RESUMEN
BACKGROUND: Overprescription of opioids has led to increased misuse of opioids, resulting in higher rates of overdose. The workplace can play a vital role in an individual's intentions to misuse prescription opioids with injured workers being prescribed opioids, at a rate 3 times the national average. For example, health care workers are at risk for injuries, opioid dispensing, and diversion. Intervening within a context that may contribute to risks for opioid misuse while targeting individual psychosocial factors may be a useful complement to interventions at policy and prescribing levels. OBJECTIVE: This pilot study assessed the effects of a mobile-friendly opioid misuse intervention prototype tailored for health care workers using the preparation phase of a multiphase optimization strategy design. METHODS: A total of 33 health care practitioners participated in the pilot intervention, which included 10 brief web-based lessons aimed at impacting psychosocial measures that underlie opioid misuse. The lesson topics included: addiction beliefs, addiction control, Centers for Disease Control and Prevention guidelines and recommendations, beliefs about patient-provider relationships and communication, control in communicating with providers, beliefs about self-monitoring pain and side effects, control in self-monitoring pain and side effects, diversion and disposal beliefs, diversion and disposal control, and a conclusion lesson. Using a treatment-only design, pretest and posttest surveys were collected. A general linear repeated measures ANOVA was used to assess mean differences from pretest to posttest. Descriptive statistics were used to assess participant feedback about the intervention. RESULTS: After completing the intervention, participants showed significant mean changes with increases in knowledge of opioids (+0.459; P<.001), less favorable attitudes toward opioids (-1.081; P=.001), more positive beliefs about communication with providers (+0.205; P=.01), more positive beliefs about pain management control (+0.969; P<.001), and increased intentions to avoid opioid use (+0.212; P=.03). Of the 33 practitioners who completed the program, most felt positive about the information presented, and almost 70% (23/33) agreed or strongly agreed that other workers in the industry should complete a program like this. CONCLUSIONS: While attempts to address the opioid crisis have been made through public health policies and prescribing initiatives, opioid misuse continues to rise. Certain industries place workers at greater risk for injury and opioid dispensing, making interventions that target workers in these industries of particular importance. Results from this pilot study show positive impacts on knowledge, attitudes, and beliefs about communicating with providers and pain management control, as well as intentions to avoid opioid misuse. However, the dropout rate and small sample size are severe limitations, and the results lack generalizability. Results will be used to inform program revisions and future optimization trials, with the intention of providing insight for future intervention development and evaluation of mobile-friendly eHealth interventions for employees.
RESUMEN
OBJECTIVE: Workers in industries with high rates of opioid dispensing as well as those with high rates of non-fatal work-related injuries are at greater risk for opioid misuse, which can lead to addiction, overdose, or death. METHODS: Using secondary cross-sectional data collected from 856 healthcare workers, this pilot study examines a conceptual model for workers' intentions to seek out prescription opioids and intentions to use opioids at higher doses over longer periods. RESULTS: Results showed significant protective effects of beliefs, injunctive and subjective norms, and behavioral control on intentions to seek out opioids. On intentions to use higher doses over a longer time, knowledge, beliefs, behavioral control, patient-provider communication, workplace safety, and workplace autonomy had significant protective effects. CONCLUSIONS: Findings from this study could be used to inform future multilevel interventions to prevent opioid misuse among employee populations.
Asunto(s)
Analgésicos Opioides , Trastornos Relacionados con Opioides , Humanos , Analgésicos Opioides/uso terapéutico , Estudios Transversales , Intención , Proyectos Piloto , Trastornos Relacionados con Opioides/prevención & control , Trastornos Relacionados con Opioides/tratamiento farmacológico , Prescripciones de Medicamentos , Lugar de TrabajoRESUMEN
BACKGROUND: Coaches have the potential to support athlete mental wellness, but many are unsure what to do and concerned they may unintentionally engage in behaviours that negatively impact their athletes. Education has the potential to help coaches engage in primary, secondary and tertiary preventive behaviours related to athlete mental health; however, there exists no empirical or consensus basis for specifying the target behaviours that should be included in such education. OBJECTIVE: The aim of this research was to review extant literature about the role of sport coaches in mental health prevention and promotion, and obtain expert consensus about useful, appropriate and feasible coach behaviours. DESIGN: Modified Delphi methodology with exploration (ie, narrative review) and evaluation phase. DATA SOURCES: Twenty-one articles from PubMed, PsycINFO and ProQuest, and grey literature published by prominent sport organisations. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: All studies were English-language articles that focused on the role of coaches as they relate to (1) culture setting in sport, (2) addressing athlete mental health and (3) providing ongoing support to athletes with mental health concerns. No study design, publication date limits or sport characteristics were applied. RESULTS: The coach's role should include fostering team cultures that support athlete mental health, encouraging care-seeking and supporting athletes currently receiving mental healthcare. SUMMARY/CONCLUSION: The behaviours specified herein have implications for coach education programme development. This study is the first to use a structured Delphi process to develop specific recommendations about the role coaches can play in supporting athlete mental health.