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ABSTRACT: BACKGROUND: The use of complementary and alternative medicine (CAM) among Human Immunodeficiency Virus (HIV)-positive individuals is becoming increasingly widespread. Unfortunately, some CAM therapies may jeopardize the efficacy of conventional HIV medication, making it critical to understand CAM use among this population. OBJECTIVE: To investigate the prevalence and predictors of CAM use in a theory-driven, multidimensional manner. METHODS: African-American individuals who had received a diagnosis of acquired immune deficiency syndrome (AIDS) were recruited. The computer-administered survey asked questions about participants' CAM use and various psychosocial and socio-demographic characteristics. Participants' most recent CD4+ cell counts and HIV RNA levels were abstracted from medical records. Linear regression analyses, adjusted for potential confounders, were conducted to assess the independent contribution of various factors in explaining frequency of CAM use. RESULTS: One hundred and eighty two subjects participated in the survey. Results indicate that most (94%) participants used at least one type of CAM therapy. The majority of participants (79.7%) used CAM therapies as a complement (rather than an alternative) to their HIV medications though half had not discussed these therapies with their healthcare providers. Female sex, high yearly income, high health literacy and high HIV RNA levels were associated with a greater frequency of CAM use, while stronger emotional well-being was associated with a lower frequency of CAM use. CONCLUSIONS: The implications of these findings are discussed and suggestions for future research are provided.
Focus on alternative and complementary therapies : FACT / Dept. of Complementary Medicine, Postgraduate Medical School, University of Exeter. 03/2012; 17(1):33-42.
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ABSTRACT: This column describes Opening Doors to Recovery in Southeast Georgia, a partnership between public agencies, a private corporation, a not-for-profit organization, and an academic institution. Teams of community navigation specialists that include a licensed mental health professional, a family member of an individual with a serious mental illness, and a peer with lived experience in recovery seek to enhance participants' community integration, support them in developing a meaningful day, ensure access to adequate treatment, and facilitate stable housing, improved relationships, and desired vocational, volunteer, or educational activities.
Psychiatric services (Washington, D.C.) 11/2011; 62(11):1270-2. · 2.81 Impact Factor
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ABSTRACT: There currently exists a dearth of reliable and valid instruments to examine key police officer variables of importance in the growing research on their interactions with individuals with mental illnesses. This study tested reliability and validity of four newly designed measures of the constructs of self-efficacy (Self-Efficacy Scale; SES), referral decisions and de-escalation skills (Behavioral Outcomes Scale; BOS), attitudes toward psychiatric treatment (Opinions about Psychiatric Treatment; OPT), and social distance (Adapted Social Distance Scale; ASDS) in a sample of law enforcement officers. Self-administered, anonymous surveys, which included the measures of interest, were completed by 177 officers-68 of whom were undergoing Crisis Intervention Team (CIT) training and 109 of whom were not-at the beginning and end of week-long trainings. Analyses examined the internal consistency reliability, test-retest reliability, and construct validity of the instruments. The four measures of interest were found to be reliable and valid. Specifically, internal consistency coefficients and test-retest reliability correlations were generally acceptable, all four demonstrated sensitivity to change, and validity correlations were significant and in the expected direction. Findings demonstrated the ability to measure key constructs related to attitudes and intended behaviors in law enforcement officers utilizing psychometrically sound instruments. Further testing and the development of additional reliable and valid instruments focused on attitudinal and behavioral domains among officers who have frequent interactions with individuals with mental illnesses would be of great value.
Psychiatry Research 07/2011; 189(3):458-62. · 2.52 Impact Factor
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ABSTRACT: The public's level of mental health literacy remains low, despite growing access to information regarding mental illnesses. Because few measures exist to assess the level of knowledge of mental illnesses in lay samples, the Multiple-Choice Knowledge of Mental Illnesses Test (MC-KOMIT) was developed, initially for use in a study involving police officers, some of whom received 40 h of training focused on recognizing mental illnesses, using verbal de-escalation techniques, and making mental health referrals when appropriate. This report details the initial development of the 100 questions in the item bank and the eventual selection of the final 33 items that were retained. For these 33 items, internal consistency was demonstrated, and test-retest reliability was examined among officers not in the mental health-related training who completed the test on Monday morning and again on Friday afternoon. Construct validity was examined by three hypothesis tests: the MC-KOMIT was sensitive to change related to the educational intervention, scores were significantly correlated with years of educational attainment, and officers reporting past or current treatment for a mental health problem scored higher than those without such a history. This initial report suggests that the MC-KOMIT may be useful in quantifying knowledge of mental illnesses in police officers and other diverse lay samples.
Psychiatry Research 06/2011; 189(1):141-8. · 2.52 Impact Factor
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ABSTRACT: Police officers' voluntary choice to participate in specialized, week-long crisis intervention team (CIT) training is generally assumed to be a critical factor in success as a CIT officer. However, issues about self-selection have not been empirically examined. The investigators hypothesized that officers entering CIT training, especially those electing to take it, would have a higher likelihood of exposure to and experience with mental health issues and mental health professionals and greater empathy and psychological mindedness.
A total of 177 officers-including 109 non-CIT-trained officers, 24 officers assigned to CIT training, and 44 officers who volunteered for CIT training-were assessed before and after their week-long classes (non-CIT officers were enrolled in other courses). Basic sociodemographic characteristics were assessed, and four psychometrically sound measures of empathy and psychological mindedness were administered. Associations between officer status and sociodemographic variables, past exposure to and experience with mental illness issues, and empathy and psychological mindedness were examined.
The three groups did not differ on three of four exposure and experience variables; however, self-selected CIT officers were more likely to have prior exposure to mental health issues and professionals. No differences were found between the three groups on measures of empathy or psychological mindedness. One measure of empathy increased significantly after the weeklong CIT training.
Findings did not support the hypothesis that officers self-selecting into CIT training would have greater baseline empathy and psychological mindedness. Although there may be other justifiable reasons to argue for the importance of volunteering, these two traits did not appear to be greater among officers self-selecting into CIT.
Psychiatric services (Washington, D.C.) 06/2011; 62(6):632-8. · 2.81 Impact Factor
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ABSTRACT: The purpose of the current study was to develop and evaluate the psychometric properties of a culturally- and stage-of-disease-appropriate measure of complementary and alternative medicine (CAM) use among a population of African-American individuals with acquired immune deficiency syndrome (AIDS) using a mixed-method design.
Data were collected in two phases. In phase 1, qualitative data were used to refine an existing CAM measure for the specific study population in the present study. In phase 2, this refined instrument was implemented in a larger sample. The resulting numeric data were analyzed to evaluate the psychometric properties of the revised CAM instrument.
Data were collected from patients who were receiving care from the infectious disease clinic of a large, public, urban hospital in the Southeastern United States.
Patients were eligible to participate if they (1) were receiving their care from the clinic, (2) had an AIDS diagnosis, (3) were identified as African-American, (4) were > or =21 years of age, (5) spoke English, and (6) were not cognitively impaired.
Focus groups in phase 1 were conducted with a semistructured focus group guide. Participants also completed a basic sociodemographic survey. Phase 2 participants used programmed laptops to answer questions about their CAM use and several sociodemographic questions.
Information from the focus groups prompted some substantive revisions in the already-existing CAM survey. The revised instrument had satisfactory face validity and adequate test-retest reliability (r = 0.79). Furthermore, the instrument factored in a manner that was interpretable and consistent with prior findings.
In order for human immunodeficiency virus health care providers to provide the best care to their patients, they need to be informed about the types and frequency of CAM use among their patients. This can be accomplished by methodologically developing CAM instruments, rigorously implementing and assessing these instruments, and then disseminating the findings to researchers and practitioners.
Journal of alternative and complementary medicine (New York, N.Y.) 05/2010; 16(5):569-77. · 1.69 Impact Factor
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ABSTRACT: The Crisis Intervention Team (CIT) model of collaboration between law enforcement and mental health is widely recognized as being "more than just training" for police officers; the core elements of CIT include a number of other components. However, several system- and policy-level obstacles can make successful implementation of CIT difficult in many communities. Three such challenges are addressed in this article: insufficient training and policies for dispatchers, poor availability of psychiatric emergency receiving facilities, and complexities related to implementation of CIT in rural settings. Collaboratively addressing these and other challenges will undoubtedly advance the goals of CIT.
Journal of Police Crisis Negotiations 01/2010; 10(1-2):72-85.
