Topical trends in tobacco and alcohol articles published in three dental journals, 1980-2010.

The aim of this study was to conduct a review of articles about tobacco or alcohol published from 1980 to 2010 in the Journal of the American Dental Association (JADA), Journal of Dental Education (JDE), and Journal of Public Health Dentistry (JPHD) in an attempt to identify trends by decade in topics relevant to oral health consequences, oral cancer linkages, and cessation counseling. NVivo qualitative analysis software was used to code abstracts using the keywords "tobacco" or "alcohol." The search identified 269 articles: tobacco=211 (78%), alcohol=58 (22%). This number represented 2.4% of the total articles published in these journals for the specified years. While the percentage of tobacco-related articles increased over this period (with highs in the 1990s of 4.1% in the JDE and 9% in the JPHD), the percentage of alcohol articles reached only 1% for JADA and 3.3% for the JPHD in the 2000s. The number of tobacco-related articles addressing oral health effects, oral cancer linkages, and cessation counseling increased in the 1990s. Although there were modest increases in the number of articles about alcohol-related oral health effects and oral cancer linkages (particularly in the JPHD in the 2000s), only two articles (in JADA in the 2000s) addressed alcohol cessation counseling. This study concluded that tobacco and alcohol have received limited, though increasing, attention in these three major journals between 1980 and 2010, with alcohol receiving less attention than tobacco. These results suggest a need for more published studies on tobacco and alcohol interventions in dental and allied dental education to prepare students to contribute to this aspect of their patients' health.

Effectiveness of a Screening and Brief Intervention protocol for heavy drinkers in dental practice: A cluster-randomized trial.

Results of a cluster-randomized trial of a Screening and Brief Intervention for heavy drinkers in dental practice are reported. Data were obtained from 103 heavy drinking patients recruited from randomized intervention (7; n = 50) and control (6; n = 53) practices. Analysis of data revealed that 6-month decreases in total drinks per week were significantly (p < .05) greater for heavy drinking intervention (43%) than control patients (21%)-a 4 drink per week difference. Similar decreases were obtained for quantity and frequency among intervention patients compared to control patients. Despite power limitations, the 6-month results support the effectiveness of the Screening and Brief Intervention.

A brief motivational intervention for heavy alcohol use in dental practice settings: rationale and development.

Although brief alcohol interventions have proven effective in a variety of health care settings, the present article describes the development of the first brief intervention for heavy drinkers in dental practice. Elements of motivational interviewing and personalized normative feedback were incorporated in a 3- to 5-minute intervention delivered by dental hygienists. The intervention is guided by a one-page feedback report providing personalized normative feedback regarding the patient's current oral health practices, their drinking in comparison to others, and oral cancer risk associated with current smoking and drinking. Future publications will present data regarding intervention effectiveness from an ongoing randomized trial.

Alcohol use, predisposing, enabling, and oral health need variables as predictors of preventive and emergency dental service use.

Analyses of the 2002 U.S. National Health and Examination Survey (1,490 adults) examined relationships between alcohol frequency, quantity, and total weekly consumption and preventive and emergency dental service use during the past 12 months. Logistic regression analyses indicated a significant, small percentage of variance in dental service use explained by alcohol use (1%), controlling for predisposing (19%), enabling (18%), or need (4%) covariates. Preventive and emergency service use were associated with higher frequency drinking, but lower total consumption (significant only for preventive services). Limitations and implications for brief alcohol interventions in dental practice are discussed.

Sex differences among dentists regarding eating disorders and secondary prevention practices.

BACKGROUND: The purpose of this cross-sectional study was to assess sex differences among dentists pertaining to current behaviors and behavioral beliefs with regard to eating disorders. METHODS: The authors collected data via a self-administered paper-and-pencil questionnaire from a randomized sample of 350 practicing male and female dentists. RESULTS: The results showed a low level of practice regarding secondary prevention (that is, measures leading to early diagnosis and prompt intervention) of eating disorders. The authors found statistically significant differences, with more female than male dentists reporting that they assessed patients for oral cues (P < .001), more female dentists reporting that they provided specific dental care instructions (P = .038) and more female dentists referring patients who have oral signs of eating disorders (P = .028). They also found sex differences with regard to mediating factors. Female dentists had greater knowledge of oral manifestations of eating disorders (P = .001), greater knowledge of physical cues of anorexia nervosa (P < .001), greater perception of the severity of anorexia nervosa (P = .007) and greater knowledge of physical cues of bulimia nervosa (P < .001). CONCLUSIONS: Although the dentist may be the first health care provider to assess oral effects of eating disorders, his or her involvement may be influenced in part by sex and sex-related health beliefs. CLINICAL IMPLICATIONS: Female dentists may be more sensitive to oral cues related to women's health issues. Further research is warranted to explore the mediating factors regarding secondary prevention of eating disorders.

Contrasting faith-based and traditional substance abuse treatment programs.

This article (a) discusses the definition of faith-based substance abuse treatment programs, (b) juxtaposes Durkheim's theory regarding religion with treatment process model to highlight key dimensions of faith-based and traditional programs, and (c) presents results from a study of seven programs to identify key program dimensions and to identify differences/similarities between program types. Focus group/Concept Mapping techniques yielded a clear "spiritual activities, beliefs, and rituals" dimension, rated as significantly more important to faith-based programs. Faith-based program staff also rated "structure and discipline" as more important and "work readiness" as less important. No differences were found for "group activities/cohesion" and "role modeling/mentoring," "safe, supportive environment," and "traditional treatment modalities." Programs showed substantial similarities with regard to core social processes of treatment such as mentoring, role modeling, and social cohesion. Implications are considered for further research on treatment engagement, retention, and other outcomes.

Applying behavior change models to understand spiritual mechanisms underlying change in substance abuse treatment.

Despite increasing attention directed to conceptual and methodological issues surrounding spirituality and despite the centrality of "spiritual transformation" in the recovery literature, there is little systematic evidence to support the role of spiritual change as a necessary condition for substance abuse behavior change. As an explicit conceptualization of mechanisms underlying behavior change is fundamental to effective interventions, this article: 1) briefly reviews relevant behavior change theories to identify key variables underlying change; 2) presents an integrative conceptual framework articulating linkages between program components, behavior change processes, spiritual change mechanisms and substance abuse outcomes; and 3) presents a discussion of how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, we argue that spiritual transformation at an individual level takes place in a social context involving peer influence, role modeling, and social reinforcement.

Psychological adaptation and distress among HIV+ Latina women: adaptation to HIV in a Mexican American cultural context.

In order to examine the relative importance of general individual orientations (mastery and self-esteem) and specific coping styles with regard to psychological distress among women with HIV, data are examined from a pilot study involving in-depth face-to-face interviews with 32 HIV+ Latinas receiving care at 4 clinics serving the South Texas population. Interviews were conducted to provide preliminary psychometric information on coping and distress instruments in this predominantly Mexican American population as well as to examine psychosocial factors related to individual adjustment to HIV among Latina females. Refusal rates were low in this study (approximately 10%) and measurement instruments generally had acceptable internal consistency reliability. Results of exploratory multiple regression analyses suggest that self-esteem and mastery may be more salient predictors of depression and anxiety symptoms than are specific coping strategies.

Functional impairment as a predictor of depressive symptomatology: the role of race, religiosity, and social support.

The study discussed in this article examined the relationship between depression symptomatology and functional impairment among white and African American elderly people and investigated the effect of race, religiosity, and social support on this relationship. Study results indicate that although African American elderly people were more impaired in the performance of activities of daily living (ADL) and instrumental activities of daily living (IADL) than white elderly people, they did not experience higher levels of depression. However, African Americans did report significantly higher levels of religiosity and social support.

Syringe type and drug injector risk for HIV infection: a case study in Texas.

Studies of accidental needlestick exposure to blood containing human immunodeficiency virus (HIV) have shown that the volume of blood in an exposure is a strong predictor of subsequent infection. Illicit drug injectors, a group at elevated risk for HIV transmission, use syringes manufactured in two styles, one of which (the integral cannula type) retains substantially less blood after intravenous use than the other (the detachable needle type). In this report, we examine some of the factors associated with use of syringes with detachable needles among drug injectors in San Antonio, Texas using data from epidemiological surveys, ethnographic studies, and historical observations. We compare personal history of syringe type use with HIV serostatus in a sample of 501 active drug injectors interviewed and screened for HIV in 1997-1998. Ninety-nine percent of these respondents reported that they currently used only integral cannula syringes, but 13% had used a syringe with a detachable needle within the past 2 years, and 37% had used one in their lifetime. Only 9% had ever used one > or = 20 times in a year. Hispanic (Mexican American) respondents were significantly less likely than other ethnic groups to have ever used a detachable needle syringe. HIV seroprevalence was < 1% among heterosexual injectors who had never used a detachable needle syringe compared to 4% among those who had used one (p<0.05).

Predictive validity of a measure of treatment readiness for out-of-treatment drug users: enhancing prediction beyond demographic and drug history variables.

The predictive validity of a treatment readiness measure designed for out-of-treatment drug users, tapping dimensions of perceived problem severity, perceived need for formal treatment, motivation for treatment, and negative attitudes toward treatment is examined using data from a National Institute on Drug Abuse (NIDA)-funded HIV outreach intervention in San Antonio, Texas. Logistic regression is used to predict use of substance abuse treatment services three months after program intake on the basis of readiness scores, controlling for demographic and drug history variables. Analyses of data from 673 drug users in an HIV outreach intervention indicated that treatment readiness dimensions accounted for a 12% increase in variation in "use of any modality" and 14% for "use or attempted service use". Only Motivation to Quit was a significant predictor of "use of any modality" and both Perceived Need for Treatment and Motivation to Quit were significant predictors of "use or attempted use". Findings support the importance of the individual's perception of "readiness" to change their substance-abusing behavior and enter treatment.