditional treatment modalities.” Programs showed substantial similarities with regard to core social processes of treatment such as mentoring, role modeling, and social cohesion. Implications are considered for further research on treatment engagement, retention, and other outcomes. [Copyright &y& Elsevier]

Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of "spiritual transformation" in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement. [ABSTRACT FROM AUTHOR]

The article focuses on spiritual mechanisms underlying substance abuse behavior change in faith-based substance abuse treatment. Several definitions of faith-based organizations are being discussed. An integrative conceptual framework articulating connections between spiritual intervention components, behavior change processes and substance abuse outcomes is presented. Faith-based substance abuse treatment programs concerns the distinction between religion and spirituality. The article states that the ecological perspective and the model of social work practice provide for the incorporation of the element of personal spirituality, and therefore spiritual change, in viewing any individual presenting for services. A number of human and social service organizations have been addressed by faith-based programs. It has been found that religious or spiritual involvement may serve as a protective factor against the development of substance abuse problems. During substance abuse treatment some spiritual changes occur and substance abuse interventions may be effective for those for whom religion or spirituality is salient.

In order to examine the relative importance of general individual orientations (mastery and self-esteem) and specific coping styles with regard to psychological distress among women with HIV, data are examined from a pilot study involving in-depth face-to-face interviews with 32 HIV+ Latinas receiving care at 4 clinics serving the South Texas population. Interviews were conducted to provide preliminary psychometric information on coping and distress instruments in this predominantly Mexican American population as well as to examine psychosocial factors related to individual adjustment to HIV among Latina females. Refusal rates were low in this study (approximately 10%) and measurement instruments generally had acceptable internal consistency reliability. Results of exploratory multiple regression analyses suggest that self-esteem and mastery may be more salient predictors of depression and anxiety symptoms than are specific coping strategies. [ABSTRACT FROM AUTHOR]

The study discussed in this article examined the relationship between depression symptomatology and functional impairment among white and African American elderly people and investigated the effect of race, religiosity, and social support on this relationship. Study results indicate that although African American elderly people were more impaired in the performance of activities of daily living (ADL) and instrumental activities of daily living (IADL) than white elderly people, they did not experience higher levels of depression. However, African Americans did report significantly higher levels of religiosity and social support. [ABSTRACT FROM AUTHOR]

The predictive validity of a treatment readiness measure designed for out-of-treatment drug users, tapping dimensions of perceived problem severity, perceived need for formal treatment, motivation for treatment, and negative attitudes toward treatment is examined using data from a National Institute on Drug Abuse (NIDA)-funded HIV outreach intervention in San Antonio, Texas. Logistic regression is used to predict use of substance abuse treatment services three months after program intake on the basis of readiness scores, controlling for demographic and drug history variables. Analyses of data from 673 drug users in an HIV outreach intervention indicated that treatment readiness dimensions accounted for a 12% increase in variation in "use of any modality" and 14% for "use or attempted service use". Only Motivation to Quit was a significant predictor of "use of any modality" and both Perceived Need for Treatment and Motivation to Quit were significant predictors of "use or attempted use". Findings support the importance of the individual's perception of "readiness" to change their substance-abusing behavior and enter treatment. [ABSTRACT FROM AUTHOR]

This article presents the results of a confirmatory factor analysis expanding and enhancing a previously developed measure of "machismo" both to explore the dimensionality of the measure and to test the invariance of factor structure in a sample of Anglo, African American, and Mexican American adult male drinkers. Specifically, this article (a) describes the development of a multidimensional 13-item machismo measure, (b) tests the goodness of fit of a series of confirmatory factor models examining single versus multiple factor solutions (e.g., Does a unitary machismo factor fit, or must positive and negative dimensions be modeled?), and (c) tests the invariance of the resulting model across racial-ethnic groups. Results support the use of the measures for cross-ethnic studies and emphasize the importance of a multidimensional measure including both positive and negative dimensions. [ABSTRACT FROM AUTHOR]

Studies the impact of intensive outpatient mental health interventions on the hospitalization rate and length of stay of adults with mental retardation and severe psychiatric disorder. Attributes of the respondents who were chosen for the study; Decreases in both hospitalizations and length of stay after the respondents' entry in a mental health program.

Three models of continuing education--full-day, half-day, and brief workshop--for health providers treating patients with HIV/AIDS were compared on measures of effectiveness with regard to knowledge, attitude, and practice outcomes. Analyses of pre- and postintervention data from two years of training events suggest consistent, modest, program effects in the full-day and half-day approaches, specifically in the area of knowledge enhancement. [ABSTRACT FROM AUTHOR]

Evaluates a causal model of the Health Belief Model in HIV infections. Emphasis on possible indirect paths linking distal demographic susceptibility variables to HIV infections; Ethnic comparison of the data; Epidemiology of HIV/AIDS.

Background: Although great emphasis has been placed on educating the public regarding HIV and sexually trasmitted disease (STD)prevention, equally important is provider education, as primary care and other health care practitioners have considerable potential for patienteducation.Recentreviews ofthe continuing medical education (CME) literature 1,2 have proposed the need for innovative educational approaches, suggesting limited support for the effectiveness of traditional didactic 1-day or shorter conferences that do not specifically involve enabling or reinforcing approaches such as role modeling, rehearsal, and case discussion. 2 Purposes: To examine short-term (2-month)and long-term (12-month)effects of the interventions with regard to STD knowledge, attitudes toward STD/HIV risk assessment,and frequencyofboth STDdiagnosis and STDpatienteducation and counseling. Methods: Pre- and postintervention (2-month and 12-month)data were obtained from a CME conference (n = 32) and 3 Clinic Workshop interventions (n = 93) held in South Texas. Results: Consistentpre-postgains in outcome measures were found in both CMEand CWmodels and among both STD practitioners and nonpractitioners among participants with lower initial knowledge or practice levels. Analyses did not support the posited facilitative effect of having multiple staff members from specific clinics in the CWcondition. Conclusions: For both models,significantgains frombaseline were found among those with initially lower knowledge/practice levels for knowledge and attitude dimensions, with the largest gains observed for patient education/counseling frequency. [ABSTRACT FROM AUTHOR]

The present study examined career pathways and current work patterns for 110 graduates of an internship program. Results show that the group trained after 1980 went into private practice more rapidly than those trained prior to 1980. Both groups do extensive psychological testing. Implications are discussed. [ABSTRACT FROM AUTHOR]

Presents a study that examines the hypothesis that minority male drinkers may differ from non-Hispanic White males in the propensity to mature out of patterns of heavy drinking. Research design and methodology; Drinking history parameters by ethnicity.

The failure of the labeling perspective to account for informal reaction processes is noted. Viewing informal labeling in terms of emergence and the documentary method, definitional processes are divided into two categories: (1) intra-situational definitions concerning the practical problems of negotiating an interactional encounter, and (2) frans-situational definitions in which the actor is evaluated in terms of cultural knowledge and prior experience. A repeated measures experimental study is discussed which indicates that intra-situational and trans-situational definitions are differentially responsive to variations over time in the typicality of an actor's behavior. Implications for the concept of "aligning actions" are discussed. [ABSTRACT FROM AUTHOR]

Examines the relationship among ethnicity, gender, alcohol consumption and sexual behaviors in a community survey sample of adults. Description of the predictors used; Independence of alcohol use and sexual relationship with psychosocial background characteristics; Relationship of situated drinking with sexual behavior; AIDS sexual risk behavior.

This paper addresses the phenomenon of ‘solitary drinking’, considering whether Anglo, African American and Mexican American male regular drinkers differ in the propensity to drink in solitary contexts and whether such differences may help to explain observed ethnic variation in patterns of heavy drinking. Further, the paper considers whether apparent relationships between solitary drinking and drinking patterns are explained by individual personality characteristics such as social isolation and/or by endorsement of ‘escape drinking’ motives. Data were analysed from a random community sample of 481 adult male regular drinkers in San Antonio, Texas, USA. Contingency table and logistic regression analyses indicated that initially observed ethnic differences in high quantity and high maximum drinking were largely eliminated by controls for education, escape motives and solitary drinking. Ethnic variation in the role of solitary drinking was suggested as well, with solitary drinking more strongly related to high quantity consumption, in particular, among African Americans than among Mexican Americans. The nature of the observed interactions suggests that fundamental differences between Anglos and African Americans in the roles of solitary drinking and escape drinking motives may underlie seemingly similar frequent, lower quantity drinking patterns in these groups that appear more frequently than among Mexican American males. [ABSTRACT FROM PUBLISHER]

An integrated model of change in knowledge, highlighting the role of technologic and organisational paradigms and the activities of professional and extra-professional groups, is used to clarify the historical development of psychiatry and to account for current specialty choice trends. American psychiatry and medicine stem from disparate scientific/philosophical roots. A review of events leading to the establishment of psychiatry as a medical specialty indicates that the merger of psychiatry and neurology may have stemmed as much from professional competition as from technological or paradigmatic convergence. Recent perceived declines in the choice of psychiatry as a medical specialty are examined in light of this sociology of knowledge perspective. Declining choice of psychiatry as a specialty reflects both underlying paradigmatic conflicts with medicine as well as declining federal support for psychiatric training. Solutions proposed for the perceived problem within psychiatry are designed to solidify ties with medicine, increase political power and prestige, and retain federal support. [ABSTRACT FROM AUTHOR]

Data from a community sample of 1,784 Anglo, African-American, and Mexican-American adults were examined to assess: (I) the nature and magnitude of observed racial/ethnic and acculturation level differences in depression, (2) the relative contribution of sociodemographic and psychosocial factors (fatalism and religiosity) to observed differences, and (3) the joint effects of fatalism and religiosity as sociocultural resources with regard to depression in differing racial/ethnic and acculturation level subgroups. Analyses indicate the most dramatic differences in depression among males- African Americans were roughly similar to Anglos and levels of depression were significantly higher among the least acculturated Mexican Americans relative to Anglos, even after statistical controls. Acculturation level differences among Mexican-American females were explained by statistical controls. Lower levels of depression among more highly acculturated than among less acculturated Mexican Americans provide little support for a simplistic stress formulation of acculturation. Rather, the interplay of acculturation, Fatalism, and religiosity supports a more complex cultural marginality model, emphasizing the consistency of attitudinal elements and language use as facilitators or inhibitors of assimilation into Anglo culture. Both those who successfully acculturate and those who are most insulated in traditional culture appear least depressed from this perspective. [ABSTRACT FROM AUTHOR]

Previous rural studies have indicated that life events are most strongly related to depressive symptoms among abstainers and heavy drinkers, and least strongly among moderate drinkers. The generalizability of possible stress-buffering properties of moderate alcohol use were evaluated using data from 554 white residents of 9 rural counties around Nashville, Tennessee, and from 314 white and 306 black residents of Nashville. Information on typical quantity and frequency of alcohol consumption was used to classify respondents as abstainers, occasional, moderate, or heavy drinkers. The event-by-drinking pattern interaction was significant only for the rural sample. There was some suggestive evidence of buffer effects among urban whites, though events were fairly consistently related to depressive symptoms among urban black drinkers. Further controls for religious identification/commitment did not account for the specificity of buffer effects to rural communities. [ABSTRACT FROM AUTHOR]

Examines the accidental needlestick exposure to blood containing the human immunodeficiency virus (HIV) showing strong predictor of subsequent infection. Elevation on the risk for HIV transmission; Use of syringe with detachable needles among drug injectors; Types of syringes.

The article presents information on the efforts of a organization in AIDS control. Located in Cleveland, Ohio, the Xchange Point is a nonprofit community-based AIDS services organization founded in 1996 as a street-based outreach and SEP. Trained community health outreach workers have conducted street-based, roving outreach in four areas of Cleveland on a weekly basis since the program's inception. A substance abuse services has been the rise of the harm-reduction model and non- abstinence-based services. Harm reduction is based on the suppositions that drug use will continue to exist for most users and that safer use is always possible. The first syringe exchange program (SEP) was established in the U.S. in 1988 in Tacoma, Washington. There is strong evidence supporting the effectiveness of SEPs with regard to decreased HIV- infection rates, decreased incidence of sharing of injection equipment, and increased frequency of the disinfection of injection equipment.