“I Tried to Get Help About My Addiction but He Just Gave Me Tablets:” Male Aboriginal Drug and Alcohol Rehabilitation Clients’ Experiences and Preferences Speaking About Substance Use in Primary Care

Background Primary healthcare (PHC) services are crucial in supporting people with substance use problems. The aims of this study were to explore Aboriginal and Torres Strait Islander (hereafter Aboriginal) males in treatment for substance use problems experiences about speaking about their substance use with PHC staff, and their preferences for accessing PHC about their substance use.MethodsSemi-structured interviews with residential drug and alcohol rehabilitation treatment service clients. Thematic analysis was used to develop themes inductively and deductively. Two interviews were independently double coded by an Aboriginal researcher and the project was supported by an Aboriginal Advisory Group.ResultsTwenty male adults who self-identified as Aboriginal participated (mean age 27 years). Half reported visiting PHC and talking about their substance use before their residential service stay. Two major themes developed: (1) asking for help for substance use or mental health problems linked with substance use, (2) ways to improve access to PHC about substance use. Although some males were offered treatment, some were not, and others had concerns about the treatments offered. ConclusionThis research highlights opportunities to improve access and to better support Aboriginal males with substance use problems in PHC. Focus on culturally appropriate PHC and providing staff with training around substance use and treatment options may improve access. It is important to foster culturally appropriate services, develop PHC staff knowledge around substance use, focus on therapeutic relationships and have a range of treatment options available that can be tailored to individual circumstances.

“I Tried to Get Help About my Addiction but he Just gave me Tablets:” Male Aboriginal Drug and Alcohol Rehabilitation Clients’ Experiences and Preferences Speaking about Substance use in Primary Care

Background Primary healthcare (PHC) services are crucial in supporting people with substance use problems. The aims of this study were to explore Aboriginal and Torres Strait Islander (hereafter Aboriginal) males in treatment for substance use problems experiences about speaking about their substance use with PHC staff, and their preferences for accessing PHC about their substance use.MethodsSemi-structured interviews with residential drug and alcohol rehabilitation treatment service clients. Thematic analysis was used to develop themes inductively and deductively. Two interviews were independently double coded by an Aboriginal researcher and the project was supported by an Aboriginal Advisory Group.ResultsTwenty male adults who self-identified as Aboriginal participated (mean age 27 years). Half reported visiting PHC and talking about their substance use before their residential service stay. Two major themes developed: (1) asking for help for substance use or mental health problems linked with substance use, (2) ways to improve access to PHC about substance use. Although some males were offered treatment, some were not, and others had concerns about the treatments offered. ConclusionThis research highlights opportunities to improve access and to better support Aboriginal males with substance use problems in PHC. Focus on culturally appropriate PHC and providing staff with training around substance use and treatment options may improve access. It is important to foster culturally appropriate services, develop PHC staff knowledge around substance use, focus on therapeutic relationships and have a range of treatment options available that can be tailored to individual circumstances.

Use of the Instagram Hashtags #winemom and #momjuice Among Mothers During the COVID-19 Pandemic: Descriptive, Cross-sectional Study (Preprint)

BACKGROUND The tendency of parents to consume alcohol during the COVID-19 pandemic is likely to be moderated by pandemic-related stress combined with the ongoing demands of childcare and home-based education, which are reported to be more burdensome for females than males. OBJECTIVE The purpose of this study was to describe alcohol-related content posted by mothers on Instagram during the COVID-19 pandemic. METHODS Using two popular hashtags, #momjuice and #winemom, 50 Instagram posts on each were collected from the “top posts” tab. The coding categories were created inductively and were as follows: displays alcohol (drinking/holding alcohol or alcohol itself), person is making alcoholic beverages, type of alcohol featured or discussed, highlights anxiety and/or depression/mental state, highlights struggling (in general), highlights parenting challenges, encourages alcohol consumption, discourages alcohol consumption, features a person wearing clothing or shows products promoting alcohol, promotes alcohol rehabilitation, highlights caffeine to alcohol daily transition throughout the day, and highlights other drugs besides caffeine and alcohol. RESULTS Overall, the 100 selected posts had a total of 5108 comments and 94,671 likes. The respective averages were 51.08 (SD 77.94) and 946.71 (SD 1731.72). A majority (&gt;50%) of the posts reviewed encouraged alcohol consumption (n=66) and/or displayed alcohol (n=56). Of the 66 that encouraged and/or displayed alcohol, the common type of alcohol discussed or featured was wine (n=55). Only 6 posts discouraged alcohol use and only 4 provided the audience with a disclaimer. None of the videos promoted or endorsed alcohol rehabilitation in any way. Only 37 posts highlighted struggle. However, these posts garnered more than a majority of the likes (n=50,034, 52.3%). Posts that showed struggle received an average of 1359.57 (SD 2108.02) likes. Those that did not show struggle had an average of 704.24 (SD 1447.46) likes. An independent one-tailed <i>t</i> test demonstrated this difference to be statistically significant (<i>P</i>=.0499). CONCLUSIONS The findings of this investigation suggest that though these hashtags ostensibly exist to valorize excess alcohol consumption, they may be serving as a support system for mothers who are experiencing increased burdens and role stress during the pandemic. Given the strains placed on mothers overall and especially during the COVID-19 pandemic, efforts must be taken to increase access to and affordability of telehealth-based mental health care.

Psychosocial Problems and Its Associated Factors among Individual Residing in Drug and Alcohol Rehabilitation Centers

Introduction: Psychosocial problems among substance abusers are one of the important, challenging public health problems in a worldwide context which is often remain unrecognized and left untreated. This study aims to identify the psychosocial problems and its associated factors among individuals residing in drug and alcohol rehabilitation centers. Methods : A cross-sectional analytical study was conducted among 271 participants from January to July 2019 who are residing in four different rehabilitation centers in Kathmandu. A standard tool ‘Drug Use Screening Inventory – Revised (DUSI-R)’ was used to assess psychosocial problem with face to face interview method. Data were entered in Epi-Data and analyzed using SPSS. Results: Majority of the participants (54.2%) had secondary level education. Most of the participants (43.5%) were unemployed and were found to be involved in substance abuse. The majority of the family member of the participant (62.7%) didn't use alcohol. The starting age of most of the participants (94.5%) who were using drugs was less than 25 years. The mean score of DUSI-R tools was found to be 48.89. The majority of the participants were using alcohol, which was easily available in the market. It was also found that the psychosocial problem was associated with age and education. The psychological problem is seen in less than half (46.1%) of the participant and found to be more prevail in below 30 years of age group and mostly who are in secondary level of education. Conclusions: About half of the participants residing in rehabilitation center had psychosocial problem. Secondary level education period is a crucial time to be more aware where students are at greater risk of having substance abuse including psychosocial problem.

Participatory food events as collaborative public engagement opportunities

There is an urgent need to ‘get creative’ with the way we tackle social and nutritional inequalities. The Food as a Lifestyle Motivator (FLM) project has explored the use of creative participatory approaches to engage ‘harder to reach’ communities in dialogues to improve their well-being and life skills. Preliminary findings have confirmed that food can be a powerful catalyst for social inclusion with the potential to empower ‘marginalised’ individuals. Part of this exploratory study has involved two participatory food events (November 2015 and November 2016) run in a local day centre for drug and alcohol rehabilitation. The aim of these events was to bring together key stakeholders (from the service user and provider communities) to exchange food-based knowledge, using collaborative and co-creative participatory approaches. Following ethical clearance, a range of data were collected at the events to assess their ‘social impact’. These consisted of (1) audio interviews (service providers and users), (2) oral surveys (service users and key workers) and (3) observations of social cooking and eating engagement, and creative visual arts (photography, collage, food games and quizzes). In this article, we detail how the range of creative approaches used has successfully engaged individuals (average attendance: n = 80, service users: n = 32) to participate in these food-themed events. We reflect on the overarching themes from data capture of the social and therapeutic aspects of food (activities). We also reflect on the collation (and curation) of findings, systematically critiquing the approaches used, including consideration of ethics, and drivers for engagement. Finally, we consider how the utility of such creative approaches can optimise public engagement activities, not only to enhance research impact but also to inform collaborative developments with and between service users, service providers and other stakeholders, with the potential to lead to transformative food-related changes.