Biomedical subjects

John A Cunningham

Publications and source records attributed to John A Cunningham.

5 recordsLinked to original sources

PubMed2003

Interest in self-help materials among a general population sample of smokers.

Previous studies have shown that self-help materials can be effective in helping people quit smoking. However, it is not known what proportion of smokers in the general population are interested in this method of cessation. A representative sample of 267 daily smokers participated in a random digit dialing telephone survey. Respondents were asked about their level of interest in self-help materials that would help them quit smoking. Potential predictors of level of interest were examined first through bivariate analyses, followed by a multinomial logistic regression. Of daily smokers, 27% were very interested in receiving a self-help booklet, 28% were somewhat interested, and 45% were not at all interested. Interest in self-help materials was positively related to intent to quit in the next 6 months and to low family income.

Adult↗

PubMed2002

Intravenous and non-intravenous cocaine abusers admitted to inpatient detoxification treatment: a 3-year medical-chart review of patient characteristics and predictors of treatment re-admission.

This naturalistic study examined the admissions and re-admissions of 341 intravenous (IV) and non-IV cocaine abusers over a 3-year period to an inpatient, hospital-based drug-and-alcohol detoxification treatment program. IV cocaine abusers reported higher rates of residential instability, unemployment, Hepatitis C, HIV and cirrhosis than non-IV cocaine abusers. In addition, IV cocaine abusers were administered more medical evaluative tests during treatment and accessed inpatient detoxification treatment more often during the 3-year study period. A Cox regression model demonstrated that residential instability and IV route of cocaine administration were significant predictors of inpatient detoxification re-admission. In light of the important differences between IV and non-IV cocaine-abusing groups, detoxification services should view route of cocaine administration as a key topic in treatment delivery and residential stability as an important topic in the discharge-and-referral process.

Adult↗

PubMed2002

Gender differences in detoxification: predictors of completion and re-admission.

This study examined the medical records of 2595 consecutive admissions over a 3-year period to an inpatient mixed-gender, hospital-based alcohol and drug detoxification unit. Women reported a significantly different pattern of primary drug use, a younger age, a different pattern of referral sources, and higher rates of parenting status and unemployment. In addition, females were administered prescription medication and medical evaluation tests at a significantly higher rate than males. Multiple regression analyses demonstrated that an opiate as a primary drug of choice was a significant risk factor for dropout. Risk factors for re-admission to inpatient detoxification included: alcohol as a primary drug of choice, residential instability, multiple drug use, single marital status, unemployment, an older age (> 37 years), and treatment dropout at Time 1 in the study. For both the final prediction models, gender was not a significant factor. The treatment implications of these findings are discussed.

Adult↗

PubMed2002

Treating alcohol problems with self-help materials: a population study.

OBJECTIVE: An experimental trial was used to assess the effectiveness of a self-help book and a personalized assessment-feedback intervention, both separately and in combination with each other, in a general population survey. METHOD: Participants (N = 86; 66.3% male) were recruited through a random digit dialing telephone survey conducted by the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Respondents were randomly assigned to one of four conditions in a two-by-two factorial design: "no-intervention" control group, "personalized feedback only," "self-help book only" and "both personalized feedback and self-help book." Respondents were followed up in 6 months' time, and differences in drinking status were compared between experimental conditions using a multivariate analysis of covariance with baseline drinking severity as the covariate. RESULTS: Support was provided for an interaction hypothesis in which respondents who received both interventions reported significantly improved drinking outcomes at 6-month follow-up, compared with respondents who received just one of the interventions or who received no intervention. CONCLUSIONS: Because respondents were recruited from a representative sample of the general population into a randomized trial with a no-intervention control group, this research design maximized both external and internal validity in examining the effectiveness of self-help interventions.

Alcohol Drinking↗

PubMed2002

Promoting self-change with alcohol abusers: a community-level mail intervention based on natural recovery studies.

BACKGROUND: By using a public health approach to the treatment of alcohol problems, this study analyzed the efficacy and cost analysis of two versions of a community-level mail intervention to promote self-change among alcohol abusers who had never sought help or treatment. METHODS: A total of 825 participants who responded to media solicitations were randomly assigned to one of two interventions: (a) for bibliotherapy/drinking guidelines (n = 411), they were given two pamphlets with information about the effects of alcohol and guidelines for low-risk drinking and self-monitoring, and (b) for motivational enhancement/personalized feedback (n = 414), personalized advice/feedback was provided on the basis of the participants' assessment of their drinking and related behaviors. RESULTS: Although both groups exhibited significant reductions in drinking from 1 year before to 1 year after intervention, there were no significant differences between the two interventions for any variable. This suggests that the materials, irrespective of whether they were personalized, facilitated the reduction of drinking. Cost analysis revealed that a brief mail intervention could reduce drinking at a very low cost per participant (US$46 to US$97). CONCLUSIONS: A brief community-level mail intervention for problem drinkers who had never sought treatment resulted in sizable reductions in alcohol use over the year after the intervention compared with the year before. Furthermore, many of those with poorer outcomes engaged in a natural stepped-care process by seeking help. These results, coupled with the low cost to deliver the intervention, suggest that public health campaigns could have a substantial effect on reducing alcohol problems and associated costs as well as getting some individuals into treatment. Such an approach would represent a shift from the alcohol field's long-standing clinical focus to a broader public health perspective.

Adult↗