Biomedical subjects

L A Kaskutas

Publications and source records attributed to L A Kaskutas.

23 records · Page 2Linked to original sources

PubMedDate not supplied

Measuring treatment philosophy: a scale for substance abuse recovery programs.

The assessment of the philosophy that guides substance abuse treatment programs has been a difficult subject to approach by those working in treatment research. Differing treatment philosophies are generally represented by multi-dimensional theoretical constructs that do not easily lend themselves to assessment by quantitative means. In the U.S., substance abuse treatment programs have been suggested as fitting into a disease (or medical) model, a social learning (or psychological) model, or a social community model in designing a treatment regime for clients. This paper presents a Social Model Philosophy Scale (SMPS) to classify the extent to which a given treatment program follows a social model approach to treatment. The final version of the SMPS (available from the first author) contains 33 questions for use in residential programs, divided into six conceptual domains: physical environment, staff role, authority base, view of substance abuse problems, governance, and community orientation. Overall internal reliability is high (alpha = .92), with subscale alphas ranging between .57 and .79. Test-retest analyses showed that the information obtained from the SMPS is consistent across time, administrators, and respondents. In addition, the SMPS is brief and easy to administer. Methodology used in item creation and final item selection is reported. Although not designed to distinguish philosophies other than social model, early results suggest that the SMPS may also be used to classify other program philosophies.

Humans↗

PubMedDate not supplied

Didactic and experiential education in substance abuse programs.

Medical model and social model programs both include client education as part of their service mandate, although the two models may define and accomplish the task of education differently. The role of education in substance abuse recovery has not been clear in either the treatment or recovery models. This paper therefore begins with a debate of the value of "educating" substance abuse clients, using several possible definitions of education and drawing upon a variety of theories from health education and community psychology. We divide these types of education into two broad definitional categories: knowledge acquisition and life skills development. Using data collected during a process evaluation at one medical and two social model programs, we provide examples of how knowledge acquisition and life skills development are accomplished at these sites. Analysis of the observational data pointed to two approaches to education, one didactic, the other experiential. All three sites used a didactic approach to knowledge about addiction. Only the social model sites used an experiential approach to convey knowledge and skills about recovery, and the development of life skills.

Alcoholism↗

PubMedDate not supplied

Changes in drinking problems among whites, blacks, and Hispanics: 1984-1992.

This paper reports changes in drinking problems among Whites, Blacks, and Hispanics between 1984 and 1992. A probability sample including 1,777 Whites. 1,947 Blacks, and 1,453 Hispanics in the United States adult household population was interviewed in 1984. In 1992 a subsample consisting of 788 Whites, 723 Blacks, and 703 Hispanics was reinterviewed. Results show a decrease in problem prevalence among Whites, stability among Blacks, and an increase among Hispanics. Problem incidence was higher among Hispanics than among Whites and Blacks, put problem remission was higher among Whites. Women had a lower problem incidence but a higher problem remission than men, independent of ethnicity. The two best predictors of problem status in 1992 were reporting a problem in 1984 and reporting a high level of consumption in 1984.

Adolescent↗

PubMedDate not supplied

The role of health consciousness in predicting attention to health warning messages.

PURPOSE: Guided by information processing theory and the health belief model, this paper considers the relationship between health consciousness among the general population and attention to environmental health warnings about alcohol consumption. Mechanisms of exposure to three dominant types of impersonal alcohol-related health messages in the environment are explored. DESIGN: Cross-sectional survey using telephone interview data. SUBJECTS: A representative nationwide sample of adults was interviewed in 1993 (n = 1026), with a response rate of 63%. MEASURES: Key variables include exposure to warning labels on alcoholic beverages, to point-of-sale posters, and to advertisements in the media, as well as respondents' alcohol consumption, health problems (indicative of salience of health warnings), and level of health consciousness assessed by items tapping concern with nutrition and seeking information on health topics. RESULTS: In the total sample, over a third had seen a warning label or poster and almost all had seen an advertisement about the risks associated with alcohol consumption in 1993. Survey respondents scored very high on five individual items that make up the health consciousness scale introduced here, with 69% endorsing all items. The scale demonstrated good internal reliability (alpha = .70) and was significantly correlated (p < .01) with not enjoying getting drunk and with usually reading product warning labels, suggesting construct validity. Yet the hypothesized strong relationships between health consciousness and attention to health warnings about drinking were not observed; nor was salience of messages a predictor of recall. Importantly, high proportions of underage drinkers and young adults at elevated risk for drinking problems are reached by container warning label messages. Mechanisms of exposure recall vary based on message source, with "container label recall" associated with heavier drinking, younger age, and purchasing patterns; "poster recall" associated with purchasing and health consciousness; and "advertisement recall" associated with heavy consumption and younger age. CONCLUSIONS: These results are contrary to predictions from skeptics of broad-based informational interventions, who argue that only the already-health conscious are attentive to health warnings about the risks of alcohol consumption. These data suggest that the label is reaching intended target audiences, especially younger people, males, and heavier alcohol consumers. Future research in predicting attention to impersonal health warnings in the environment should continue to improve the assessment of constructs such as salience and health consciousness, and should further test the applicability of available theoretical models. Subsequent research should also consider additional measures to tap mechanisms of exposure to impersonal health messages to enable a better understanding of the population that is not being reached by such public health interventions.

Adolescent↗

PubMedDate not supplied

Relationship between cumulative exposure to health messages and awareness and behavior-related drinking during pregnancy.

PURPOSE: This paper describes the relationship between exposure to multiple sources of health messages about the risk of drinking during pregnancy and respondents' awareness and behavior related to this risk. DESIGN: Observational study using telephone interview data. SETTING: Exposure to this message occurs via a government warning on alcoholic beverage containers, warning posters in restaurants and bars, and media advertisements. SUBJECTS: Representative nationwide samples of adults were interviewed in 1990 (n = 2,000) and 1991 (n = 2,017), with response rates of 64% and 62%, respectively. MEASURES: Outcomes assessed are knowledge of the alcohol-related risk of birth defects, conversations about drinking during pregnancy, and self-reported reduction of alcohol consumption due to health concerns. RESULTS: Multivariate logistic regression models were used. In the total sample, respondents exposed to one, two, and three different message sources were more likely to converse about drinking during pregnancy than those exposed to no messages (odds ratio = 2.6, 3.8, and 4.1, respectively), while reduced alcohol consumption due to health concerns associated with exposure to two and three different sources (odds ratio = 1.6 and 2.0, respectively). Among women aged 18 to 40, a similar relationship is found for conversations, but it was only among those seeing all three message types that a reduction in consumption was observed (odds ratio = 2.8). Interpretation of these findings are limited because of respondent bias in alcohol consumption, message source exposure, and the cross-sectional nature of the data employed. CONCLUSIONS: These findings support the public health approach of implementing multi-faceted strategies to maximize risk reduction interventions.

Adult↗