Browsing by Subject "Alcohol Drinking"
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Item Association of Magnesium Intake with Liver Fibrosis among Adults in the United States(MDPI, 2021-01-02) Tao, Meng-Hua; Fulda, Kimberly G.Liver fibrosis represents the consequences of chronic liver injury. Individuals with alcoholic or nonalcoholic liver diseases are at high risk of magnesium deficiency. This study aimed to evaluate the association between magnesium and calcium intakes and significant liver fibrosis, and whether the associations differ by alcohol drinking status. Based on the National Health and Nutrition Examination Survey (NHANES) 2017–2018, the study included 4166 participants aged >18 years who completed the transient elastography examination and had data available on magnesium intake. The median liver stiffness of 8.2 kPa was used to identify subjects with significant fibrosis (≥F2). The age-adjusted prevalence of significant fibrosis was 12.81%. Overall total magnesium intake was marginally associated with reduced odds of significant fibrosis (p trend = 0.14). The inverse association of total magnesium intake with significant fibrosis was primarily presented among those who had daily calcium intake <1200 mg. There were no clear associations for significant fibrosis with calcium intake. Findings suggest that high total magnesium alone may reduce risk of significant fibrosis. Further studies are needed to confirm these findings.Item Do brief motivational interventions increase motivation for change in drinking among college students? A meta-analysis of individual participant data(2022-08) Tan, Zhengqi; Mun, Eun-Young; Walters, Scott T.; Zhou, Zhengyang; Huh, David; Nandy, Rajesh R.Brief Motivational Interventions (BMIs) have been identified as one of the most effective individually focused alcohol intervention strategies for college students in the United States. Despite the central role of motivation for change in BMIs, whether BMIs increase motivation for change has rarely been investigated. The current study conducted a meta-analysis of individual participant data (IPD; 15 studies, N = 5,903) from Project INTEGRATE (Mun et al., 2015) to examine whether BMIs increase motivation for change in drinking. Different measures and responses used in the original trials were harmonized across studies, and effect size estimates were derived from a model that adjusted for baseline motivation and demographic variables for each study (step 1) and subsequently combined in a random-effects meta-analysis model (step 2). After adjustment for baseline levels of motivation level and demographic variables, the intervention effects of BMIs on motivation for change was not statistically significant (standard mean difference [SMD]: 0.026, 95% CI: [-0.001, 0.053], p = .06, k = 19). Subsequent metaregression analyses among BMI subtypes indicated that the intervention effect did not differ between individually delivered motivational interviewing with personalized feedback (MI+PF), stand-alone personalized feedback (PF), and group-based motivational interviewing (GMI). Among all BMI subtypes, only GMI had a statistically significant intervention effect on motivation compared to controls (SMD: 0.055, 95% CI: [0.007, 0.103], p = .025, k = 5). Within the first three months post-intervention, there was a decrease in SMD of 0.05 (95% CI: [0.01, 0.08]) in motivation per month. However, no statistically significant difference in the intervention effects was found between studies with short-term vs. long-term follow-up. Although the results from the current study do not support the hypothesis that BMIs improve motivation for change, the evidence as a whole suggests ways in which motivation may be improved following intervention and can be tested in future studies.Item Lifestyle Factors and Depressive Symptoms Among Permanent Supportive Housing Residents(2020-05) Holmes, Esther J.; Walters, Scott T.Background: Depression is prevalent among low-income populations. Many lifestyle factors may influence depressive symptoms, including vegetable and fruit intake, physical activity, tobacco use, alcohol use, social support, and satisfaction with leisure activities. However, the influence of lifestyle factors on depressive symptoms among permanent supportive housing (PSH) residents is unclear. In addition, it is unclear if PSH residents with depressive symptoms are interested in working on lifestyle factors. Methods: A longitudinal analysis was conducted among 420 PSH residents participating in a technology-assisted health coaching program. Three timepoints were included, corresponding with the screening/baseline, six-month, and twelve-month assessment visits. The independent variables were total vegetable and fruit intake, physical activity, tobacco use, alcohol use, social support, and satisfaction with leisure activities. The dependent variable was depressive symptoms, measured by the 9-item Patient Health Questionnaire (PHQ-9). Covariates were race, sex, age, and visit. In addition, social support was examined as a potential effect modifier. Participants' interest in working on health areas was evaluated as well. Results: Moderate alcohol consumption predicted lower depressive symptoms compared with heavy alcohol consumption (b=-1.54, p=0.01). Additionally, the difference in depressive symptoms between non-consumers and heavy consumers of alcohol approached statistical significance with non-consumers of alcohol having less depressive symptoms than heavy consumers of alcohol (b = -.76, p = .07). High compared with low satisfaction with leisure activities (b=-0.83, p<0.0001) and high compared with low social support (b=-1.86, p<.0001) predicted lower depressive symptoms. Tobacco use was a marginally statistically significant predictor of depressive symptoms (b=0.92, p=0.05). Total vegetable and fruit intake and physical activity were not statistically significant predictors of depressive symptoms. Social support was not a statistically significant modifier of the effect of lifestyle factors on depressive symptoms. Participants with moderate, moderately severe, and severe depressive symptoms were most interested in working on diet, exercise, and substance use and least interested in working on social support and recreation/leisure activities. Conclusions: Alcohol use, tobacco use, social support, and satisfaction with leisure activities may influence depressive symptoms among PSH residents. However, participants may not be interested in working on social support and satisfaction with leisure activities. An ecological approach may be necessary to influence social support and satisfaction with leisure activities among PSH residents. Lifestyle interventions designed to reduce depressive symptoms among PSH residents should aim to increase PSH residents' social support and satisfaction with leisure activities.Item Using machine learning to identify predictors of imminent drinking and create tailored messages for at-risk drinkers experiencing homelessness(Elsevier Inc., 2021-04-20) Walters, Scott T.; Businelle, Michael S.; Suchting, Robert; Li, Xiaoyin; Hebert, Emily T.; Mun, Eun-YoungAdults experiencing homelessness are more likely to have an alcohol use disorder compared to adults in the general population. Although shelter-based treatments are common, completion rates tend to be poor, suggesting a need for more effective approaches that are tailored to this understudied and underserved population. One barrier to developing more effective treatments is the limited knowledge of the triggers of alcohol use among homeless adults. This paper describes the use of ecological momentary assessment (EMA) to identify predictors of "imminent drinking" (i.e., drinking within the next 4 h), among a sample of adults experiencing homelessness and receiving health services at a homeless shelter. A total of 78 mostly male (84.6%) adults experiencing homelessness (mean age = 46.6) who reported hazardous drinking completed up to five EMAs per day over 4 weeks (a total of 4557 completed EMAs). The study used machine learning techniques to create a drinking risk algorithm that predicted 82% of imminent drinking episodes within 4 h of the first drink of the day, and correctly identified 76% of nondrinking episodes. The algorithm included the following 7 predictors of imminent drinking: urge to drink, having alcohol easily available, feeling confident that alcohol would improve mood, feeling depressed, lower commitment to being alcohol free, not interacting with someone drinking alcohol, and being indoors. The research team used the results to develop intervention content (e.g., brief tailored messages) that will be delivered when imminent drinking is detected in an upcoming intervention phase. Specifically, we created three theoretically grounded message tracks focused on urge/craving, social/availability, and negative affect/mood, which are further tailored to a participant's current drinking goal (i.e., stay sober, drink less, no goal) to support positive change. To our knowledge, this is the first study to develop tailored intervention messages based on likelihood of imminent drinking, current drinking triggers, and drinking goals among adults experiencing homelessness.