News & Announcements

Socioeconomic Disparities in Community-Based Treatment of Tobacco Dependence

Posted: March 30, 2012

A recent study published in the American Journal of Public Health found socioeconomic status (SES) to be a significant indicator for treatment outcome disparities in community-based tobacco treatment programs. 

Prior research shows that people of color and people in lower-SES groups encounter greater tobacco cessation challenges, according to the authors. They note that these groups are less likely to have access to accurate information about nicotine replacement and tobacco dependence treatment programs, receive cessation advice from health care providers, and have smoking bans in place in the home or workplace. The authors sought to determine how SES, ethnicity, nicotine dependence, stress levels, treatment use, and other factors contribute to maintaining tobacco cessation by exploring community-based tobacco dependence treatment programs in Arkansas. A total of 2,739 participants at 14 sites from 2005 to 2008 were included in the study. SES was defined using a scale combining household income and educational level. Other variables included age, gender, race and ethnicity, and insurance status. Overall, the abstinence rate at 3 months after treatment was 28.2 percent and 27.3 percent at 6 months, the authors note. Significant differences in abstinence rates were found across SES levels at the end of treatment and at 3 and 6 months, with those in the lowest SES group being the least likely to be tobacco free at the end of treatment, as well as at 3 and 6 months following treatment, according to the authors. The findings suggest future efforts to enhance treatment approaches for lower-SES groups should include increasing access to treatment content, addressing clinical and environmental factors that affect treatment outcomes, and managing clinical and environmental challenges, such as implementing smoking bans or managing stress. Though ethnicity was not a statistically significant variable in the study, people of color made up a greater proportion of lower-SES groups, suggesting the perspective of ethnic minorities be considered when evaluating the needs of lower-SES groups.

The authors note that future research is needed to explore more effective ways to innovatively treat low-SES smokers and reduce treatment disparities. 

Read more on the Kaiser Family Foundation website. Read the abstract of the study.

Updated—SAMHSA’s Working Definition of Recovery

Posted: March 29, 2012

In December 2011, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a working definition of recovery and a set of guiding principles. At the time SAMHSA released the working definition, they had indicated continued dialogue with the field to refine the definition and principles. Based on additional stakeholder input, SAMHSA has now issued a slightly revised working definition and principles. The revised working definition and principles give more emphasis to the role of abstinence in recovery from addictions, and indicate that an individual may be in recovery from a mental disorder, a substance use disorder, or both. The revised definition is:

Recovery from Mental Disorders and/or Substance Use Disorders:  A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

Through the Recovery Support Strategic Initiative, SAMHSA has delineated four major dimensions that support a life in recovery:

  • Health: overcoming or managing one’s disease(s) or symptoms—for example, abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has an addiction problem—and for everyone in recovery, making informed, healthy choices that support physical and emotional wellbeing.
  • Home: a stable and safe place to live;
  • Purpose: meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society; and
  • Community: relationships and social networks that provide support, friendship, love, and hope.

Guiding Principles of Recovery

  • Recovery emerges from hope
  • Recovery is person-driven
  • Recovery occurs via many pathways
  • Recovery is holistic
  • Recovery is supported by peers and allies
  • Recovery is supported through relationship and social networks
  • Recovery is culturally-based and influenced
  • Recovery is supported by addressing trauma
  • Recovery involves individual, family, and community strengths and responsibility
  • Recovery is based on respect

Read more on the SAMHSA website.


Preventing Youth Suicide in Indian Country: Incorporating Culture in Trauma Informed Care

Posted: March 28, 2012

The National Child Traumatic Stress Network (NCTSN) recently released the Spring edition of it's quarterly newsletter IMPACT (pdf), devoted entirely to the relationship between culture and trauma. It describes the incredible work being done across the Network by members with informed perspectives on the cultural dimensions of trauma at multiple levels: the individual; the organization; and the broader community.

One article from the issue describes work being done by the National Native Children’s Trauma Center (NNCTC) to prevent youth suicides in Indian communities. In Montana, just over 16% of the state’s high school students living on or near a reservation attempted suicide in the past year, according to the Centers for Disease Control and Prevention’s 2011 Youth Risk Behavior Survey. In partnership with tribal leadership, schools, and child-serving agencies, the NNCTC has worked for the past eight years with Alaska Native communities, the Ojibwe in the Midwest, and seven Montana reservation communities to raise awareness of and encourage active participation in suicide prevention.

The article discusses the importance of becoming authentic partners with the Native Indian communities: Whenever the NNCTC staff are asked by tribal leaders to work among their people (services are not offered without an invitation from the tribal community), the staff’s first action is to simply listen. Building a foundation of trust and respect is always the first order of business, says Matt Taylor, Director of Montana Safe Schools Center, at the University of Montana’s Institute for Educational Research and Service: “There is a great danger and disservice done when outside consultants and trainers drop in to native communities and presume to understand what the community needs.” Added Bruguier Zimmerman, Director of the NNCTC, “We spend a lot of our time, resources, and energy connecting with the community and becoming authentic partners with tribal health departments, law enforcement, and courts.”

Listen for Resiliency: Complex factors contribute to the mental health risks faced by American Indian youth. Chronic unemployment is endemic in many American Indian communities. Widespread poverty, historical trauma, isolation, and a lack of services can all put youth at higher risk for mental illness, substance abuse, and suicide. Youth are also exposed to family and interpersonal violence, and may have experienced multiple losses—of loved ones, of cultural and spiritual traditions, and of their tribal identity. However, it is a mistake to assume that all American Indian youth experience and respond to risk factors in the same way. With more than 565 recognized tribes in the US, heterogeneity is the rule rather than the exception. “Risk factors in one area cannot be generalized to another,” Taylor said. Tribal cultures can also be resilient, and their sense of cultural identity and community cohesion, when accessed, can be extraordinarily protective for their youth. That’s why NNCTC staff members assess a tribe’s readiness before they proceed. 

Read the complete article (pdf) in the newsletter. Access previous issues of the newsletter.

LGBT Health Awareness Week is March 26 to 30

Posted: March 26, 2012

March 26-30, 2012 marks the 10th Annual LGBT Health Awareness Week and is a call to action (pdf) for community members, advocates, service providers, and governmental officials to recognize health and wellness as an essential part of the social justice movement for lesbian, gay, bisexual, and transgender individuals, families and the wider community. The 2012 observance advances the core health principle of "Culturally Competent Services," among others. The American Psychological Association's (APA) Lesbian, Gay, Bisexual, and Transgender Concerns Office provides a range of information and resources for increasing psychologists' and others' cultural competence:

Access more resources on the APA website. Visit the National Coalition for LGBT Health website.

Faith Communities now Offering or Hosting Recovery Programs

Posted: March 26, 2012

Faith communities have known there were plenty of people trapped in addiction sitting in the pews, afraid to suffer the shame that would come from sharing their problems. But some places of worship are now offering or hosting recovery programs, minimizing the stigma. While Celebrate Recovery programs have started in a variety of Christian churches, many houses of faith have long been supporters of 12-step recovery programs such as Alcoholics Anonymous. Some faith groups have developed programs to teach clergy and laity about addiction and treatment. 

Annette Harper directs addiction ministries for the Oklahoma Conference of the United Methodist Church, which offers an education program and support group. The church started its Summer School on Chemical Dependency 30 years ago after an addict confided in a pastor and found the spiritual leader did not have the resources to help. "It was one layperson who went to his pastor to seek help and did not receive it because the pastor did not know what to do," Harper said. "That layperson took it upon himself to find what needed to be done." The 12-day education program is open to anyone who has been sober for two years. It serves as a opportunity to learn about the addictive mind, the spiritual dynamics of addiction and how substance abuse impacts faith communities. 

The United Methodist Church also supports Faith Partners, a program creating teams in churches to help people deal with addiction. "On a Faith Partner team, you may have a person in long-term recovery that the pastor can call on to take somebody to a 12-step meeting that day, immediately," Harper said. 

Rabbi Barry Cohen of Temple B'nai Israel in Oklahoma City said Jewish faith communities address addiction in a straightforward manner, most often working directly with clergy. He said the stigma has decreased, providing Jewish leaders a greater opportunity to help within a congregational setting rather than members seeking assistance outside the Jewish community. 

Read more from this Tulsa World article.

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