A theoretical explanation of naloxone provision among primary care physicians and community pharmacists in Tennessee.

Background: Increasing access to naloxone reduces opioid-related morbidity and mortality. Primary care and community pharmacy settings are critical access points, yet limited theoretical research has examined naloxone prescribing and dispensing behaviors.

Objectives: To determine if the theory of planned behavior (TPB) combined with theoretical constructs from communication science explains intentions to co-prescribe and discuss co-dispensing naloxone among primary care physicians and community pharmacists, respectively.

Primary care physicians' opioid-related prevention behaviors and intentions: A descriptive analysis.

Objective: Primary care physicians (PCPs) are positioned to mitigate opioid morbidity and mortality, but their engagement in primary, secondary, and tertiary opioid-related prevention behaviors is unclear. The objective of this study was to evaluate Tennessee PCPs' engagement in and intention to engage in multiple opioid-related prevention behaviors.

Methods: A survey instrument was developed, pretested, and pilot tested with practicing PCPs.

Health workers' perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda.

Background: Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda.

The next wave? Mental health comorbidities and patients with substance use disorders in under-resourced and rural areas.

The rapid spread of the coronavirus disease (COVID-19) has impacted the lives of millions around the globe. The COVID-19 pandemic has caused increasing concern among treatment professionals about mental health and risky substance use, especially among those who are struggling with a substance use disorder (SUD). The pandemic's impact on those with an SUD may be heightened in vulnerable communities, such as those living in under-resourced and rural areas.

Association between per and polyfluoroalkyl substances and markers of inflammation and oxidative stress.

Objectives: This study aimed to examine the association of Per and Polyfluoroalkyl substances (PFAS) and markers of chronic inflammation and oxidative stress.

Methods: Using data (n = 6652) from the National Health and Nutrition Examination Survey (NHANES) 2005-2012, generalized linear models were used to examine the association between PFAS and inflammatory (ferritin, alkaline phosphatase, C-reactive protein, absolute neutrophil count and lymphocyte count) and oxidative stress (serum bilirubin, albumin and iron) per unit exposure to PFAS while adjusting for covariates. Study participants were those ≥20 years of age.

A cross-sectional study of the association between perfluorinated chemical exposure and cancers related to deregulation of estrogen receptors.

Background: Environmental exposures acting through different mechanisms have been linked with a number of cancers. Perfluoroalkyl chemicals (PFCs) are endocrine disrupting chemicals affecting estrogen homeostasis.

Objectives: We examined the association between PFCs and a group of estrogen related cancers and explored if increased non-occupational exposure was associated with increased odds of developing these cancers.

Community pharmacist engagement in opioid use disorder prevention and treatment behaviors: A descriptive analysis.

Objectives: This study describes community pharmacists' opioid analgesic and medication for opioid use disorder (MOUD) practice behaviors and behavioral intentions in the context of primary, secondary, and tertiary prevention of opioid use disorder (OUD).

Methods: The study sampling frame consisted of 2302 Tennessee community-practice pharmacists who were asked to complete a mailed, paper questionnaire. Behavioral intentions were elicited by asking pharmacists to indicate the number of times (0 to 10) they engage in a behavior, given 10 patients in 3 distinct vignettes.

Communication Experiences of DATA-Waivered Physicians with Community Pharmacists: A Qualitative Study.

Patients engaged in evidence-based opioid use disorder (OUD) treatment can obtain prescriptions for buprenorphine containing products from specially trained physicians that are subsequently dispensed by community pharmacists. Despite the involvement of physicians and community pharmacists in buprenorphine prescribing and dispensing, respectively, our understanding of their interactions in this context is limited. To qualitatively describe the communication and collaborative experiences between Drug Addiction Treatment Act 2000 (DATA)-waivered physicians and community pharmacists from the perspective of the physician.

"It's Took Over This Region": Patient Perspectives of Prescription Drug Abuse in Appalachia.

Prescription drug abuse is a public health problem in the United States and the region of Appalachia, specifically. Primary care and addiction medicine-as possible points of access for prescription drugs with abuse potential and points of intervention for prescription drug abuse-are among the medical fields at its forefront. Little is known, however, about perceptions of prescription drug abuse across the two patient populations.

Provider-patient communication about prescription drug abuse: A qualitative analysis of the perspective of prescribers.

Provider-patient communication underpins many initiatives aimed at reducing the public health burden associated with prescription drug abuse in the United States. The purpose of this qualitative analysis was to examine the characteristics of provider-patient communication about prescription drug abuse from the perspective of prescribers. From 2014 to 2015, 10 semi-structured interviews were conducted with a purposive sample of prescribers from multiple professions and medical fields in Central and South Central Appalachia.

Almost Everything We Need to Better Serve Children of the Opioid Crisis We Learned in the 80s and 90s.

Opioid use disorder impedes dependent parents' abilities to care for their children. In turn, children may languish in unpredictability and persistent chaos. Societal responses to these children are often guided by a belief that unless the drug dependent parent receives treatment, there is little help for the child.

A Dissemination and Implementation Science Approach to the Epidemic of Opioid Use Disorder in the United States.

Purpose Of Review: This review aims to (1) conceptualize the complexity of the opioid use disorder epidemic using a conceptual model grounded in the disease continuum and corresponding levels of prevention and (2) summarize a select set of interventions for the prevention and treatment of opioid use disorder.

Recent Findings: Epidemiologic data indicate non-medical prescription and illicit opioid use have reached unprecedented levels, fueling an opioid use disorder epidemic in the USA. A problem of this magnitude is rooted in multiple supply- and demand-side drivers, the combined effect of which outweighs current prevention and treatment efforts.

HIV/HCV Co-infection: Burden of Disease and Care Strategies in Appalachia.

Purpose Of Review: The purpose of this review is to address infection with HIV and hepatitis C in the Appalachian region of the USA and the driving forces underlying this epidemic. We seek to discuss epidemiology of disease and the possible interventions to reduce incidence and burden of disease in this resource-limited area.

Recent Findings: The rise of the opioid crisis has fueled a rise in new hepatitis C infection, and a rise in new HIV infection is expected to follow.

Interprofessional prescription opioid abuse communication among prescribers and pharmacists: A qualitative analysis.

Background: Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed support for interventions that improve interprofessional communication and reduce prescription opioid abuse. The objective of this study was to describe prescription opioid abuse-related communication among and between prescribers and community pharmacists in South Central Appalachia.

Prescription drug abuse communication: A qualitative analysis of prescriber and pharmacist perceptions and behaviors.

Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited.

Objectives: This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists.

Correlates of Prescription Opioid Legitimacy Judgments Among Community Pharmacists.

Background: Community pharmacists are legally required to evaluate and confirm the legitimacy of prescription opioids (POs) prior to dispensing. Yet, previous research has indicated community pharmacists perceive nearly 50% of dispensed POs to be issued lacking a legitimate medical purpose.

Objective: To analyze correlates of PO legitimacy judgments across pharmacist and pharmacy setting characteristics.

Factors associated with provision of addiction treatment information by community pharmacists.

Community pharmacists in the United States have significant opportunity to engage in community-level prescription substance abuse prevention and treatment efforts, including dissemination of information specific to available addiction treatment options. Our cross-sectional study of Tennessee community pharmacists noted that 26% had previously provided addiction treatment facility information to one or more patients in the past. The purpose of this study was to employ multivariate modeling techniques to investigate associations between community pharmacist and community pharmacy factors and past provision of addiction treatment information to pharmacy patients.

Theoretical exploration of Tennessee community pharmacists' perceptions regarding opioid pain reliever abuse communication.

Background: Community pharmacists are a key intervention point in efforts to prevent and mitigate the impact of prescription drug abuse and misuse (PDA/M); yet pharmacists' perceptions regarding PDA/M have been explored only briefly in the literature.

Objectives: 1) To explore Tennessee community pharmacists' perceptions regarding opioid pain reliever (OPR) prescribing, dispensing and abuse; 2) to explore community pharmacists' self-efficacy beliefs regarding PDA/M-specific communication; and 3) to evaluate perceived barriers to engaging patients in PDA/M-specific communication.

Methods: A 55-item survey instrument was developed using the Theory of Planned Behavior (TpB) as a theoretical framework.

Prescription drug abuse: a comparison of prescriber and pharmacist perspectives.

This study compared perceptions of prescribers and pharmacists (N = 89) regarding multiple aspects of prescription drug abuse. Questionnaires were developed to assess perceptions regarding the prevalence of prescription drug abuse, self-perceived communication competence, and additional communication and prescription drug abuse domains. Pharmacists perceived a larger percentage of patients (41%) to be abusing opioid pain relievers as compared with their prescriber colleagues (17%).

Psychosocial Correlates of Dual Methods for Contraception and STI Protection in Urban Adolescents.

Purpose. To identify correlates of combined hormonal contraception and condom use (dual method use) compared with no methods, condoms only or hormonal contraception only. Data are from a baseline assessment of 335 youth (52% female) enrolled in an intervention trial.

Potential approaches to address the undergraduate public health training needs for working professionals: a case study of one rural area.

The leadership of several health districts in the rural Appalachian region of northeast Tennessee and southwest Virginia has expressed interest in addressing the educational needs of their employees. The majority of these workers have not completed an undergraduate degree, but they desire to further their education. The College of Public Health at East Tennessee State University has begun preliminary discussions with these leaders to identify potential approaches to address these needs.

Preliminary evaluation of the WV Prescription Drug Abuse Ouitline.

Purpose: To evaluate the effectiveness of the West Virginia Prescription Drug Abuse Quitline (WVPDAQ).

Methods: Descriptive data and inferential analyses are provided for the period of operations from 9/11/2008 to 3/1/2010. Chi-square tests for Independence compared differences between callers completing at least one follow-up survey against callers completing only the baseline intake survey were observed.

Epidemiological criminology: drug use among African American gang members.

Epidemiological methods and public health theories can be tied to theories of crime and delinquency and used to create evidence-based policy. Interdisciplinary theoretical approaches to existing, and emerging, public health and criminal justice problems hold great promise. Differential association theory postulates that close association with delinquent peers leads to an increase in deviant activities such as illicit drug use.