PubMed Health⌕ Search

Biomedical subjects

S G McRae

Publications and source records attributed to S G McRae.

7 recordsLinked to original sources
PubMed1997

Underdiagnosis of PTSD and substance use disorders in hospitalized female veterans.

Discharge diagnoses of 31 female veterans and 31 male veterans hospitalized at a large urban VA medical center were examined to elucidate possible biases in clinicians' diagnostic practices. Only one woman in the sample was diagnosed as having posttraumatic stress disorder, compared with seven men. All men given this diagnosis were combat veterans. Although about half of each group had a drug-positive urine screen on admission, only 11 women received a diagnosis of a substance use disorder, compared with 24 men. VA clinicians may need further training and experience assessing the presentation of PTSD and substance use disorders in women.

Adult↗
PubMed1995

The tribal tobacco policy project: working with Northwest Indian tribes on smoking policies.

BACKGROUND: This article reports on the objectives, study design, intervention methods, baseline results, and process data from a trial involving 39 Northwest Indian tribes. METHODS: Tribes were stratified and then randomized to either early or late intervention conditions. Intervention consisted of a consultation process to assist tribes to review and modify existing tobacco policies or to develop new policies relevant for their tribe and that protect tribal members from environmental tobacco smoke. Outcome measures consist of: (a) phone interviews to assess the comprehensiveness of tribal tobacco policy, (b) surveys of tribal leaders to assess norms and attitudes regarding tobacco use, and (c) observations of tribal settings to assess policy implementation and indicants of tobacco use. RESULTS: Early and later intervention tribes were well matched on baseline measures and tribal characteristics potentially related to policy outcomes. There was considerable variability across tribes on all measures though, in general, tribal leaders expressed support for more stringent tobacco use policies. Process data indicated that early intervention tribes strengthened their tobacco policies, but generally did not do so through tobacco policy committees as originally envisioned. CONCLUSIONS: There is good potential for tobacco policy interventions with Indian tribes. Consultation processes and products, such as policy guidebooks, that are sensitive to traditional uses of tobacco and to differences among tribes can help to modify policies to reduce exposure of tribal members to environmental tobacco smoke.

Attitude↗
PubMed1995

Promoting tobacco control policies in northwest Indian tribes.

A culturally sensitive consultative process to facilitate adoption by tribal councils of more effective tobacco control policies was developed and evaluated. Thirty-nine Northwest Indian tribes were randomized to early intervention or late intervention conditions. Early intervention tribes received a policy workbook and consultation by means of meetings and telephone calls. Late intervention tribes were assessed but received no assistance or encouragement regarding tobacco use policies. The stringency of the policies was assessed via telephone at baseline and after intervention. At postintervention, there were consistent, and generally statistically significant, differences in adoption of more stringent and comprehensive smoking policies for early intervention tribes compared with late intervention tribes. The intervention could be used in other Indian settings.

Cultural Characteristics↗
PubMed1993

A stop-smoking telephone help line that nobody called.

The purpose of this study was to evaluate the reach of a smoker's hotline that provided a variety of services to over 2100 health maintenance organization members. Formative evaluation procedures identified topics of concern, and repeated promotions advertised the service via multiple channels. Excluding a special giveaway promotion, an average of less than three calls per month were made during the 33 months of operation. To be cost-effective, smoker's hotlines should be offered to large populations and should be consistently and intensively publicized.

Hotlines↗
PubMed1991

Providing an integrated program of low intensity tobacco cessation services in a health maintenance organization.

This paper reports on the development, promotion and use of a coordinated program of low intensity intervention services designed to appeal to smokers (and smokeless tobacco users) at various stages of change. An initial package of four components: a telephone advice line, self-help materials, single session group meetings and bi-monthly newsletter was offered to subjects in a variety of different settings (outpatient clinics, dental offices, worksites, hospitals) within a health maintenance (HMO) program project. Based upon consumer response and formative evaluations, these components were modified during the course of the year-long intervention. Results revealed differences in use of the various components of the program, with greatest use of self-help materials (manuals, 'tobacco substitutes' and a computerized smoking cessation aid) and least response to group meetings and the advice line. Most encouraging was the finding that it was possible to reach heavy smokers and to engage them in tobacco cessation activities through a centralized program of low intensity services. Data are presented on member characteristics associated with use/non-use of the various low intensity resources and suggestions are made for wider use of such interventions in other health care systems.

Adult↗
PubMedDate not supplied

Temporal patterns of veterans' psychiatric service utilization, disability payments, and cocaine use.

This study examined temporal patterns of service utilization, disability benefits, and substance use. Specifically, it investigated whether the first day of the first week of each month (when disability payments are disbursed) was associated with increased emergency room (ER) use and more frequent cocaine use among psychiatric patients. All 1993 psychiatric ER presentations (n=1,448) at a Veterans Administration hospital were reviewed in order by the week of each month in which they occurred. A random subsample of only those admitted to an inpatient psychiatric service (n=143) was further assessed for amount of disability payments received and recent cocaine use. This study found that for the total population of patients utilizing the ER, most ER visits occurred during the first week, followed by weeks two, three, and four respectively. The highest percentage (49%) of patients who used cocaine were those admitted during the first week of the month, followed by week two (39%), week four (28%) and week three (25%). For the subsample of patients admitted to inpatient services, patients hospitalized during the fourth week of the month were those receiving the highest disability payments. This study found that cocaine users have the most ER visits during the first week of the month following receipt of benefits. Current data, if confirmed, would suggest public policy changes, such as payment of entitlement money to cocaine users through a third-party payee and stipulated treatment for psychiatric patients with substance use disorders as a condition of payment. Ethical and political issues, including confidentiality and patient autonomy, would need to be considered in any such policy changes.

Adult↗