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Biomedical subjects

Jichuan Wang

Publications and source records attributed to Jichuan Wang.

At least 19 recordsLinked to original sources
PubMed2006

Respondent-driven sampling in the recruitment of illicit stimulant drug users in a rural setting: findings and technical issues.

Increasingly, respondent-driven sampling (RDS) is being applied to study not-in-treatment users of illicit drugs. Although RDS has been successfully applied in recruiting active users in densely-populated, metropolitan areas, its utility with hidden populations in rural areas has yet to be determined. This study critically evaluates the sample of not-in-treatment, illicit stimulant drug users (n=249) recruited from the application of RDS in three rural counties in west-central Ohio. The findings of this study largely support the results of earlier studies in urban areas and suggest that RDS is a useful method of sampling hidden drug using populations in less densely populated rural areas. Some limitations of RDS are also discussed.

Adult↗
PubMed2006

Using SAS to conduct nonparametric residual bootstrap multilevel modeling with a small number of groups.

In multilevel modeling, researchers often encounter data with a relatively small number of units at the higher levels. As a result, of this and/or non-normality of the residuals, model parameter estimates, particularly the variance components and standard errors of parameter estimates at the group level, may be biased, thus the corresponding statistical inferences may not be trustworthy. This problem can be addressed by using bootstrap methods to estimate the standard errors of the parameter estimates for significance testing. This study illustrates how to use statistical analysis system (SAS) to conduct nonparametric residual bootstrap multilevel modeling. Specific SAS programs for such modeling are provided.

Models, Statistical↗
PubMed2006

Prevalence and correlates of current depressive symptomatology among a community sample of MDMA users in Ohio.

Research suggests that MDMA can cause serotonin depletion as well as serotonergic neurodegradation that may result in depression among users of the drug. Several small-scale studies have used various editions of the Beck Depression Inventory (BDI) to quantify depressive symptomatology among MDMA users. This study represents the largest application of the BDI to date to explore symptoms of current depression among a community sample of young adult MDMA users (n = 402). Internal consistency testing of the BDI-II with this sample revealed Cronbach's alpha = .92. Results show a mean BDI-II score of 9.8, suggesting low levels of depressive symptomatology among study participants. Two-thirds of the sample had scores that placed them in the non-depressed/minimal depression category, while 4.7% had scores indicative of severe depression. Logistic regression analysis revealed that men were significantly less likely than women and people who used opioids were significantly more likely than non-users to have higher levels of depressive symptomatology. Higher lifetime occasions of MDMA use were marginally related to symptoms of serious depression.

Adult↗
PubMed2006

Treatment barriers identified by substance abusers assessed at a centralized intake unit.

The 59-item Barriers to Treatment Inventory (BTI) was administered to 312 substance abusers at a centralized intake unit following assessment but before treatment entry to assess their views on barriers to treatment. Factor analysis identified 25 items in 7 well-defined latent constructs: Absence of Problem, Negative Social Support, Fear of Treatment, Privacy Concerns, Time Conflict, Poor Treatment Availability, and Admission Difficulty. The factorial structure of the barriers is consistent with the findings of other studies that asked substance abusers about barriers to treatment and is conceptually compatible with Andersen's model of health care utilization. Factors were moderately to highly correlated, suggesting that they interact with one another. Selected characteristics were generally not predictive of barrier factors. Overall, results indicate that the BTI has good content validity and is a reliable instrument for assessing barriers to drug treatment. The potential utility of the BTI in assessment settings is discussed.

Adolescent↗
PubMed2006

Emergency department utilization by crack-cocaine smokers in Dayton, Ohio.

The objective of this study was to determine the frequency, principal diagnoses, and correlates of emergency department (ED) visits made by persons with a history of crack-cocaine use (n = 333) over a 3-year period. Data were collected from participant self-reports and hospital records. During the study a total of 643 ED visits were made by 211 people, ranging from 53.5 to 76.7/100 persons/year. Injury and poisoning accounted for the largest single category of ED visits (29.5%). Men had lower odds of visiting the ED (OR=0.79, 95%CI=0.62-0.99), as did participants with higher levels of education (OR=0.83, 95%CI=0.73-0.94). Number of times in drug abuse treatment (OR=1.04, 95%CI=1.01-1.09), having a chronic disease (OR=1.46, 95%CI=1.06-1.99), and higher Addiction Severity Index composite medical scores (OR=1.62, 95%CI=1.15-2.29) increased the odds of an ED visit. Factors in addition to drug use are likely to affect ED utilization rates among crack-cocaine smokers.

Adolescent↗
PubMed2006

Psychiatric disorders and their correlates among young adult MDMA users in Ohio.

This study describes the lifetime prevalence, correlates, and age of onset of selected psychiatric disorders among a community sample of MDMA users (n = 402), aged 18 to 30, in Ohio. Participants responded to interviewer-administered questionnaires, including sections of the computerized Diagnostic Interview Schedule for DSM-IV. Fifty-five percent of the sample had at least one lifetime disorder, with major depression (35.3%) and antisocial personality disorder (ASPD) (25.4%) the most common. Proportionately more women were diagnosed with depression, generalized anxiety disorder, and posttraumatic stress disorder (PTSD), while proportionately more men were diagnosed with ASPD. Proportionately more non-White participants had attention deficit/hyperactivity disorder (AD/HD). Higher levels of education were associated with proportionately less PTSD, ASPD, and AD/HD. Higher frequencies of MDMA use were associated with proportionately more ASPD and AD/HD. Comparing the age of first MDMA use with the age of onset for selected psychiatric disorders revealed that for most participants disorders preceded use. Multivariate analysis revealed participants with more than a high school education were less likely to have experienced a lifetime disorder, while those who had used MDMA more than 50 times were more likely. Variations in the prevalence of psychiatric disorders have practical implications for drug abuse prevention and treatment programs.

Adolescent↗
PubMed2006

Perspectives on health among adult users of illicit stimulant drugs in rural Ohio.

CONTEXT: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. PURPOSE: This research describes illicit stimulant drug users' views on health and health-related concepts that may affect their utilization of health care services. METHODS: A respondent-driven sampling plan was used to recruit 249 not-in-treatment, nonmedical stimulant drug users who were residing in 3 rural counties in west central Ohio. A structured questionnaire administered by trained interviewers was used to collect information on a range of topics, including current drug use, self-reported health status, perceived need for substance abuse treatment, and beliefs about health and health services. FINDINGS: Participants reported using a wide variety of drugs nonmedically, some by injection. Alcohol and marijuana were the most commonly used drugs in the 30 days prior to the interview. Powder cocaine was used by 72.3% of the sample, crack by 68.3%, and methamphetamine by 29.7%. Fair or poor health status was reported by 41.3% of the participants. Only 20.9% of the sample felt they needed drug abuse treatment. Less than one third of the sample reported that they would feel comfortable talking to a physician about their drug use, and 65.1% said they preferred taking care of their problems without getting professional help. CONCLUSIONS: Stimulant drug users in rural Ohio are involved with a range of substances and hold health beliefs that may impede health services utilization.

Adult↗
PubMed2006

Correlates of rural methamphetamine and cocaine users: results from a multistate community study.

OBJECTIVE: Use and production of methamphetamine (MA) has dramatically increased in the United States, especially in rural areas, with concomitant burdens on the treatment and criminal justice systems. However, cocaine is also widely used in many rural areas. The purpose of this article is to contrast MA and cocaine users in three geographically distinct rural areas of the United States. METHOD: Participants were recent not-in-treatment adult cocaine and MA users living in rural Ohio, Arkansas, and Kentucky, who were recruited by a referral recruitment method for sampling hidden community populations. Participants were interviewed for demographics, drug and alcohol use, criminal justice involvement, and psychological distress (Brief Symptom Inventory). RESULTS: The sample of 706 comprised 29% nonwhite and 38% female participants; the average age was 32.6 years; 58% had a high school education or higher, and 32% were employed. In the past 6 months, they had used either MA only (13%), cocaine only (52%), or both (35%). MA users were seldom (8.2%) nonwhite, but type of stimulant use did not vary by gender. Combined MA/cocaine users reported significantly greater use of alcohol and other drugs, including marijuana and nonprescribed opiates and tranquilizers, and reported significantly higher psychological distress. MA users (with or without cocaine use) had greater odds of recent criminal justice involvement compared with cocaine-only users. CONCLUSIONS: There is a clear need for accessible substance-use treatment and prevention services in rural areas of the United States, including services that can address MA, cocaine, polydrug use, and mental health needs. There is a particular need of these services for polydrug users.

Adult↗
PubMed2005

Drug use practices among MDMA/ecstasy users in Ohio: a latent class analysis.

This study describes the drug use practices among 402 recent MDMA (3,4-methelyenedioxymethamphetamine) users recruited in Ohio using respondent-driven sampling. About 64% of the participants were men, 81.6% were white, and the mean age was 20.9 years. Latent class analysis was used to identify subgroups of MDMA users. Use of cocaine, opioids, amphetamines, tranquilizers, inhalants, marijuana, and hallucinogens during the previous 6 months, and days of "drunkenness" in the past 30, were used for classification. A three-class model was preferable and reflected "Limited range," "Moderate range," and "Wide range" drug use patterns. For example, the conditional probability of using opioids during the previous 6 months was .07 in Class 1, .59 in Class 2, and .88 in Class 3. Other substances followed similar patterns. Predictors of class membership were examined in a multinomial logit model in which the "Limited range" Class was treated as the reference group. Participants who were white, younger, and who reported more than 10 occasions of MDMA use were more likely to be in the "Wide range" drug use Class. Latent class analysis is a useful method to help describe and understand variability in polydrug use patterns.

Adolescent↗
PubMed2005

Nonmedical drug use among stimulant-using adults in small towns in rural Ohio.

This study describes the drug-use practices and treatment histories of 249 not-in-treatment, drug-using individuals living in small towns in rural Ohio. Respondent-driven sampling was used to recruit participants who answered questionnaires administered by interviewers. Descriptive statistics and latent class analysis (LCA) were used to examine the data. The illicit drugs most commonly used in the 6 months before entering the study were marijuana (89.6%), cocaine hydrochloride (80.3%), and crack cocaine (76.3%). Injection drug use was not uncommon. About a third of the sample experienced drunkenness frequently. Less than 14% had been in substance abuse treatment recently. LCA revealed two groups: (1) heavy users of virtually all drug classes and (2) moderate-to-light users of fewer drug classes. White and younger people were more likely to be classified in the heavy user group. The results suggest that comprehensive substance abuse prevention and treatment programs are needed in rural communities.

Adult↗
PubMed2004

Respondent-driven sampling to recruit MDMA users: a methodological assessment.

Recruiting samples that are more representative of illicit drug users is an on-going challenge in substance abuse research. Respondent-driven sampling (RDS), a new form of chain-referral sampling, is designed to eliminate the bias caused by the non-random selection of the initial recruits and reduce other sources of bias (e.g. bias due to volunteerism and masking) that are usually associated with regular chain-referral sampling. This study provides a methodological assessment of the application of RDS among young adult MDMA/ecstasy users in Ohio. The results show that the sample compositions converged to equilibrium within a limited number of recruitment waves, independent of the characteristics of the initial recruits (i.e. seeds). The sample compositions approximated the theoretical equilibrium compositions, and were not significantly different from the estimated population compositions-with the exception that White respondents were over-sampled and Black respondents were under-sampled. The effect of volunteerism and masking on the sampling process was found not to be significant. Though identifying productive seeds and improving the referral rate are significant challenges when implementing RDS, the findings demonstrate that RDS is a flexible and robust sampling method. RDS has the potential to be widely employed in studies of illicit drug-using populations.

Epidemiologic Research Design↗
PubMed2004

Sources of information about MDMA (3,4-methylenedioxymethamphetamine): perceived accuracy, importance, and implications for prevention among young adult users.

The goal of this cross-sectional study was to assess the perceived accuracy and the importance of various sources of information about MDMA/ecstasy among young adult users. A respondent driven sampling plan was used to recruit a community sample of recent ecstasy users (n = 304), aged 18-30, in Ohio, who responded to structured interviews. Friends, drug abuse treatment programs, and physicians were perceived to be the most accurate sources of information about ecstasy by 45.7, 37.2, and 30.3% of the sample, respectively. Friends were considered the most important source of information about ecstasy (40.2%), followed by web sites like DanceSafe (16.2%), and MTV/VH1 television specials (6.9%). About half the sample used the Internet to obtain information about ecstasy, with younger and more educated participants significantly more likely to do so. Educated users were also significantly more likely to consider the Internet to be an important source of information. Web sites like DanceSafe were visited by four times as many users as government-sponsored web sites. Findings support the development of peer-oriented, network strategies to reach ecstasy users with prevention messages. Efforts to make prevention web sites more attractive should be considered.

Adolescent↗
PubMed2004

The prevalence of psychiatric disorder among a community sample of crack cocaine users: an exploratory study with practical implications.

The Diagnostic Interview Schedule for DSM-IV was used to assess the lifetime prevalence of psychiatric disorder among not-in-treatment crack cocaine users (N = 313). The most common dependencies involved cocaine (59.7%), alcohol (37.7%), and cannabis (12.1%). The most common nondependency disorders were antisocial personality disorder (ASPD; 24%), depression (17.8%), and posttraumatic stress disorder (PTSD; 11.8%). Comorbidity was present in 36.4% of the sample. Proportionately more white than black users were dependent on cocaine, alcohol, amphetamine, and sedative-hypnotics. More white than black users experienced ASPD, depression, PTSD, and attention deficit disorder. Proportionately fewer black users suffered comorbid disorders. Proportionately more men had ASPD, whereas more women had PTSD and phobias. Multinominal modeling revealed that black users and users with a high school education were less likely to have comorbid disorders; married users were less likely to have nondependency disorders. White crack users were more likely to have comorbidity, complicating their treatment.

Adult↗
PubMed2003

Components of difference in HIV seropositivity rate among injection drug users between low- and high-HIV-prevalence regions.

Comparative studies on regional HIV seroprevalence or seropositivity rate among injection drug users (IDUs) have focused primarily on assessing the risk factors for HIV infection. This study used a nonparametric analytic approach, known as standardization and decomposition, to to compare HIV seropositivity rates among IDUs between low- and high-HIV-prevalence regions in the United States. The regional difference in HIV seropositivity rate was decomposed into different components: (1) a "rate effect," which was attributed to the differences in factor-specific rates, and (2) "compositional factor effects," which were attributed to the differences in distributions of sociodemographic factors across regions. The analytic results show that the regional difference in HIV seropositivity rate was considerable (21.04%); however, the difference would be adjusted down to 17.65% if sociodemographic factors were proportionally distributed across the regions. Differential distribution of ethnic groups between the two regions accounted for about 15.02% of the regional difference in HIV seropositivity rate. The application of the standardization and decomposition method provides HIV researchers with opportunities to look at familiar data from a different perspective.

Adult↗
PubMed2003

Test-retest reliability of a complex human immunodeficiency virus research questionnaire administered by an Audio Computer-assisted Self-interviewing system.

OBJECTIVES: To evaluate the test-retest reliability of a complex questionnaire administered by Audio Computer-assisted Self-interviewing to recently diagnosed human immunodeficiency virus-positive patients. METHODS: Thirty-seven English-speaking and 32 Spanish-speaking participants completed both test and retest interviews. Pearson correlation coefficients (r) and kappa (kappa) and weighted kappa (kappa) statistics were obtained for individual questions. From these, overall kappa and Pearson correlation coefficients were calculated across all variables and for groups of questions. RESULTS: Overall measures of reliability were kappa = 0.767, r = 0.728. Some variation in reliability existed for different response formats, question content groups, and languages of the participants. Differences in overall reliability by Spanish compared with English participants were small and not statistically significant. CONCLUSIONS: Audio Computer-assisted Self-interviewing provides reliable measures for items assessed in the Antiretroviral Treatment and Access Study baseline questionnaire. Some differences exist as a result of question content, interview language, and response format, requiring assessment in future studies and consideration in designing Audio Computer-assisted Self-interviewing systems and questionnaires.

Adult↗
PubMed2002

Predictors of drug abuse treatment entry among crack-cocaine smokers.

The goal of this study was to identify factors that predicted drug abuse treatment program entry among a community sample of 430 crack-cocaine users. Subjects were recruited using a targeted sampling methodology and responded to interviewer-administered questionnaires at 6 months intervals over a 3-year period. At baseline, 40.5% (n=174) reported they had never been in a drug abuse treatment program. During the observation period, 37.7% (n=162) of the sample reported they had entered a program. Of these, 43.8% (n=71) reported that their treatment was court-ordered. Slightly more than one-quarter (n=44) entered treatment for the first time. A host of variables, including individual characteristics, frequency and duration of crack use, frequency of drunkenness, Addiction Severity Index (ASI) family/social, medical, and psychiatric status composite scores, perceived need for treatment, history of treatment, and medical insurance coverage, was explored. The results of Cox proportional hazards model suggested that younger people, users with more severe legal problems, people who perceived a need for treatment, and individuals with prior treatment experience had a greater likelihood of entering treatment. Developing a strategy to practically apply these findings may facilitate treatment entry among a population involved with a dangerous and debilitating drug.

Adult↗
PubMed2002

Variability in drug use prevalence across school districts in the same locale in Ohio.

Substance use by adolescents continues to present a problem schools must address. Data from survey research can prove useful in helping schools determine the nature and extent of youth drug use. This study identified variations in drug use prevalence among ninth grade students in different school districts in the same locale in Ohio. Possible explanations for the differences were explored. Students (n = 3,016) from 12 suburban high schools anonymously completed self-report drug use questionnaires. School and community-level data were collected from other sources. Cluster analysis was used to group the school districts. ANOVA revealed statistically significant differences (P < or = 0.001) in levels of drug use by cluster. The cluster with significantly lower levels of drug use consisted of districts with at least one full-time drug abuse prevention coordinator, higher economic levels, and the highest per pupil expenditures. Drug use among youth is influenced, at least in part, by local contextual factors. Local survey data can inform local policy and programs. These findings have practical implications for policymakers, program developers, and school districts in other areas of the country.

Adolescent↗