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author:("rondani, elmo")
1.  Staff Commitment to Providing Tobacco Dependence in Drug Treatment: Reliability, Validity, and Results Of a National Survey 
Although most people in treatment for illicit drug use smoke cigarettes, few facilities offer any form of treatment for tobacco dependence. One reason for this may be that drug treatment staff have varying levels of commitment to treat tobacco. We developed and validated a 14-item Tobacco Treatment Commitment Scale (TTCS), using 405 participants in leadership positions in drug treatment facilities. We first conducted a confirmatory factor analysis to evaluate four a priori domains suggested by our original set of 38 items—this did not produce a good fit (CFI=0.782, RMSEA=0.067). We then conducted a series of exploratory factor analyses to produce a more precise and reliable scale. The final confirmatory factor analysis indicated a three-factor solution, produced a good fit (CFI=0.950, RMSEA=0.058), and had substantial unified reliability of 0.975. The final TTCS contained 14 items in 3 domains: Tobacco is less harmful than other drugs; It’s not our job to treat tobacco; and Tobacco treatment will harm clients. These constructs account for most of the variance in the survey items and emerged as major sentiments driving staff commitment to providing tobacco services. The TTCS can be used to understand the role of staff attitudes in the adoption of tobacco services in this important treatment setting.
PMCID: PMC4180218  PMID: 24128292
tobacco; health services; substance abuse; attitudes; scale development
2.  Brief intervention and decrease of alcohol consumption among women: a systematic review 
Problems related to alcohol consumption are priority public health issues worldwide and may compromise women’s health. The early detection of risky alcohol consumption combined with a brief intervention (BI) has shown promising results in prevention for different populations. The aim of this study was to examine data from recent scientific publications on the use of BI toward reducing alcohol consumption among women through a systematic review. Electronic searches were conducted using Web of Science, PubMed(Medline) and PsycInfo databases. In all databases, the term “brief intervention” was associated with the words “alcohol” and “women”, and studies published between the years 2006 and 2011 were selected. Out of the 133 publications found, the 36 scientific articles whose central theme was performing and/or evaluating the effectiveness of BI were included. The full texts were reviewed by content analysis technique. This review identified promising results of BI for women, especially pregnant women and female college students, in different forms of application (face-to-face, by computer or telephone) despite a substantial heterogeneity in the clinical trials analyzed. In primary care, which is a setting involving quite different characteristics, the results among women were rather unclear. In general, the results indicated a decrease in alcohol consumption among women following BI, both in the number of days of consumption and the number of doses, suggesting that the impact on the woman’s reproductive health and the lower social acceptance of female consumption can be aspects favorable for the effectiveness of BI in this population.
PMCID: PMC3847063  PMID: 24016074
Brief intervention; Women; Alcohol; Prevention; Systematic review
3.  Screening and brief intervention for alcohol and other drug use in primary care: associations between organizational climate and practice 
Numerous studies have demonstrated that positive organizational climates contribute to better work performance. Screening and brief intervention (SBI) for alcohol, tobacco, and other drug use has the potential to reach a broad population of hazardous drug users but has not yet been widely adopted in Brazil’s health care system. We surveyed 149 primary health care professionals in 30 clinics in Brazil who were trained to conduct SBI among their patients. We prospectively measured how often they delivered SBI to evaluate the association between organizational climate and adoption/performance of SBI.
Organizational climate was measured by the 2009 Organizational Climate Scale for Health Organizations, a scale validated in Brazil that assesses leadership, professional development, team spirit, relationship with the community, safety, strategy, and remuneration. Performance of SBI was measured prospectively by weekly assessments during the three months following training. We also assessed self-reported SBI and self-efficacy for performing SBI at three months post-training. We used inferential statistics to depict and test for the significance of associations.
Teams with better organizational climates implemented SBI more frequently. Organizational climate factors most closely associated with SBI implementation included professional development and relationship with the community. The dimensions of leadership and remuneration were also significantly associated with SBI.
Organizational climate may influence implementation of SBI and ultimately may affect the ability of organizations to identify and address drug use.
PMCID: PMC3598982  PMID: 23399417
Organizational climate; Screening; Brief intervention; Alcohol; Tobacco; Substance abuse

Results 1-11 (11)