Ekaterina Burduli

Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey

OBJECTIVE to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R). STUDY DESIGN a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected using electronic linkages (Qualtrics™). PARTICIPANTS a convenience sample of childbearing women (n=2229) who had planned to birth in their home or birth center from the US (United States) participated. Participants were recruited via professional and personal contacts, primarily their midwives. RESULTS the total 30-item BSS score mean was 128.98 (SD 16.92) and the 10-item BSS-R mean score was 31.94 (SD 6.75). Sub-scale mean scores quantified the quality of care provision, womens personal attributes, and stress experienced during labour. Satisfaction was higher for women with vaginal births compared with caesareans deliveries. In addition, satisfaction was higher for women who had both planned to deliver in a home or a birth centre, and who had actually delivered in a home or a birth center. KEY CONCLUSIONS total and subscale birth satisfaction scores were positive and high for the overall sample IMPLICATIONS FOR PRACTICE: the BSS and the BSS-R provide a robust tool to quantify womens experiences of childbirth between variables such as birth types, birth settings and providers.

Measurement and structural invariance of the US version of the Birth Satisfaction Scale-Revised (BSS-R) in a large sample

BACKGROUND The 10-item Birth Satisfaction Scale-Revised (BSS-R) is being increasingly used internationally. The use of the measure and the concept has gathered traction in the United States following the development of a US version of the tool. A limitation of previous studies of the measurement characteristics of the BSS-R is modest sample size. Unplanned pregnancy is recognised as being associated with a range of negative birth outcomes, but the relationship to birth satisfaction has received little attention, despite the importance of birth satisfaction to a range of postnatal outcomes. AIM The current investigation sought to evaluate the measurement characteristics of the BSS-R in a large postpartum sample. METHODS Multiple Groups Confirmatory Factor Analysis (MGCFA) was used to evaluate a series of measurement and structural models of the BSS-R to evaluate fundamental invariance characteristics using planned/unplanned pregnancy status to differentiate groups. FINDINGS Complete data from N=2116 women revealed that the US version of the BSS-R offers an excellent fit to data and demonstrates full measurement and structural invariance. Little difference was observed between women on the basis of planned/unplanned pregnancy stratification on measures of birth satisfaction. DISCUSSION The established relationship between unplanned pregnancy and negative perinatal outcomes was not found to extend to birth satisfaction in the current study. The BSS-R demonstrated exemplary measurement and structural invariance characteristics. CONCLUSION The current study strongly supports the use of the US version of the BSS-R to compare birth satisfaction across different groups of women with theoretical and measurement confidence.

Cross-cultural invariance of the Birth Satisfaction Scale-Revised (BSS-R): comparing UK and US samples

Abstract Objective: This research sought to test the measurement invariance of the Birth Satisfaction Scale-Revised (BSS-R) across United States (US) and United Kingdom (UK) samples. Multiple-group measurement was tested and latent means analysis compared levels of birth satisfaction across the samples. Method: Using Confirmatory Factor Analysis (CFA), data previously collected from 409 mothers (181 US mothers; 228 UK mothers) were used to examine the multiple-group measurement invariance of the BSS-R across US and UK samples. Results: A correlated factors BSS-R model demonstrated partial measurement invariance. US mothers had significantly lower birth satisfaction levels on the three BSS-R subscales. Conclusions: This research demonstrates that the BSS-R is a robust tool that can be used to reliably measure women’s birth satisfaction within and across the US and UK.

Impact of tobacco, alcohol and cannabis use on treatment outcomes among patients experiencing first episode psychosis: Data from the national RAISE‐ETP study

The primary aim of this study was to examine the effect of recent tobacco, alcohol and cannabis use on treatment outcomes among participants experiencing first episode psychosis (FEP).

A review of contingency management for the treatment of substance-use disorders: adaptation for underserved populations, use of experimental technologies, and personalized optimization strategies

This review of contingency management (CM; the behavior-modification method of providing reinforcement in exchange for objective evidence of a desired behavior) for the treatment of substance-use disorders (SUDs) begins by describing the origins of CM and how it has come to be most commonly used during the treatment of SUDs. Our core objective is to review, describe, and discuss three ongoing critical advancements in CM. We review key emerging areas wherein CM will likely have an impact. In total, we qualitatively reviewed 31 studies in a systematic fashion after searching PubMed and Google Scholar. We then describe and highlight CM investigations across three broad themes: adapting CM for underserved populations, CM with experimental technologies, and optimizing CM for personalized interventions. Technological innovations that allow for mobile delivery of reinforcers in exchange for objective evidence of a desired behavior will likely expand the possible applications of CM throughout the SUD-treatment domain and into therapeutically related areas (eg, serious mental illness). When this mobile technology is coupled with new, easy-to-utilize biomarkers, the adaptation for individual goal setting and delivery of CM-based SUD treatment in hard-to-reach places (eg, rural locations) can have a sustained impact on communities most affected by these disorders. In conclusion, there is still much to be done, not only technologically but also in convincing policy makers to adopt this well-established, cost-effective, and evidence-based method of behavior modification.

The Birth Satisfaction Scale – Revised (BSS-R): should the subscale scores or the total score be used?

ABSTRACT Objective and background: The 10-item Birth Satisfaction Scale – Revised (BSS-R) is increasingly being used internationally as the instrument of choice for the assessment of birth satisfaction. There remains conjecture over the most appropriate way to score the instrument; subscale scores overall total score, or both approaches. The current study sought to clarify this issue by examining the measurement characteristics of the United States version of the BSS-R from a large data set. Methods: Secondary analysis of a data matrix from a large sample US BSS-R validation study (N = 2116) using structural equation modelling. Results: A bi-factor model revealed an excellent fit to data (χ2(df = 25) = 208.21, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.04), demonstrating relative independence of the BSS-R quality of care subscale, while in contrast the women’s attributes and stress experienced during childbearing subscales could be explained more plausibly by a general factor of experience of childbirth. Conclusion: Consistent with the recommendations of the original BSS-R validation study, the current investigation found robust empirical evidence to support the use of both the subscale scoring system and the total score. Researchers and clinicians can therefore select either approach (or both) with confidence.

Exploratory Factor Analysis of the Caffrey Cultural Competency in Health Care Scale

Background and Purpose: The purpose of this study was to psychometrically analyze the Caffrey Cultural Competence in Healthcare Scale (CCCHS), a scale that measures self-assessed cultural competency of nursing students participating in international immersion experiences during their nursing curriculum. Methods: A sample of 105 health professions students completed the CCCHS. Inter-item correlations, exploratory factor analysis (EFA), and Cronbach’s α were used to examine validity and reliability. Results: Results indicated that items were positively related. A 1-factor model of the CCCHS was found in which all items loaded onto a single factor at ≥ .30, except two items dealing with national policy, which may not be a component of cultural competence. Conclusion: The CCCHS was internally consistent (α = .93) and is a valid and reliable scale consisting of a unidimensional factor.

Predictors of tobacco and alcohol co-use from ages 15 to 32: The Amsterdam growth and health longitudinal study.

Tobacco and alcohol are often used in tandem over time, but specific predictors of course and patterns of course over time need explication. We examined differences in alcohol and tobacco course among an adolescent population as they transitioned into young adulthood across a 17-year period. Data came from participants (n = 303 for ages 15–21, n = 196 for ages 21 to 32; 52% female and 54% female, respectively) enrolled in the Amsterdam Growth and Health Longitudinal Study, an epidemiologic investigation examining disease across the life span. We utilized parallel latent growth modeling to assess the impact of sex, personality traits, cholesterol, blood pressure, and body mass index (BMI), on initial status and linear change over time in course of tobacco and alcohol. Females reported less alcohol use at adolescent baseline (&bgr; = −21.79), less increase during adolescence (&bgr; = −7.92, p < .05), slower decrease during young adulthood (&bgr; = 4.67, p < .05), and more rapid decline in tobacco use during young adulthood (&bgr; = −70.85, p < .05), relative to males. Alcohol and tobacco use baseline status’ and change over time were all significantly associated with one another during both adolescence and young adulthood (p < .05; aside from alcohol baseline and slope during young adulthood). Effects of BMI, cholesterol, blood pressure, and personality traits were also observed on tobacco and alcohol course. In light of the strong, but sex dependent relationship between alcohol and tobacco course, particularly from ages 15 to 21, prevention efforts to curb heavy alcohol and tobacco use should consider targeting course taking into account biological sex and other notable covariates.

Using a randomized controlled trial to test whether modifications to contingency management improve outcomes for heavy drinkers with serious mental illness

BACKGROUND In contingency management (CM), individuals receive rewards for alcohol abstinence. CM is associated with reduced alcohol use in adults with co-occurring serious mental illnesses (SMI). Pre-treatment urine ethyl glucuronide (uEtG) levels equivalent to daily heavy drinking (uEtG >349ng/mL) are associated with poor response to CM. Modifications to CM are needed to improve outcomes for non-responders. AIMS To determine if pre-treatment heavy drinkers, defined by uEtG, with SMI achieve higher levels of alcohol abstinence when they receive an increased magnitude of reinforcement for abstinence (High-Magnitude CM) or reinforcers for reduced drinking, prior to receiving reinforcers for abstinence (Shaping CM), relative to those who receive typical low-magnitude abstinence based CM (Usual CM). Additionally, variables in the Addictions Neuroclinical Assessment model will be examined as treatment response moderators. METHODS Participants (N=400) will be recruited from two urban mental health organizations and complete a 4-week induction period where they will be reinforced for submitting samples for uEtG testing. Participants who attain a mean uEtG >349mg/mL will be randomized to receive either Usual CM, High-Magnitude CM, or Shaping CM for 16weeks. Differences in abstinence, assessed by uEtG, will be examined during treatment and during a 12-month follow-up. Measures of negative emotionality, alcohol reinforcer salience, and executive functioning will be gathered at study intake and used to predict treatment outcomes. DISCUSSION This novel approach to CM will use an alcohol biomarker to identify those at risk for treatment non-response and determine if adaptations to CM might improve outcomes for this group.

Contingency management intervention targeting co-addiction of alcohol and drugs among American Indian adults: Design, methodology, and baseline data:

Background/Aims American Indian adults have some of the highest alcohol abstinence rates compared to the overall US population. Despite this, many American Indian people are more likely to concurrently use alcohol and illicit drugs and are less likely to participate and remain in outpatient treatment for alcohol and other drug use compared to the general US population. There is limited knowledge about effective interventions targeting alcohol and drug co-addiction among American Indian adults. Contingency management is a behavioral intervention designed to increase drug abstinence by offering monetary incentives in exchange for drug and alcohol negative urine samples. We aim to evaluate and describe a culturally tailored contingency management intervention to increase alcohol and other drug abstinence among American Indian adults residing in a Northern Plains reservation. Methods This 2 × 2 factorial, randomized controlled trial currently includes 114 American Indian adults with alcohol and/or drug dependence who are seeking treatment. Participants were randomized into one of four groups that received (1) contingency management for alcohol, (2) contingency management for other drug, (3) contingency management for both substances, or (4) no contingency management for either substance. We present descriptive, baseline data to characterize the sample and describe the modified contingency management approach that is specific to the community wherein this trial was being conducted. Results The sample is 49.1% male, with an average age of 35.8 years (standard deviation = 10.4 years). At baseline, 43.0% of the sample tested positive for ethyl glucuronide, 50.9% of participants self-reported methamphetamine as their most used drug, 36.8% self-reported cannabis, and 12.3% self-reported prescription opiates as their most used drug. Among randomized participants, 47.4% tested positive for cannabis, 28.1% tested positive for methamphetamine, 16.7% tested positive for amphetamines, and 2.1% tested positive for opiates. Conclusion This is the first study to examine a culturally tailored contingency management intervention targeting co-addiction of two substances among American Indian adults. By establishing a tribal–university partnership to adapt, implement, and evaluate contingency management, we will increase the literature on evidence-based addiction treatments and research, while improving trust for addiction interventions among American Indian communities through ongoing collaboration. Moreover, results have implications for the use of contingency management as an intervention for co-addiction in any population.