Jeffersson Santos, Amanda Acevedo-Morales, Lillian Jones, Tara Bautista, Carolyn Camplain, Chesleigh N. Keene and Julie Baldwin
Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in…
Abstract
Purpose
Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in Arizona, United States of America (USA). This study aimed to explore the perspectives of people with a substance use disorder (SUD) on accessing integrated primary care (IPC) services in a rural-serving behavioral healthcare organization in Arizona.
Design/methodology/approach
Clients from a behavioral health facility in Arizona (n = 10) diagnosed with SUDs who also accessed IPC participated in a 45-min semi-structured interview.
Findings
The authors identified six overarching themes: (1) importance of IPC for clients being treated for SUDs, (2) client low level of awareness of IPC availability at the facility, (3) strategies to increase awareness of IPC availability at the behavioral health facility, (4) cultural practices providers should consider in care integration, (5) attitudes and perceptions about the experience of accessing IPC and (6) challenges to attending IPC appointments. The authors also identified subthemes for most of the main themes.
Originality/value
This is the first study in rural Arizona to identify valuable insights into the experiences of people with SUDs accessing IPC, providing a foundation for future research in the region on care integration.
Details
Keywords
Betty G. Brown, Julie A. Baldwin and Margaret L. Walsh
Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the contributing…
Abstract
Purpose – The purpose of this chapter is to provide a comprehensive overview of the substance use disparities among American Indian/Alaska Native (AI/AN) youth, the contributing factors to these disparities, proven and promising approaches through strengths-based methods, barriers to implementation of prevention and treatment efforts, and future recommendations for effective programs and research.
Approach – We have conducted a thorough literature review of relevant research studies, as well as a review of government, tribal, and community-based curricula and resources. This review of programs is not exhaustive but provides several examples of best practices in the field and suggestions for future directions.
Social implications – We strongly advocate that to accurately explore the true etiology of substance abuse and to respond to the concerns that AI/AN have prioritized, it is necessary to utilize a strengths-based approach and draw upon traditional AI/AN perspectives and values, and active community participation in the process. More specifically, prevention and treatment programs should use methods that incorporate elders or intergenerational approaches; foster individual and family skills-building; promote traditional healing methods to recognize and treat historical, cultural, and intergenerational and personal trauma; focus on early intervention; and tailor efforts to each Native nation or community.
Value – Ultimately, to reduce substance abuse disparities in AI/AN youth, we must find better ways to merge traditional Native practices with western behavioral health to ensure cultural competency, as well as to develop mechanisms to effect system- and policy-level changes that reduce barriers to care and promote the well-being of AI/AN youth, families, and communities.
Details
Keywords
Emery R. Eaves, Ricky L. Camplain, Monica R. Lininger and Robert T. Trotter II
The purpose of this paper is to characterize the relationship between adverse childhood experiences (ACEs) and substance use among people incarcerated in a county jail.
Abstract
Purpose
The purpose of this paper is to characterize the relationship between adverse childhood experiences (ACEs) and substance use among people incarcerated in a county jail.
Design/methodology/approach
A questionnaire was administered to 199 individuals incarcerated in a Southwest county jail as part of a social-epidemiological exploration of converging comorbidities in incarcerated populations. Among 96 participants with complete ACEs data, the authors determined associations between individual ACEs items and a summative score with methamphetamine (meth), heroin, other opiates and cocaine use and binge drinking in the 30 days prior to incarceration using logistic regression.
Findings
People who self-reported use of methamphetamine, heroin, other opiates or cocaine in the 30 days prior to incarceration had higher average ACEs scores. Methamphetamine use was significantly associated with living with anyone who served time in a correctional facility and with someone trying to make them touch sexually. Opiate use was significantly associated with living with anyone who was depressed, mentally ill or suicidal; living with anyone who used illegal street drugs or misused prescription medications; and if an adult touched them sexually. Binge drinking was significantly associated with having lived with someone who was a problem drinker or alcoholic.
Social implications
The findings point to a need for research to understand differences between methamphetamine use and opiate use in relation to particular adverse experiences during childhood and a need for tailored intervention for people incarcerated in jail.
Originality/value
Significant associations between methamphetamine use and opiate use and specific ACEs suggest important entry points for improving jail and community programming.
Details
Keywords
Brian Joseph Biroscak, Carol Bryant, Mahmooda Khaliq, Tali Schneider, Anthony Dominic Panzera, Anita Courtney, Claudia Parvanta and Peter Hovmand
Community coalitions are an important part of the public milieu and subject to similar external pressures as other publicly funded organizations – including changes in required…
Abstract
Purpose
Community coalitions are an important part of the public milieu and subject to similar external pressures as other publicly funded organizations – including changes in required strategic orientation. Many US government agencies that fund efforts such as community-based social marketing initiatives have shifted their funding agenda from program development to policy development. The Florida Prevention Research Center at the University of South Florida (Tampa, Florida, USA) created community-based prevention marketing (CBPM) for policy development framework to teach community coalitions how to apply social marketing to policy development. This paper aims to explicate the framework’s theory of change.
Design/methodology/approach
The research question was: “How does implementing the CBPM for Policy Development framework improve coalition performance over time?” The authors implemented a case study design, with the “case” being a normative community coalition. The study adhered to a well-developed series of steps for system dynamics modeling.
Findings
Results from computer model simulations show that gains in community coalition performance depend on a coalition’s initial culture and initial efficiency, and that only the most efficient coalitions’ performance might improve from implementing the CBPM framework.
Originality/value
Practical implications for CBPM’s developers and users are discussed, namely, the importance of managing the early expectations of academic-community partnerships seeking to shift their orientation from downstream (e.g. program development) to upstream social marketing strategies (e.g. policy change).
Details
Keywords
Lisa Ogilvie and Julie Prescott
The positive addiction recovery website (https://positiveaddictionrecovery.com) has been created following a successful pilot study of a programme of work known as positive…
Abstract
Purpose
The positive addiction recovery website (https://positiveaddictionrecovery.com) has been created following a successful pilot study of a programme of work known as positive addiction recovery therapy (PART). The aim of the website is to disseminate PART to an online audience, extending its reach to a larger population. The purpose of this study is to explain the process of creating this online resource and to conduct a user evaluation to understand how well received the website is likely to be to its target audience.
Design/methodology/approach
An implementation framework cognisant of positive computing, positive technology, contemporary understanding of human–computer interaction and knowledge acquired from the delivery of eHealth interventions from the past decade was used to create the website. To understand user opinion of the resultant website, data were collected using the mobile application ratings scale user version.
Findings
By adopting a tailored implementation framework, with appropriate determinant factors of wellbeing and evidenced theoretical input, a website resource was created that users considered engaging and informative. The findings also suggest that participants appreciated the importance of intended behavioural change, having interacted with the interventions on the website.
Originality/value
To the best of the authors’ knowledge, the website is the first online version of PART, a new programme of work aimed at people in addiction recovery.
Details
Keywords
Research has shown that one of the reasons lean transformations fail is inadequate lean knowledge of supervisors. The purpose of this paper is to discuss the development of a lean…
Abstract
Purpose
Research has shown that one of the reasons lean transformations fail is inadequate lean knowledge of supervisors. The purpose of this paper is to discuss the development of a lean training program for front-line manufacturing supervisors to provide them with the knowledge needed to engage their teams in daily continuous improvement.
Design/methodology/approach
A literature review was conducted on best practices in training design for positive transfer. Action research using qualitative methodologies was used to develop and pilot a new lean leadership training program for supervisors at one site within a case study company. The pilot was evaluated and continuously improved for future waves of training, consistent with action research, lean philosophies and training best practices.
Findings
Employee engagement has dramatically increased since the training class began and the number of lean improvements implemented in Operations at the case study company has increased 160 per cent. Manufacturing lead-time has also been reduced by more than 30 per cent. Because of the positive results from the training, it has been expanded at the pilot site and spread to other sites within the case study company.
Research limitations/implications
As with any case study, one must take care when attempting to generalize findings beyond the case being examined. However, the pilot training program was successfully extended to several sites across different business segments of the case study company, increasing the likelihood that similar results may apply in other cases.
Originality/value
The case provides empirical evidence of the development of an effective training program to mature the lean capability of supervisors. Other companies seeking to provide training to develop front-line lean leaders can benefit from the lessons learned from the case study.