Sven Buth

‘Learning how to ask’: Effectiveness of a training for trauma inquiry and response in substance use disorder healthcare professionals

Context: Exposure to traumatic events should be systematically assessed in health care services so that trauma-related treatment can be offered when appropriate. However, professionals often lack expertise in trauma inquiry and response, and therefore require training in this field. Objective: We aimed to determine whether the “Learning how to ask” training for trauma inquiry and response (Read, Hammersley, & Rudegeair, 2007) is effective in increasing health care professionals’ trauma inquiry behavior. Method: 148 professionals working in outpatient substance use disorder (SUD) services were cluster-randomized into an intervention or a waiting control group. The intervention group received a 1-day training and a refresher session 3 months later, while the control group received no training. The primary outcome was the change from baseline in the frequency of asking clients about traumatic events. Secondary outcomes were professionals’ evaluation of the training, knowledge, attitudes toward and confidence in trauma inquiry and response. Results: Change from baseline in the frequency of asking clients about traumatic events was significantly greater at 3-month and 6-month follow-up in the intervention group compared with the control group (b = 0.43, 95% CI [0.27, 0.59], p < .001). The training was positively evaluated by the participants. Knowledge, positive attitudes toward and confidence in trauma inquiry and response all showed significantly greater increases in the intervention group than in the control group. Conclusions: These findings suggest that health care professionals can acquire skills in trauma inquiry and response from short trainings, which may enhance systematic assessment of traumatic events.

Tobacco use among prison staff in Germany: a cross-sectional study

BACKGROUND Studies on tobacco in the prison environment report high prevalence of use among detainees, but little data regarding staff are available. An observational study addressing tobacco control in German prisons was conducted in 2011. It involved multiple strands (quantitative and qualitative components) both among detainees and staff. This article presents quantitative results regarding staff. METHODS Cross-sectional study among prison employees in 16 different institutions in nine regions (Länder) in Germany. Tobacco use and second-hand smoke (SHS) exposure (primary outcomes) were assessed by a questionnaire designed specifically. Logistic regression models were used to assess the risk factors associated with each outcome. RESULTS Among 704 participants (60.6% male, mean age 43.9 years ± 9.33), 27.7% are smokers and 68% declared to be exposed to SHS. Independent factors associated with smoking were female gender [odds ratio (OR) 1.49,P= 0.026], an age below 45 years (OR 1.35,P= 0.08) and working in areas other than administration (ORP= 0.08). An age below 45 was associated with a higher degree of self-reported SHS exposure. The association between SHS and gender was different depending on occupational area with significantly more men exposed to SHS in administrative area and more women in health/social area (interaction between gender and occupational area,P= 0.02). CONCLUSION Importance of SHS exposure among prison employees and confirm the need for a comprehensive tobacco control policy including support to smoking cessation and better enforcement of the smoke-free regulation, especially where staff contributes to SHS. Particular attention has to be given to female employees.

Comparative Analysis of Potential Risk Factors for at-Risk Gambling, Problem Gambling and Gambling Disorder among Current Gamblers—Results of the Austrian Representative Survey 2015

Background: The risk of developing a problem gambling behavior is distributed unequally among the population. For example, individuals who report stressful life events, show impairments of mental health or belong to a socio-economically deprived group are affected more frequently by gambling problems. The aim of our study is to investigate whether these risk factors are equally relevant for all gambling groups (social = 0 DSM-5 criteria, at risk = 1 DSM-5 criterion, problem = 2–3 DSM-5 criteria, disordered = 4–9 DSM-5 criteria). Methods: Of a total of 10,000 participants in the representative gambling survey in Austria in 2015, 4,082 individuals reported gambling during the last 12 months and were allocated to the four gambling groups according to DSM-5. With social gamblers as the reference group, relevant risk factors for the other three groups were identified by means of bi- and multivariate multinomial logistic regression. Results: Significant risk factors for gambling disorder are at-risk alcohol use (OR = 4.9), poor mental health (OR = 5.9), young age (≤26 years, OR = 2.1), a low level of formal education (OR = 2.4), having grown up with a single parent (OR = 2.5), parents with addiction problems (OR = 2.3) and belonging to the working class (OR = 2.9). Risk factors for problem gambling are parents with addiction problems (OR = 3.8), poor mental health (OR = 2.6) and a young age (OR = 2.2). With regard to at-risk gambling, only growing up with a single parent was relevant (OR = 2.4). Conclusion: Overall, the results of this study suggest, that the number and the influence of the included risk factors differ between gambling problem groups. Apparently, the development of severe gambling problems is to a lesser extent facilitated by specific risk factors than by their cumulative presence. Therefore, future prevention and treatment measures should place a particular focus on individuals who have experienced growing up in a difficult family situation, have poor mental health, suffer from substance-related problems or have a low level of formal education.

Bekanntheit und Akzeptanz der ambulanten Suchthilfe in der Bevölkerung

Hintergrund: Der Beitrag gibt die Ergebnisse einer Reprasentativbefragung zur Bekanntheit und Akzeptanz des ambulanten Suchthilfesystems im Bundesland Hessen aus der Sicht der Allgemeinbevolkerung wieder. Methodik: Es wurden im Zeitraum vom 15. Oktober bis 12. November 2007 insgesamt 5.600 Personen, die in Hessen wohnen und zwischen 17 bis 69 Jahre alt sind, telefonisch per Zufallsauswahl befragt. Bei den Auswertungen wurden sechs mogliche Einflussfaktoren systematisch berucksichtigt: Geschlecht, Alter, Region, Schulbildung, Erwerbssituation und der problematische Konsum psychoaktiver Substanzen. Ergebnisse: Die Akzeptanz der ambulanten Suchthilfe in Hessen ist sehr hoch. 91 % der Hessen wurden einem Angehorigen/Bekannten empfehlen, bei Suchtproblemen eine ambulante Suchthilfeeinrichtung aufzusuchen. Konkrete Kenntnis von einer ambulanten Suchthilfeeinrichtung in ihrem Landkreis bzw. kreisfreien Stadt haben dagegen nur 39 %. Bei Personen mit problematischem Substanzkonsum liegt dieser Anteil bei 49 %. Sch...