Assessing Mental Health Treatment Receipt Among Asian Adults with Limited English Proficiency Using an Intersectional Approach.

U.S. Asian adults and people with limited English proficiency (LEP) confront mental health treatment receipt disparities. At the intersection of racial and language injustice, Asian adults with LEP may face even greater disparity, but studies have not assessed this through explicitly intersectional approaches. Using 2019 and 2020 National Survey of Drug Use and Health data, we computed disparities in mental health treatment among those with mental illness comparing: Non-Hispanic (NH) Asian adults with LEP to NH White adults without LEP (joint disparity), NH Asian adults without LEP to NH White adults without LEP (referent race disparity), NH Asian adults with LEP to those without LEP (referent LEP disparity), and the joint disparity versus the sum of referent disparities (excess intersectional disparity). In age- and gender-adjusted analyses, excess intersectional disparity was 26.8% (95% CI=-29.8%-83.4%) of the joint disparity in 2019 and 63.0% (95% CI=29.1%-96.8%) in 2020. The 2019 joint disparity was 1.37 (95% CI=0.31-2.42) times that if the race-related disparity did not vary by LEP, and if LEP-related disparity did not vary by race; this figure was 2.70 (95% CI=0.23-5.17) in 2020. These findings highlight the necessity of considering the intersection of race and LEP in addressing mental health treatment disparities.

Perceived reward from using cigarettes with alcohol or cannabis and concurrent use: A smartphone-based daily diary study.

INTRODUCTION: Smoking cigarettes under the influence of alcohol or cannabis is associated with perceived pleasure. However, it is unclear whether these changes in perceived reward impact the extent of concurrent use of cigarettes with alcohol or cannabis. The current study investigated if self-reported changes in perceived reward from concurrent use of cigarettes with alcohol or cannabis are related to the extent of concurrent use in real-world contexts using a smartphone-based Ecological Momentary Assessment (EMA) study. METHODS: The sample included 126 diverse young adult smokers in the San Francisco Bay Area who reported current alcohol or cannabis use at baseline (M = 22.8 years, 50.8% male, 40.5% sexual minority, 39.7% Non-Hispanic White). Participants completed an online baseline survey and 30 days of smartphone-based daily EMA surveys of cigarette, alcohol, and cannabis use. The baseline assessed self-reported changes in perceived pleasure of smoking cigarettes while using alcohol or cannabis separately. EMA surveys included detailed questions about concurrent use (i.e., the extent of smoking while using another substance) covering the previous day. A total of 2,600 daily assessments were analyzed using mixed models. RESULTS: Higher perceived pleasure from smoking cigarettes while drinking alcohol or using cannabis at baseline were both associated with a greater extent of concurrent use of cigarettes with alcohol (b = 0.140; SE = 0.066; t = 2.1; p = .035) and cannabis (b = 0.136; SE = 0.058; t = 2.4; p = .019) on a given day. CONCLUSIONS: Results suggest that perceived reward from concurrently using cigarettes with alcohol or cannabis is associated with the extent of concurrent use. Findings can inform tailored smoking cessation interventions.

Digital health for assessment and intervention targeting tobacco and cannabis co-use.

PURPOSE OF REVIEW: This article aims to summarize current research on digital health for assessment and intervention targeting tobacco and cannabis co-use and to answer the following questions: Which digital tools have been used? Which populations have been targeted? And what are implications for future research? RECENT FINDINGS: Ecological Momentary Assessment (EMA) via text messages or interactive voice response calls has been used to capture co-use patterns within a time window or co-administration of both substances via blunts among young adults. Feasibility of multicomponent interventions targeting dual cessation of both substances among adult co-users with cannabis use disorder, delivered via smartphone apps, online, and computer modules has been demonstrated. SUMMARY: Digital tools, particularly those using EMAs and mobile sensors, should be expanded to assess co-use of emerging tobacco and cannabis products. Digital cessation interventions should be tailored to different groups of co-users and address specific mechanisms underlying different co-use patterns.

The Importance of a Complete Allergy Assessment in Clinical Stewardship.

National agencies have championed stewardship initiatives to enhance antimicrobial and opioid use in long-term care facilities. Health care providers for these residents have been given the task to ensure "the right drug is used for the right indication at the right time and duration." One potential challenge to this is incorrect or incomplete documentation of allergies. Many long-term care facilities have traditionally, and currently, used a "list format" of allergies in, or on, the resident's chart. This approach is incomplete as it rarely provides detailed information about the reaction to a particular drug. Senior care pharmacists and their students can play a role within long-term care facilities by helping ensure the optimal selection of drugs by providing a detailed allergy assessment that documents detailed reaction information, whenever possible.