| 1. |
- Agardh, Emilie E., et al.
(författare)
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Disease Burden Attributed to Drug use in the Nordic Countries : a Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2019
- 2023
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Ingår i: International Journal of Mental Health and Addiction. - 1557-1874 .- 1557-1882.
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Tidskriftsartikel (refereegranskat)abstract
- The Nordic countries share similarities in many social and welfare domains, but drug policies have varied over time and between countries. We wanted to compare differences in mortality and disease burden attributed to drug use over time. Using results from the Global Burden of Disease (GBD) study, we extracted age-standardized estimates of deaths, DALYs, YLLs and YLDs per 100 000 population for Denmark, Finland, Iceland, Norway, and Sweden during the years 1990 to 2019. Among males, DALY rates in 2019 were highest in Finland and lowest in Iceland. Among females, DALY rates in 2019 were highest in Iceland and lowest in Sweden. Sweden have had the highest increase in burden since 1990, from 252 DALYs to 694 among males, and from 111 to 193 among females. Norway had a peak with highest level of all countries in 2001-2004 and thereafter a strong decline. Denmark have had the most constant burden over time, 566-600 DALYs among males from 1990 to 2010 and 210-240 DALYs among females. Strict drug policies in Nordic countries have not prevented an increase in some countries, so policies need to be reviewed.
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| 2. |
- Elling, Devy L., et al.
(författare)
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Effects of a multi-component alcohol prevention program in the workplace on hazardous alcohol use among employees
- 2023
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Background: The workplace can be affected negatively by hazardous alcohol use, and intervening at an early stage remains a challenge. Recently, a multi-component alcohol prevention program, Alcohol Policy and Managers’ skills Training (hereafter, ‘APMaT’), was delivered at the organizational level. In a previous outcome evaluation, APMaT appeared to be effective at the managerial level. The current study takes a step further by aiming to evaluate the effectiveness of APMaT in decreasing the alcohol risk level among employees.Methods: Data from 853 employees (control: n = 586; intervention: n = 267) were gathered through a cluster-randomized study. To analyze changes in the odds of hazardous alcohol use among employees, multilevel logistic regression was applied using group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time) as the main predictors. The intervention effect was further adjusted for sociodemographic characteristics and policy awareness.Results: No statistically significant difference was observed in the odds of hazardous alcohol use, although employees in the intervention group showed a larger decrease compared to the control group. This remained even after adjusting for several factors, including the sociodemographic factors and policy awareness.Conclusions: The findings are insufficient to determine the effectiveness of APMaT at the employee level at the current stage of the evaluation. Future studies should strive to identify issues with implementation processes in workplace-based alcohol interventions.
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| 3. |
- Elling, Devy L., et al.
(författare)
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Effects of a multi-component alcohol prevention programme in the workplace on hazardous alcohol use among employees
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The workplace can be affected negatively by hazardous alcohol use, and intervening at an early stage remains a challenge. Recently, a multi-component alcohol prevention program, Alcohol Policy and Managers’ skills Training (hereafter, ‘APMaT’), was delivered at the organizational level. In a previous outcome evaluation, APMaT appeared to be effective at the managerial level. The current study takes a step further by aiming to evaluate the effectiveness of APMaT in decreasing the alcohol risk level among employees.Methods: Data from 853 employees (control: n = 586; intervention: n = 267) were gathered through a cluster-randomized study. To analyze changes in the odds of hazardous alcohol use among employees, multilevel logistic regression was applied using group (control vs intervention), time (baseline vs 12-month follow-up), and the multiplicative interaction term (group × time) as the main predictors. The intervention effect was further adjusted for sociodemographic characteristics and policy awareness.Results: Employees in the intervention group showed a larger decrease in the odds of hazardous alcohol use compared to the control group. However, this difference was not statistically significant, even after adjusting for several factors, including the sociodemographic factors and policy awareness.Conclusions: The findings are insufficient to determine the effectiveness of APMaT at the employee level at the current stage of the evaluation. Future studies should strive to identify issues with implementation processes in workplace-based alcohol interventions. Trial registration: ISCRTN: ISRCTN17250048.
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| 4. |
- Elling, Devy L., et al.
(författare)
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Evaluation of a workplace alcohol prevention program targeted on managers’ inclination to initiate early alcohol interventions
- 2022
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 73:2, s. 517-526
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Tidskriftsartikel (refereegranskat)abstract
- Background: Alcohol interventions targeting the adult population are often conducted in healthcare settings, while preventive interventions often target adolescents or young adults. The general working population is often overlooked. A workplace-based intervention, consisting of development and implementation of an organizational alcohol policy, and skills development training for managers (APMaT) was carried out in order to prevent and reduce alcohol-related harms by identifying hazardous consumers at an early stage. Objective: This study aims to evaluate APMaT by focusing on managers’ inclination to initiate early alcohol intervention.Methods: In a cluster randomized design, data were obtained from 187 managers (control: n = 70; intervention: n = 117). Inclination to initiate early alcohol intervention was measured using three items on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Changes in managers’ inclination to intervene were analyzed by applying multilevel ordered logistic regression. Predictors included in the model were group (control vs. intervention), time (baseline vs. 12-month follow-up), and the multiplicative interaction term (group × time).Results: Significant increase in inclination to intervene against hazardous alcohol consumption among managers in the intervention group compared to managers in the control group was observed. Specifically, a 50% increase of confidence to initiate an intervention was observed among managers in the intervention group.Conclusions: APMaT seems effective to increase managers’ inclination to intervene early against hazardous consumption in the workplace. The effectiveness of APMaT at the employee level should be explored in prospective studies.
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| 5. |
- Elling, Devy Lysandra, 1992-
(författare)
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Intervening in a social world : An evaluation of an alcohol prevention programme in a Swedish workplace context
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A sizeable portion of hazardous alcohol consumers are found in the workforce, suggesting that the workplace could provide opportunities for preventing and reducing hazardous alcohol use at an early stage. One such intervention is the multi-component alcohol prevention programme, ‘APMaT’ (Alcohol Policy and Managers’ skills Training), designed and delivered by Alna, an organisation that provides services to prevent harmful behaviours in Swedish workplaces. This thesis is a programme evaluation of APMaT, assessing its effectiveness through survey data at the managerial and employee levels.Study I described the sociodemographic, work-, and health-related characteristics of managers relative to their inclination to intervene and organisational alcohol policy knowledge. Moreover, the association between managers’ inclination to intervene and knowledge about organisational alcohol policy was examined. The number of supervised employees was strongly associated with both the inclination to intervene and alcohol policy knowledge, and a graded positive association was found between managers’ inclination to intervene and alcohol policy knowledge. The findings implied that managerial characteristics may play a role in potential actions to initiate early alcohol interventions.Study II evaluated the effectiveness of APMaT, focusing on changes in the inclination to intervene at an early stage among managers at one-year follow-up. The findings suggested that APMaT is somewhat effective in increasing managers’ inclination to initiate an intervention by increasing their confidence in initiating a dialogue with employees, which may increase the likelihood of initiating an intervention at an early stage.Study III further assessed the effectiveness of APMaT by examining changes in the risk of hazardous alcohol use among employees at one-year follow-up. The study did not provide strong empirical evidence in support of the effectiveness of APMaT regarding the reduction of hazardous alcohol use within the given follow-up time.Given the mixed support for the effectiveness provided by Studies II and III, Study IV described managers’ perceived barriers in the dissemination of their organisational alcohol policy. This dissemination was an important component of APMaT because all managers were expected to facilitate its implementation throughout the workplace. Uncertainties and a variety of perceived organisational obstacles were reported by the managers to have hindered the dissemination of the organisational alcohol policy.This thesis highlights the complexity of delivering and implementing an intervention in a complex and dynamic setting, such as the workplace. The findings suggested that the investigated intervention, APMaT, might be effective in changing attitudes among managers, whereas no concrete effects on employees’ hazardous alcohol use could be demonstrated. Nevertheless, the studies contributed with knowledge to the development of prospective workplace prevention programmes.
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| 6. |
- Sundqvist, Kristina, 1973-, et al.
(författare)
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Problem gambling and anxiety disorders in the general swedish population : a case control study
- 2022
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Ingår i: Journal of Gambling Studies. - : Springer Science and Business Media LLC. - 1050-5350 .- 1573-3602. ; 38, s. 1257-1268
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Tidskriftsartikel (refereegranskat)abstract
- Co-occurring psychiatric comorbidity is high among problem gamblers, and anxiety disorders has repeatedly been linked to problem gambling. Less conclusive, however, is the association between problem gambling and specific anxiety disorders. The aim of this study is to examine the association between problem gambling and specific anxiety disorders in subgroups of gender, age and socio-economic status (SES) in the general Swedish population. A case-control design was employed - nested in the Swedish longitudinal gambling study cohort. All anxiety disorders studied - Panic Disorder, Social Phobia, Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD), were significantly associated with problem gambling, however the pattern differed across subgroups. Social Phobia was the anxiety disorder most commonly associated with problem gambling across subgroups. The strongest associations between problem gambling and various anxiety disorders were found in participants under the age of 25, among females, and in the group with middle SES. In those groups three of the four anxiety disorders studied were significantly associated with problem gambling, with different patterns. Quite remarkably, participants under the age of 25 had three times higher risk of having had GAD compared to their controls. Efforts to prevent an escalation of either gambling or anxiety could target the presented vulnerable groups specifically.
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| 7. |
- Sundqvist, Kristina, 1973-, et al.
(författare)
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The Association Between Problem Gambling and Suicidal Ideations and Attempts : A Case Control Study in the General Swedish Population
- 2022
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Ingår i: Journal of Gambling Studies. - : Springer Science and Business Media LLC. - 1050-5350 .- 1573-3602. ; 38:2, s. 319-331
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Tidskriftsartikel (refereegranskat)abstract
- The association between problem gambling and suicidal behaviours is well established in treatment seeking populations, but less explored among sub-clinical problem gamblers in the general population. The aim of this study was to examine the association between problem gambling (including moderate risk gambling) and suicidal ideations/suicide attempts, in the general Swedish population. Another aim was to compare problem gamblers with and without suicide ideation/attempts. A case-control study nested in the Swelogs cohort was used. Both ideations and attempts were about twice as frequent among the cases compared to the controls. After controlling for socio-economic status and life-time mental health problems, suicidal ideation, but not attempts, remained significantly higher among the cases compared to the controls. The largest difference between attempters and non-attempters were on payment defaults and illicit drug abuse, whereas depression yielded the largest difference between ideators and non-ideators. Problem gambling severity (PGSI 8+) resulted in the smallest difference, compared to the other variables, between attempters and non-attempters. Even though no conclusion regarding the casual relationship can be drawn in this type of study, it seems like sub-clinical levels of problem gambling might have an impact on suicidal ideations whereas for suicide attempts to occur, other factors need to be present. In addition to mental health issues, financial difficulties may be such factors.
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| 8. |
- Anderberg, Mats, 1961-, et al.
(författare)
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Criminality among young people with substance use problems in Sweden : A one-year follow-up study
- 2022
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Ingår i: Journal of Drug Issues. - : Sage Publications. - 0022-0426 .- 1945-1369. ; 52:3, s. 406-420
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Tidskriftsartikel (refereegranskat)abstract
- Swedish drug policy has a strong focus on minor drug violations. This longitudinal study analyses the association between criminality and substance use problems among young people who have received outpatient treatment and risk factors that predict continued problems with criminality. Research on this target group is under development in Sweden, but there are few follow-up studies. The study indicates that about one-quarters of the young people who begin outpatient treatment have been convicted of crimes at 1-year follow-up. Most of them who had been convicted with offences also have ongoing problems with substance use and three-quarters of the young people had been charged with a drug-related offence. More than five risk factors give an elevated risk of continued criminality. Interventions meeting the needs of young people, moving away from the current emphasis on penal law principles, may also contribute to reduced criminality in this target group.
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| 9. |
- Berglund, Kristina, 1969, et al.
(författare)
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Can a History of Childhood Trauma Impact the Effectiveness of Treatment in Individuals with Alcohol Use Disorders? A 2.5- and 5-Year Follow-up
- 2023
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Ingår i: International Journal of Mental Health and Addiction. - 1557-1874 .- 1557-1882.
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Tidskriftsartikel (refereegranskat)abstract
- Experienced childhood trauma (CT) is prevalent in individuals with alcohol use disorders (AUDs). Few studies examine how experienced CT affects alcohol-treatment outcome. This study accordingly investigates whether experienced CT independently affects treatment outcome 2.5- and 5-years post-treatment, controlling for other significant variables, such as self-efficacy, self-directedness, and mental health. Participants (n = 349) with AUDs (without severe psychiatric comorbidity or drug dependence) were recruited from three alcohol-treatment settings and followed up 2.5- and 5 years after treatment initiation. The group with experienced CT had more mental health problems, less self-efficacy, and less self-directedness. Multiple and logistic regressions were conducted using the outcome variables total number of DSM-IV criteria and abstinence. The results indicated that CT did not independently affect treatment outcome. Individuals with AUDs and experienced CT benefitted the same from alcohol treatment as those without such experience; however, studies should also examine groups with AUD and psychiatric comorbidity.
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| 10. |
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