Publications by authors named "Sara Becker"

Background: Contingency management (CM) is the most effective treatment for stimulant use disorder but is underutilized by opioid treatment programs (OTPs), despite the high prevalence of stimulant use in this setting. As part of a state-wide initiative, we piloted a novel assessment, the Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS), to examine determinants of implementation of a digital CM platform across a set of OTPs. We describe how the IFASIS was used to elucidate both generalizable and context-specific implementation determinants, and to guide the provision of implementation facilitation.

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Epidemiological research over the past two decades has highlighted substance use disparities that affect Native Hawaiian and Pacific Islander youth, and the lack of effective approaches to address such disparities (Okamoto et al., 2019). The Ho'ouna Pono curriculum is a culturally grounded, teacher-implemented, video-enhanced substance use prevention program that has demonstrated efficacy in rural Hawai'i in a large-scale trial (Okamoto et al.

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Background: It is well established that an adolescent's neighborhood is associated with their likelihood of developing a substance use disorder. The availability of drugs, lack of access to resources, and exposure to violence are all associated with greater substance use among young people, leading to more pronounced health inequities. Technology assisted interventions (TAIs) have been touted to enhance the reach of substance use treatment and improve outcomes for high-need families living in underserved neighborhoods.

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  • - The study focuses on how decision-making for individuals living with dementia and their care partners can be improved through knowledge translation (KT) interventions, particularly in areas like advance care planning (ACP).
  • - Researchers reviewed 22 previous studies and identified 32 different KT interventions, finding that discussions around ACP were the most common focus among them.
  • - The analysis revealed that most interventions were geared towards care partners, enhancing their knowledge and confidence, while leading to reduced uncertainty in decision-making for both parties involved.
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  • During the pandemic, many people in the U.S. started using opioids more due to feeling lonely and experiencing more pain.
  • Researchers studied whether this loneliness affected how much pain these people felt while they were on medication for opioid addiction.
  • They found that feeling isolated from others during the pandemic made the pain worse for patients who had trouble with opioids, especially if they were already struggling with pain before the pandemic.
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Background: Adolescents with chronic medical conditions (CMC) use alcohol and marijuana at levels equal to or even greater than their peers without CMC and are more likely to initiate substance use at 14 years or younger. Approximately 33% of adolescents with CMC binge drink alcohol and 20% use marijuana. When using substances, adolescents with CMC are at elevated risk for problem use and adverse consequences given their medical conditions.

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Objective: Screening, brief intervention, and referral to treatment (SBIRT) for adolescent alcohol and drug (AOD) use is recommended to occur with adolescents admitted to pediatric trauma centers. Most metrics on SBIRT service delivery only reference medical record documentation. In this analysis we examined changes in adolescents' perception of SBIRT services and concordance of adolescent-report and medical record data, among a sample of adolescents admitted before and after institutional SBIRT implementation.

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Background: The COVID-19 social distancing guidelines resulted in a dramatic transition to telephone and video technologies to deliver substance use disorder (SUD) treatment. Before COVID-19, the question was "Will telehealth ever take hold for SUD services?" Now that social distancing guidelines have been lifted, the question is "Will telehealth remain a commonly used care modality?"

Objective: The principal purpose of this investigation was to examine the extent to which telehealth use in SUD service settings persisted following the lifting of COVID-19 safety distancing recommendations. Additionally, the study aimed to explore practitioners' perceptions of telehealth convenience and value after its regular implementation during the pandemic.

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Background: Pediatric trauma centers have had challenges meeting the American College of Surgeons criteria for screening and intervening for alcohol with adolescent trauma patients. The study objective was to conduct an implementation trial to evaluate the effectiveness of the Science to Service Laboratory (SSL) implementation strategy in improving alcohol and other drugs (AOD) screening, brief intervention, and referral to treatment (SBIRT) delivery at pediatric trauma centers.

Methods: Using a stepped wedge cross-over cluster randomized design, 10 US pediatric trauma centers received the SSL implementation strategy to deliver SBIRT with admitted adolescent (12-17 years old) trauma patients.

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Introduction: Opioid use (OU) skyrockets as youth transition into young adulthood, indicating adolescence is a critical time for prevention. The juvenile legal system (JLS) presents an ideal setting for OU prevention, as it is the single largest referral source for youth outpatient OU treatment, after self-referral. However, no OU prevention programs have been developed for youth in JLS diversion programs or their families.

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Unlabelled: Renin-angiotensin system (RAS) modulators, including Angiotensin receptor blockers (ARB) and angiotensin-converting enzyme inhibitors (ACEI), are effective medications for controlling blood pressure. Cognitive deficits, including lack of concentration, memory loss, and confusion, were reported after COVID-19 infection. ARBs or ACEI increase the expression of angiotensin-converting enzyme-2 (ACE-2), a functional receptor that allows binding of SARS-CoV-2 spike protein for cellular invasion.

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Background: Cognitive reserve (CR) is considered a protective factor for cognitive function and may explain interindividual differences of cognitive performance given similar levels of neurodegeneration, e.g., in Alzheimer´s disease.

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Background & Aims: Anxiety and substance use disorders are highly comorbid and represent two of the leading causes of disease burden globally. Psychosocial interventions are important treatment options for people with co-occurring anxiety and substance use (A-SUD). To date, few reviews have assessed the efficacy of psychosocial treatments for patients with A-SUD.

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Khazonov et al. offer recommendations to address one of the greatest research-to-practice gaps of our time: the gap between the evidence for contingency management and patients’ ability to access it. Achieving the authors’ mission requires using rigorous methods of implementation science.

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Background: Screening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite the recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning.

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Introduction: The continuing care period following residential substance use treatment is a time when adolescents are at especially high risk for relapse, yet few families engage in traditional office-based care. Parent SMART (Substance Misuse among Adolescents in Residential Treatment) is a multi-component continuing care intervention for parents that combines three digital health technologies - an "off the shelf" online parenting program, daily phone notifications, and an online parent networking forum - with support from a parent coach. The current study solicited both qualitative and quantitative user feedback about Parent SMART to ensure responsivity to user preferences, refinement, and continuous improvement of the intervention.

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Introduction: Scant research has examined the impact of residential treatment on adolescent behavioral healthcare utilization post-discharge, even though behavioral healthcare utilization is major driver of healthcare costs. In the primary analyses of a pilot randomized trial, Parent SMART - a technology-assisted intervention for parents of adolescents in residential treatment - was found to improve parental monitoring and parent-adolescent communication, reduce adolescent drinking, and reduce adolescent school-related problems, relative to residential treatment as usual (TAU). The goal of this secondary analysis of the pilot randomized trial was to assess the effects of residential treatment and the adjunctive Parent SMART intervention on both the amount and type of subsequent behavioral healthcare utilization.

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Background: Substance use continues to remain a public health issue for youths in the United States. Black youths living in urban communities are at a heightened risk of poor outcomes associated with substance use and misuse due to exposure to stressors in their neighborhoods, racial discrimination, and lack of prevention education programs specifically targeting Black youths. Many Black youths, especially those who live in urban communities, do not have access to culturally tailored interventions, leaving a critical gap in prevention.

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Chemokines guide immune cells during their response against pathogens and tumors. Various techniques exist to determine chemokine production, but none to identify cells that directly sense chemokines in vivo. We have generated CCL3-EASER (ErAse, SEnd, Receive) mice that simultaneously report for Ccl3 transcription and translation, allow identifying Ccl3-sensing cells, and permit inducible deletion of Ccl3-producing cells.

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Article Synopsis
  • Alcohol is a big problem for people's health in the U.S., especially for those who don't have stable homes, and this study looks into how to help them with their drinking issues.
  • Researchers talked to 25 people living without stable housing who drink heavily, finding out that not having a home causes stress, which leads them to drink more.
  • To help these individuals, treatment options need to be more flexible and include both stopping drinking and reducing harm, along with providing secure housing to help solve the root of the problem.
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Background: Amidst increasing opioid-related fatalities in adolescents and young adults (AYA), there is an urgent need to enhance the quality and availability of developmentally appropriate, evidence-based treatments for opioid use disorder (OUD) and improve youth engagement in treatment. Involving families in treatment planning and therapy augments medication-based OUD treatment for AYA by increasing treatment engagement and retention. Yet, uptake of family-involved treatment for OUD remains low.

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  • Many people are really interested in learning about dissemination and implementation (D&I) science, but they often get confused about what "D" and "I" mean and how they help public health.
  • To make things clearer, researchers created a visual tool called the D&I Bridge, which shows how D&I science connects what we know about public health to what we actually do to help people.
  • The D&I Bridge covers four key gaps, helping people understand how different strategies and knowledge can make public health better and making it easier for newcomers to get involved in D&I projects.
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  • Using practical methods is important to see how well new treatments work in real life.
  • Cognitive interviewing is a way to get feedback from people which helps make these methods better and more useful.
  • The article explains why cognitive interviewing is not used enough and shares an example of how it helped create a better plan for treating people with opioid addiction.
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  • Researchers studied the differences between neighborhoods with a lot of overdoses and those without in Rhode Island from 2016 to 2020.
  • They found that neighborhoods with more Black and Latino/a residents, high unemployment, and crowded living conditions had higher overdose rates.
  • The study suggests that neighborhoods struggling with poverty and housing issues are at greater risk for overdoses, and having more social services nearby could help prevent these deaths.
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