Browsing by Author "Barnett, Tracey E."
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Item Addressing Disparities in Treatment for Substance Use Disorder Among Individuals with Developmental Disabilities: Perspectives from Treatment Facility Employees(2024-03-21) Yip, Maggie; Phan, Cong-Bao; Espinoza, Anna; Walters, Scott; Barnett, Tracey E.; Bednar, Hannah; Garcia, Lizbeth; Taha, Suha; Miller, Jackson; Lopez, Cindy; Fulda, KimberlyPurpose Research on substance use disorder (SUD) among individuals with developmental disabilities (DD) is limited. The extant literature suggests that people with DD are less likely to use substances overall compared to people without a disability; however, they are more susceptible to SUD if they do use substances. Among facilities in the United States that provide aid for individuals with DD and treatment facilities for individuals with SUD, there are currently no interdisciplinary practice guidelines or training materials available for providers treating those with a co-diagnosis of DD and SUD. Our project aims to reduce the disparities between treatment guidelines and materials available for people with a co-diagnosis of both SUD and DD. The purpose of this analysis was to gauge overall awareness of providing treatment for individuals with SUD/DD co-diagnosis and reflect on current protocols regarding this population. Methods In this project, interviews were conducted with workers at facilities that primarily provide SUD services. Relevant facilities were identified and selected through systematic internet searches. In this study, 11 questions were asked to workers at facilities through 15-30 minute phone interviews. Questions that were used for this analysis revolved around themes of workers’ perspectives on the importance of integrating SUD/DD services, their current practices, and their future recommendations for integrating care for individuals with both SUD/DD. Results We conducted a total of 12 interviews. Responses came from the South and Midwest United States geographical regions. From these interviews, we found that most programs aim to individualize their approaches to treating this specific population. However, there is no standardized approach to how they individualize these cases. Furthermore, many programs expressed that they rarely refer individuals with a co-diagnosis of SUD/DD outside of their agency and feel inadequately prepared to treat individuals with SUD/DD co-diagnosis, which further emphasizes the need for accessible standardized guidelines. Overall, many workers expressed a need for improved access to screenings, assessment tools, specific guidelines, knowledge, training, and specialized programs for the variety of specific types of DDs. Conclusions People with DD that experience SUD are a vulnerable population with few resources. To meet the needs of this vulnerable population, standardized guidelines and training materials should be developed to address the specific needs of this patient population and equip healthcare providers and stakeholders with the tools necessary to ensure this population has proper and equitable access to treatment.Item Differences by Depression Severity Category in Cigarette Smoking Among Low-Income Housing Residents(2018-03-14) Mallampati, Rajesh; Barnett, Tracey E.; Livingston, Melvin D.; Rendon, AlexisPurpose: Smoking is especially prevalent in low-income groups with additional characteristics. Smoking prevalence is estimated to be 70% among homeless individuals and 77% among low-income substance users in treatment. Among the low-income and mentally ill, the smoking prevalence is 31.7%. The most common mental illness, depression, has been frequently studied as a comorbidity of smoking. Approximately 60% of individuals with depression are current or former smokers. This association has often been studied with a binary measure of depression, which may overlook the effects of depression severity on smoking behavior. Methods: This study used data collected from participants in subsidized housing enrolled in a health coaching intervention called “Mobile Community Health Assistance for Tenants” or “m.chat.” The sample included 420 residents with a mental health condition. A zero-inflated Poisson regression was used to determine the association between smoking cigarettes and four levels of depression: minimal or none (PHQ9 ≤4), mild (PHQ9 5 - 9), moderate (PHQ9 10 - 14), and severe (PHQ9 ≥15). Results: The majority (73.3%) of individuals smoked an average of 7.5 cigarettes per day. In our population with a high prevalence of smoking and depression, when we controlled for depression severity, we found that those without depressive symptoms were more likely to smoke. Depression risk was significantly associated with both the likelihood of smoking (chi-sq=11.03, p=0.0116) and the number of cigarettes smoked among smokers (chi-sq=14.89, p=0.0019). Moderate depression severity resulted in increased odds of being a smoker (OR=2.16, 95%CI:[1.01,4.64]), but a decrease in the number of cigarettes smoked (RR=0.87, 95%CI:[0.77,0.99]). Conclusion: Further study is warranted to examine the relationship between depression severity and cigarette smoking.Item Effects of Popular Diets without Specific Calorie Targets on Weight Loss Outcomes: Systematic Review of Findings from Clinical Trials(MDPI, 2017-07-31) Anton, Stephen D.; Hida, Azumi; Heekin, Kacey; Sowalsky, Kristen; Karabetian, Christy; Mutchie, Heather; Leeuwenburgh, Christiaan; Manini, Todd M.; Barnett, Tracey E.The present review examined the evidence base for current popular diets, as listed in the 2016 U.S. News & World Report, on short-term (≤six months) and long-term (≥one year) weight loss outcomes in overweight and obese adults. For the present review, all diets in the 2016 U.S. News & World Report Rankings for "Best Weight-Loss Diets", which did not involve specific calorie targets, meal replacements, supplementation with commercial products, and/or were not categorized as "low-calorie" diets were examined. Of the 38 popular diets listed in the U.S. News & World Report, 20 met our pre-defined criteria. Literature searches were conducted through PubMed, Cochrane Library, and Web of Science using preset key terms to identify all relevant clinical trials for these 20 diets. A total of 16 articles were identified which reported findings of clinical trials for seven of these 20 diets: (1) Atkins; (2) Dietary Approaches to Stop Hypertension (DASH); (3) Glycemic-Index; (4) Mediterranean; (5) Ornish; (6) Paleolithic; and (7) Zone. Of the diets evaluated, the Atkins Diet showed the most evidence in producing clinically meaningful short-term (≤six months) and long-term (≥one-year) weight loss. Other popular diets may be equally or even more effective at producing weight loss, but this is unknown at the present time since there is a paucity of studies on these diets.Item Food Choice Priorities Change Over Time and Predict Dietary Intake at the End of the First Year of College Among Students in the U.S(MDPI, 2018-09-13) Vilaro, Melissa J.; Colby, Sarah E.; Riggsbee, Kristen; Zhou, Wenjun; Byrd-Bredbenner, Carol; Olfert, Melissa D.; Barnett, Tracey E.; Horacek, Tanya; Sowers, Morgan; Mathews, Anne E.This study assessed food choice priorities (FCP) and associations with consumption of fruits and vegetables (FV), fiber, added sugars from non-beverage sources, and sugar-sweetened beverages (SSB) among college students. Freshmen from eight U.S. universities (N = 1149) completed the Food Choice Priorities Survey, designed for college students to provide a way to determine the factors of greatest importance regarding food choices, and the NCI Dietary Screener Questionnaire. Changes in FCP and dietary intake from fall 2015 to spring 2016 were assessed. Multiple regression models examined associations between FCP and log-transformed dietary intake, controlling for sex, age, race, and BMI. Participant characteristics and FCP associations were also assessed. FCP importance changed across the freshmen year and significantly predicted dietary intake. The most important FCP were price, busy daily life and preferences, and healthy aesthetic. Students who endorsed healthy aesthetic factors (health, effect on physical appearance, freshness/quality/in season) as important for food choice, consumed more FV and fiber and less added sugar and SSB. Busy daily life and preferences (taste, convenience, routine, ability to feel full) predicted lower FV, higher added sugar, and higher SSB consumption. Price predicted lower FV, higher SSB, and more added sugar while the advertising environment was positively associated with SSB intake. FCP and demographic factors explained between 2%(-)17% of the variance in dietary intake across models. The strongest relationship was between healthy aesthetic factors and SSB (B = -0.37, p < 0.01). Self-rated importance of factors influencing food choice are related to dietary intake among students. Interventions that shift identified FCP may positively impact students' diet quality especially considering that some FCP increase in importance across the first year of college.Item Improving the Efficiency of A and D Optimal Designs for Dose Response Models(2021-08) Jasti, Srichand; Nandy, Rajesh R.; Aryal, Subhash; Thombs, Dennis; Barnett, Tracey E.; Haque, UbydulFor A-optimality, by virtue of Cramér–Rao bound, the trace of the inverse of Information matrix for the parameters serves as a lower bound for the sum of variances of the estimators and the bound is attained asymptotically. Hence, asymptotically, A-optimality is achieved by minimizing the trace of the inverse of the Information matrix. For non-linear models, Cramér–Rao bound is crude for finite samples and hence the asymptotic solution can be very different from the design that minimizes the sum of variances. We explore the validity of the asymptotic solution by directly minimizing the sum of variances using numerical methods in a restricted search space. We demonstrate that even in a very restrictive search space of point symmetric designs, the theoretical solution is half as efficient for a sample size of 100. Further improvement can be achieved by relaxing the restriction of the solution being point symmetric. The solution to A and D optimal designs for the logistic model depend on the unknown parameters of the model. Therefore, to obtain an optimal design the experimenter must inform the design based on some prior knowledge, or a guess, of the unknown parameters. This is a severe limitation on the ability to identify an optimal design especially when there is little prior information to inform the guess. Here we explore the use of a two-stage A-optimal design for finite samples and three-stage D-optimal design for large samples to mitigate the loss in efficiency which may arise due to poor guess values. We demonstrate that while two-stage finite sample model results in gain in efficiency with small sample sizes at 70% allocation to the first stage. The three-stage D optimal design is shown to be almost always better than the single stage and the corresponding two-stage design.Item Past-Year Blunt Smoking among Youth: Differences by LGBT and Non-LGBT Identity(MDPI, 2023-04-14) Yockey, R. Andrew; Barnett, Tracey E.Blunt use (co-use of tobacco and marijuana) is a growing phenomenon among youth and disproportionately affects minority populations. LGBT+ populations are significantly more likely to use marijuana and tobacco, but this relationship has yet to be examined among LGBT+ adolescents. This analysis aimed to investigate past-year blunt use among a national sample of youth and delineate the differences between non-LGBT and LGBT+ youth. We used Wave 2 of the Population and Tobacco Health (PATH) study. We analyzed data from 7518 youth, comparing past-year blunt use between LGBT+ and non-LGBT youth, controlling for biological sex, race, and age using weighted logistic regression models. Greater than 1 in 10 youth (10.6%) reported using blunts in the past year. More than one in five (21.6%) LGBT+ youth reported using blunts in the past year. There were no significant differences between boys and girls. Older youth (17 years old) were more likely to use blunts in the past year (aPR: 3.04, 95% CI 2.48, 3.79) than younger youth. Compared with non-LGBT youth, LGBT+ youth were 2.17 times (95% CI 1.86, 2.54) more likely to report using blunts in the past year. Blunt use and its respective impact on health outcomes among developing youth are of concern to public health. These findings demonstrate that certain subgroups of youth are more at risk for use and emphasize the need for tailored interventions to mitigate initiation and current use, given that one of the goals of the Healthy People 2030 initiative is to "Improve the health, safety, and well-being of lesbian, gay, bisexual, and transgender (LGBT) individuals."Item Smoking cessation and survival among people diagnosed with non-metastatic cancer(BioMed Central Ltd., 2020-08-05) Barnett, Tracey E.; Lu, Yan; Gehr, Aaron W.; Ghabach, Bassam; Ojha, Rohit P.BACKGROUND: We aimed to estimate the effects of smoking cessation on survival among people diagnosed with cancer. METHODS: We used data from a Comprehensive Community Cancer Program that is part of a large urban safety-net hospital system. Eligible patients were diagnosed with primary invasive solid tumors between 2013 and 2015, and were current smokers at time of diagnosis. Our exposure of interest was initiation of smoking cessation within 6 months of cancer diagnosis. We estimated inverse probability weighted restricted mean survival time (RMST) differences and risk ratio (RR) for all cause 3-year mortality. RESULTS: Our study population comprised 369 patients, of whom 42% were aged < 55 years, 59% were male, 44% were racial/ethnic minorities, and 59% were uninsured. The 3-year RMST was 1.8 (95% CL: - 1.5, 5.1) months longer for individuals who initiated smoking cessation within 6 months of cancer diagnosis. The point estimate for risk of 3-year mortality was lower for initiation of smoking cessation within 6 months of diagnosis compared with no initiation within 6 months (RR = 0.72, 95% CL: 0.37, 1.4). CONCLUSIONS: Our point estimates suggest longer 3-year survival, but the results are compatible with 1.5 month shorter or 5.1 longer 3-year overall survival after smoking cessation within 6 months of cancer diagnosis. Future studies with larger sample sizes that test the comparative effectiveness of different smoking cessation strategies are needed for more detailed evidence to inform decision-making about the effect of smoking cessation on survival among cancer patients. IMPLICATIONS FOR CANCER SURVIVORS: The benefits of smoking cessation after cancer diagnosis may include longer survival, but the magnitude of benefit is unclear.Item Vaping Expectancies: A Qualitative Study among Young Adult Nonusers, Smokers, Vapers, and Dual Users(Sage Publications, 2019-08-19) Harrell, Paul T.; Brandon, Thomas H.; England, Kelli J.; Barnett, Tracey E.; Brockenberry, Laurel O.; Simmons, Vani N.; Quinn, Gwendolyn P.BACKGROUND: "Expectancies," or beliefs about outcomes, robustly correlate with and predict several behaviors including electronic nicotine delivery system ("e-cigarette") use. However, there is limited qualitative research available regarding relevant e-cigarette vaping expectancies. OBJECTIVES: The present study used a qualitative approach to derive and refine e-cigarette expectancy themes among young adults. METHODS: We conducted 12 focus groups and two individual interviews with young adult nonusers, e-cigarette vapers, cigarette smokers, and dual users to assess beliefs about the effects of e-cigarettes. After a series of open-ended questions, follow-up questions assessed reactions to domains previously examined in expectancy measures for cigarette smoking and e-cigarette vaping. The constant comparative method was used to derive themes from transcripts. RESULTS: Four main themes (Positive Reinforcement, Social Benefits, Negative Affect Reduction, Negative Consequences) emerged from the results. Each theme contained three associated subthemes (Positive Reinforcement: Sensorimotor Experiences, Taste, Stimulation; Social Benefits: Social Facilitation, Influence on Others, Convenience; Negative Affect Reduction: Stress Reduction, Appetite Reduction, Boredom Reduction; and Negative Consequences: Health Risks, Addiction, Secondhand Effects). CONCLUSIONS/IMPORTANCE: Previously identified smoking expectancies appear relevant for young adult vaping, with some notable refinements. Positive reinforcement aspects encompassed aerosol clouds, vaping tricks, and unique flavors. Social benefits included influencing others via social media and competitive activity, as well as the convenience of use in a variety of places. Negative affect reduction was controversial among user groups, but vaping was seen as more interesting than smoking and thus more effective at boredom reduction. Young adults were uncertain regarding negative consequences, but appreciated a potential for secondhand effects. Measure refinement via qualitative research and future field testing can enhance our understanding of this relatively new behavior, supporting tobacco control surveillance, marketing/labeling regulations, and counter-advertising development/evaluation.