Sangeeta Agrawal | University of Western Ontario (original) (raw)

Papers by Sangeeta Agrawal

Alcoholism-clinical and Experimental Research, 2003

Journal of patient safety, 2012

Demonstrate the relationship between employee engagement and workplace safety for predicting pati... more Demonstrate the relationship between employee engagement and workplace safety for predicting patient safety culture. Patient safety is an issue for the U.S. health-care system, and health care has some of the highest rates of nonfatal workplace injuries. Understanding the types of injuries sustained by health-care employees, the type of safety environment employees of health-care organizations work in, and how employee engagement affects patient safety is vital to improving the safety of both employees and patients. The Gallup Q survey and an approved, abbreviated, and validated subset of questions from the Hospital Survey on Patient Safety Culture were administered to staff at a large tertiary academic medical center in 2007 and 2009. After controlling for demographic variables, researchers conducted a longitudinal, hierarchical linear regression analysis to study the unique contributions of employee engagement, changes in employee engagement, and employee safety in predicting pati...

Journal of gastrointestinal cancer, Jan 12, 2011

A 78-year-old Caucasian male with a history of atrial fibrillation and anticoagulation with warfa... more A 78-year-old Caucasian male with a history of atrial fibrillation and anticoagulation with warfarin presented with a change in bowel habits and weight loss. A computed tomography (CT) scan showed a 3.5 cm rectal mass. After biopsy with colonoscopy and endoscopic ultrasonography, the rectal mass was highly suspicious for rectal hematoma. When the rectal mass did not resolve after 1 month of follow-up, surgery showed the patient to have a rectal gastrointestinal stromal tumor. He is being treated with imatinib and follow-up CT scans. This case illustrates the importance of a high level of suspicion for a gastrointestinal stromal tumor when a rectal mass is found.

The American journal of gastroenterology, 1999

Recipients of renal transplants are known to have an increased incidence of cancer, which is beli... more Recipients of renal transplants are known to have an increased incidence of cancer, which is believed to be related to the use of immunosuppressive drugs used to prevent rejection. Although the risks of lymphoma and Kaposi's sarcoma are clearly increased in this setting, the association with colon cancer is controversial. We report a 44-yr-old woman, 20 yr post-renal transplant, and with no family history of colorectal cancer or polyps, who was found to have synchronous, poorly differentiated colon cancers associated with extensive abdominal lymph node, bone marrow, and bone (skull) metastasis. The long term immunosuppressive drugs that she had received may have been an important factor in her tumor development and/or progression. Our case and literature review suggest a possible mild, increased risk of colon cancer development in patients after renal transplantation.

Substance Use & Misuse, 2001

Although many people recover from substance-use associated problems on their own, little is known... more Although many people recover from substance-use associated problems on their own, little is known about this phenomenon. The paper had two objectives: to use a new research method, computer-assisted content analysis, to understand alcohol and drug abusers ' perceived reasons for self-change and to undertake a comparative evaluation across substances and cultures to validate previous findings about subjective appraisal processes. Three studies of natural recoveries of alcohol and drug abusers in two countries conducted taperecorded interviews with 216 respondents. The taped responses were coded based on a content analytic dictionary approach using a computerized content analysis program. All three studies found several processes mediating the decision to change substance use. The computer content analysis confirmed a cognitive appraisal process regardless of the cultural setting or substance. The findings suggest that several procedures might have benefit in clinical interventions.

Addictive Behaviors, 2003

To evaluate the relationship between drinking pattern and alcohol dependence severity, 209 indivi... more To evaluate the relationship between drinking pattern and alcohol dependence severity, 209 individuals voluntarily seeking treatment for alcohol problems were administered the Alcohol Dependence Scale (ADS), the Short Alcohol Dependence Data (SADD) questionnaire, and a 12-month Timeline Follow-Back (TLFB) drinking assessment as part of their pretreatment assessment. Based on their TLFB data, participants were divided into two groups: daily (DD,

Substance Use & Misuse, 2001

This article describes the psychometric characteristics of two major assessment instruments used ... more This article describes the psychometric characteristics of two major assessment instruments used in a World Health Organization (WHO) clinical trial: (a) Alcohol Timeline Followback (TLFB, which assesses daily drinking patterns), and (b) Inventory of Drinking Situations (IDS, which assesses antecedents to ''heavy'' drinking). Clients (N ¼ 308) were outpatient alcohol abusers from four countries (Australia, Canada, Mexico, and Sweden). Generally, the Alcohol TLFB and IDS were shown to be reliable and valid with outpatient alcohol abusers in four countries, and in three languages. These results suggest that the Alcohol TLFB and the IDS can be used in clinical and research settings with Swedish-, Spanish-, and English-speaking alcohol abusers.

Quality & Quantity, 2012

In comparison to conventional questionnaires, calendar interviews produce higher quality retrospe... more In comparison to conventional questionnaires, calendar interviews produce higher quality retrospective reports of factual information. This study sought to examine whether calendar interviews would also be advantageous in collecting retrospective reports of subjective assessment information. Respondents in a panel study were randomly assigned to either a calendar or conventional questionnaire method; both methods asked for retrospective reports on years in which disability was present and annual health status since young childhood. Panel data served as a source of validation for the retrospective reports. Both methods tended to underreport the number of years disabled and yielded mean levels of better annual health status in comparison to the panel reports. Calendar interviews demonstrated higher quality retrospective reports for disability in yielding a significantly stronger correlation in the frequency of years being disabled and in providing a greater number of years of higher annual correspondence with the panel data in comparison to the conventional questionnaire. Calendar interviews also demonstrated the ability to preserve the slope of change associated with aging as seen in the panel data, whereas the conventional questionnaire led to a significantly shallower slope of change. This latter finding could not be explained by the presence of an acquiescence bias.

Perspectives on Psychological Science, 2010

Perceptions of work conditions have proven to be important to the well-being of workers. However,... more Perceptions of work conditions have proven to be important to the well-being of workers. However, customer loyalty, employee retention, revenue, sales, and profit are essential to the success of any business. It is known that these outcomes are correlated with employee attitudes and perceptions of work conditions, but the research into direction of causality has been inconclusive. Using a massive longitudinal database that included 2,178 business units in 10 large organizations, we found evidence supporting the causal impact of employee perceptions on these bottom-line measures; reverse causality of bottom-line measures on employee perceptions existed but was weaker. Managerial actions and practices can impact employee work conditions and employee perceptions of these conditions, thereby improving key outcomes at the organizational level. Perceptions of specific work conditions that engage employees in their work provide practical guidance in how best to manage people to obtain desired results.

Oncology Nursing Forum, 2008

To test a model of family caregiving derived from the interactionist approach to role theory that... more To test a model of family caregiving derived from the interactionist approach to role theory that hypothesized that three caregiving role implementation variables (caregiving demand, mutuality between caregivers and patients, and preparedness for caregiving) would predict multiple caregiving-specific and generic outcomes with different patterns of association across outcomes. Descriptive, correlational. Surgical, radiation, and medical oncology settings. 87 family caregivers of adults receiving treatment for solid tumors or lymphoma. Caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; the Mutuality, Preparedness, and Global Strain scales of the Family Care Inventory; and the 30-item short form of the Profile of Mood States. Data were analyzed with simultaneous multiple regression. Caregiving demand, mutuality, preparedness, caregiving difficulty, global caregiver strain, tension, depression, anger, fatigue, vigor, confusion, and total mood disturbance. The model explained statistically significant proportions of variance in each outcome, with different patterns of association across outcomes. Demand was associated most strongly with caregiving difficulty and global strain. Mutuality was associated most strongly with caregiver anger. Unexpectedly, preparedness was associated more strongly with mood disturbance outcomes than with the caregiving-specific variables of difficulty and strain. Further research should explore models that address implementation of the caregiving role to better elucidate how family caregivers learn and carry out the important role. Clinical assessment should include caregiving demand, the quality of the relationship between caregiver and patient, and preparedness for caregiving. Interventions could be tailored to meet caregiver needs in each area.

Substance Abuse, 2006

Alcohol and other drug (AOD) use behaviors of health professions students (HPS) were assessed by ... more Alcohol and other drug (AOD) use behaviors of health professions students (HPS) were assessed by surveying both university-based HPS and other nursing programs in a Midwestern state in 1999. Response was 2,646 (56.4%) of surveyed students. Family history of alcohol-related and drug-related problems were reported by 39.8% and 13.9%, respectively, with 42.6% of respondents reporting one or both. Among nursing respondents, 48.1%, 19.2%, and 51.1%, respectively, reported family problems with alcohol, drugs, or one or both. Past-year alcohol use was comparable to undergraduate college students (UCS) nationally (83%); heavy drinking, tobacco, and recreational drug use by HPS were lower. Past year drug use was highest among medical students. Marijuana was the predominant illicit drug; medical students and males most often reported use. Health professions educational systems should proactively address student AOD prevention, education, and assistance needs.

Gastrointestinal Endoscopy, 1996

Our academic hospital center operates an open access endoscopy service that allows referring phys... more Our academic hospital center operates an open access endoscopy service that allows referring physicians to directly schedule patients for outpatient esophagogastroduodenoscopy and colonoscopy without having them first seen in the GI clinic. Although patients from the GI clinic have an opportunity to meet the endoscopist and discuss their procedures directly beforehand, patients who are scheduled to undergo endoscopy through our open access service receive only a brief telephone call from a GI fellow or nurse that is made to screen for contraindications to the procedure and to give instructions. Our objective was to find out whether patients who used our open access service were more anxious about their procedures than those referred from the GI clinic. On arrival to our endoscopy center, consecutive patients from the open access service (n = 142) and the GI clinic (n = 85) completed a questionnaire that included three measures of anxiety. After completion of the endoscopic procedure, the attending endoscopist rated patient cooperation. Patients also completed a phone questionnaire on the day after their procedures assessing their experience with endoscopy. We found no difference between patients from the open access service and those from the GI clinic in any of the measures of preprocedure anxiety, in scores measuring cooperation during procedures, or in patient ratings of their experience with endoscopy as assessed on the day after procedures. Patients who used our open access service were no more anxious about their procedures or less cooperative during them than patients first seen in the GI clinic. In both groups, procedure-related anxiety was decreased in patients who had previously undergone endoscopy.

Drug and Alcohol Dependence, 1999

Although most alcohol abusers are dependent on nicotine, studies of such individuals have been sc... more Although most alcohol abusers are dependent on nicotine, studies of such individuals have been scarce. Consequently, little information is available for advising clients who wish to consider resolving both problems. Clients entering an outpatient alcohol treatment program who were also current smokers were asked about their temporal preferences for changing their alcohol and cigarette use. Over three-quarters of alcohol abusers who were also smokers when asked said they would be willing to consider stopping smoking during or after treatment for an alcohol problem. Individuals who were interested in quitting smoking cigarettes while in treatment for an alcohol problem were different from those who did not want to stop smoking, and such differences may influence their ability to successfully address both problems together. Compared to those who preferred to change their drinking first then address their smoking, those who said they would be willing to address both problems (i.e. smoking and drinking) together in treatment were not only considerably more likely to think that quitting smoking would affect quitting drinking, but also more likely to be planning to quit smoking in the next six months. These results suggest that some individuals whose alcohol problems are not severe and who also smoke cigarettes will be more receptive to a dual recovery approach than others. In the absence of research findings, health care practitioners who encounter individuals who drink heavily and smoke cigarettes should at a minimum explore the option of dual cessation with their clients. The clinical and research implications of the present results are discussed.

Behaviour Research and Therapy, 2000

Assessing con®dence to resist drinking in high risk situations is an important part of behavioral... more Assessing con®dence to resist drinking in high risk situations is an important part of behavioral treatments for alcohol problems. The present study assessed the reliability and validity of the original 100-item Situational Con®dence Questionnaire (SCQ) and of an 8-item brief version (BSCQ). Using a visual analog scale, the BSCQ asked respondents to report their con®dence to resist urges to drink heavily using the original eight SCQ subscales (e.g., pleasant times with others, social pressure). Data were collected from 120 adult problem drinkers who voluntarily entered an outpatient alcohol treatment program. The comparability of the BSCQ and the SCQ-100 was evaluated through intraclass correlations between the eight subscales and comparison of both instruments' underlying factor structures. Correlation coecients for the subscales ranged from 0.56 to 0.80. Both instruments showed similar, but not identical factor structures. The present results indicate that the BSCQ provides comparable information to the SCQ-100. Limitations, as well as the clinical advantages, of using the BSCQ over longer versions are discussed. 7

Alcoholism: Clinical & Experimental Research, 2003

Alcoholism: Clinical and Experimental Research, 2002

Alcoholism: Clinical and Experimental Research, 2002

Background: By using a public health approach to the treatment of alcohol problems, this study an... more Background: By using a public health approach to the treatment of alcohol problems, this study analyzed the efficacy and cost analysis of two versions of a community-level mail intervention to promote self-change among alcohol abusers who had never sought help or treatment.

Addictive Behaviors, 1996

This paper describes the rationale and design for a recently implemented study involving a commun... more This paper describes the rationale and design for a recently implemented study involving a community-based intervention designed to foster self-change for individuals who otherwise would be unlikely to seek formal help or treatment for their alcohol problem. The study is based on research examining natural recovery processes with alcohol abusers and on clinical trials using a Guided Self-Change model of treatment with problem drinkers. Advertisements and mailed pamphlets are used to solicit individuals who wanted to change their drinking on their own using self-help materials. Respondents are screened and, if eligible, are randomly assigned to two conditions: Guided Self-Change (GSC) or Educational Materials Control (EMC) (projected N = 788). All subjects complete and mail in several brief assessment forms. Subjects in the GSC group receive advice and personalized feedback based on their assessment answers. Subjects in the EMC group receive educational pamphlets prepared for general medical and mental health settings. Subject characteristics and drinking-related history variables for the first 10% of the sample are presented. Subjects will be followed up at 12 months following the intervention.

Addictive Behaviors, 2008

When assessing individuals with alcohol use disorders, measurement of drinking can be a resource ... more When assessing individuals with alcohol use disorders, measurement of drinking can be a resource intensive activity, particularly because many research studies report data for intervals ranging from 6 to 12 months prior to the interview. This study examined whether data from shorter assessment intervals is sufficiently representative of longer intervals to warrant the use of shorter intervals for clinical and research purposes. Participants were 825 problem drinkers (33.1% female) who were recruited through media advertisements to participate in a community-based mail intervention in Toronto, Canada. Participants' Timeline Followback (TLFB) reports of drinking were used to investigate the representativeness of different time windows for estimating annual drinking behavior. The findings suggest that for aggregated reports of drinking and with large sample (e.g., surveys), a 1-month window can be used to estimate annual consumption. For individual cases (e.g., clinical use) and smaller samples, a 3month window is recommended. These results suggest that shorter time windows, which are more time and resource efficient, can be used with little to no loss in the accuracy of the data.

Acta Psychiatrica Scandinavica, 2006

Alcoholism-clinical and Experimental Research, 2003

Journal of patient safety, 2012

Demonstrate the relationship between employee engagement and workplace safety for predicting pati... more Demonstrate the relationship between employee engagement and workplace safety for predicting patient safety culture. Patient safety is an issue for the U.S. health-care system, and health care has some of the highest rates of nonfatal workplace injuries. Understanding the types of injuries sustained by health-care employees, the type of safety environment employees of health-care organizations work in, and how employee engagement affects patient safety is vital to improving the safety of both employees and patients. The Gallup Q survey and an approved, abbreviated, and validated subset of questions from the Hospital Survey on Patient Safety Culture were administered to staff at a large tertiary academic medical center in 2007 and 2009. After controlling for demographic variables, researchers conducted a longitudinal, hierarchical linear regression analysis to study the unique contributions of employee engagement, changes in employee engagement, and employee safety in predicting pati...

Journal of gastrointestinal cancer, Jan 12, 2011

A 78-year-old Caucasian male with a history of atrial fibrillation and anticoagulation with warfa... more A 78-year-old Caucasian male with a history of atrial fibrillation and anticoagulation with warfarin presented with a change in bowel habits and weight loss. A computed tomography (CT) scan showed a 3.5 cm rectal mass. After biopsy with colonoscopy and endoscopic ultrasonography, the rectal mass was highly suspicious for rectal hematoma. When the rectal mass did not resolve after 1 month of follow-up, surgery showed the patient to have a rectal gastrointestinal stromal tumor. He is being treated with imatinib and follow-up CT scans. This case illustrates the importance of a high level of suspicion for a gastrointestinal stromal tumor when a rectal mass is found.

The American journal of gastroenterology, 1999

Recipients of renal transplants are known to have an increased incidence of cancer, which is beli... more Recipients of renal transplants are known to have an increased incidence of cancer, which is believed to be related to the use of immunosuppressive drugs used to prevent rejection. Although the risks of lymphoma and Kaposi's sarcoma are clearly increased in this setting, the association with colon cancer is controversial. We report a 44-yr-old woman, 20 yr post-renal transplant, and with no family history of colorectal cancer or polyps, who was found to have synchronous, poorly differentiated colon cancers associated with extensive abdominal lymph node, bone marrow, and bone (skull) metastasis. The long term immunosuppressive drugs that she had received may have been an important factor in her tumor development and/or progression. Our case and literature review suggest a possible mild, increased risk of colon cancer development in patients after renal transplantation.

Substance Use & Misuse, 2001

Although many people recover from substance-use associated problems on their own, little is known... more Although many people recover from substance-use associated problems on their own, little is known about this phenomenon. The paper had two objectives: to use a new research method, computer-assisted content analysis, to understand alcohol and drug abusers ' perceived reasons for self-change and to undertake a comparative evaluation across substances and cultures to validate previous findings about subjective appraisal processes. Three studies of natural recoveries of alcohol and drug abusers in two countries conducted taperecorded interviews with 216 respondents. The taped responses were coded based on a content analytic dictionary approach using a computerized content analysis program. All three studies found several processes mediating the decision to change substance use. The computer content analysis confirmed a cognitive appraisal process regardless of the cultural setting or substance. The findings suggest that several procedures might have benefit in clinical interventions.

Addictive Behaviors, 2003

To evaluate the relationship between drinking pattern and alcohol dependence severity, 209 indivi... more To evaluate the relationship between drinking pattern and alcohol dependence severity, 209 individuals voluntarily seeking treatment for alcohol problems were administered the Alcohol Dependence Scale (ADS), the Short Alcohol Dependence Data (SADD) questionnaire, and a 12-month Timeline Follow-Back (TLFB) drinking assessment as part of their pretreatment assessment. Based on their TLFB data, participants were divided into two groups: daily (DD,

Substance Use & Misuse, 2001

This article describes the psychometric characteristics of two major assessment instruments used ... more This article describes the psychometric characteristics of two major assessment instruments used in a World Health Organization (WHO) clinical trial: (a) Alcohol Timeline Followback (TLFB, which assesses daily drinking patterns), and (b) Inventory of Drinking Situations (IDS, which assesses antecedents to ''heavy'' drinking). Clients (N ¼ 308) were outpatient alcohol abusers from four countries (Australia, Canada, Mexico, and Sweden). Generally, the Alcohol TLFB and IDS were shown to be reliable and valid with outpatient alcohol abusers in four countries, and in three languages. These results suggest that the Alcohol TLFB and the IDS can be used in clinical and research settings with Swedish-, Spanish-, and English-speaking alcohol abusers.

Quality & Quantity, 2012

In comparison to conventional questionnaires, calendar interviews produce higher quality retrospe... more In comparison to conventional questionnaires, calendar interviews produce higher quality retrospective reports of factual information. This study sought to examine whether calendar interviews would also be advantageous in collecting retrospective reports of subjective assessment information. Respondents in a panel study were randomly assigned to either a calendar or conventional questionnaire method; both methods asked for retrospective reports on years in which disability was present and annual health status since young childhood. Panel data served as a source of validation for the retrospective reports. Both methods tended to underreport the number of years disabled and yielded mean levels of better annual health status in comparison to the panel reports. Calendar interviews demonstrated higher quality retrospective reports for disability in yielding a significantly stronger correlation in the frequency of years being disabled and in providing a greater number of years of higher annual correspondence with the panel data in comparison to the conventional questionnaire. Calendar interviews also demonstrated the ability to preserve the slope of change associated with aging as seen in the panel data, whereas the conventional questionnaire led to a significantly shallower slope of change. This latter finding could not be explained by the presence of an acquiescence bias.

Perspectives on Psychological Science, 2010

Perceptions of work conditions have proven to be important to the well-being of workers. However,... more Perceptions of work conditions have proven to be important to the well-being of workers. However, customer loyalty, employee retention, revenue, sales, and profit are essential to the success of any business. It is known that these outcomes are correlated with employee attitudes and perceptions of work conditions, but the research into direction of causality has been inconclusive. Using a massive longitudinal database that included 2,178 business units in 10 large organizations, we found evidence supporting the causal impact of employee perceptions on these bottom-line measures; reverse causality of bottom-line measures on employee perceptions existed but was weaker. Managerial actions and practices can impact employee work conditions and employee perceptions of these conditions, thereby improving key outcomes at the organizational level. Perceptions of specific work conditions that engage employees in their work provide practical guidance in how best to manage people to obtain desired results.

Oncology Nursing Forum, 2008

To test a model of family caregiving derived from the interactionist approach to role theory that... more To test a model of family caregiving derived from the interactionist approach to role theory that hypothesized that three caregiving role implementation variables (caregiving demand, mutuality between caregivers and patients, and preparedness for caregiving) would predict multiple caregiving-specific and generic outcomes with different patterns of association across outcomes. Descriptive, correlational. Surgical, radiation, and medical oncology settings. 87 family caregivers of adults receiving treatment for solid tumors or lymphoma. Caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; the Mutuality, Preparedness, and Global Strain scales of the Family Care Inventory; and the 30-item short form of the Profile of Mood States. Data were analyzed with simultaneous multiple regression. Caregiving demand, mutuality, preparedness, caregiving difficulty, global caregiver strain, tension, depression, anger, fatigue, vigor, confusion, and total mood disturbance. The model explained statistically significant proportions of variance in each outcome, with different patterns of association across outcomes. Demand was associated most strongly with caregiving difficulty and global strain. Mutuality was associated most strongly with caregiver anger. Unexpectedly, preparedness was associated more strongly with mood disturbance outcomes than with the caregiving-specific variables of difficulty and strain. Further research should explore models that address implementation of the caregiving role to better elucidate how family caregivers learn and carry out the important role. Clinical assessment should include caregiving demand, the quality of the relationship between caregiver and patient, and preparedness for caregiving. Interventions could be tailored to meet caregiver needs in each area.

Substance Abuse, 2006

Alcohol and other drug (AOD) use behaviors of health professions students (HPS) were assessed by ... more Alcohol and other drug (AOD) use behaviors of health professions students (HPS) were assessed by surveying both university-based HPS and other nursing programs in a Midwestern state in 1999. Response was 2,646 (56.4%) of surveyed students. Family history of alcohol-related and drug-related problems were reported by 39.8% and 13.9%, respectively, with 42.6% of respondents reporting one or both. Among nursing respondents, 48.1%, 19.2%, and 51.1%, respectively, reported family problems with alcohol, drugs, or one or both. Past-year alcohol use was comparable to undergraduate college students (UCS) nationally (83%); heavy drinking, tobacco, and recreational drug use by HPS were lower. Past year drug use was highest among medical students. Marijuana was the predominant illicit drug; medical students and males most often reported use. Health professions educational systems should proactively address student AOD prevention, education, and assistance needs.

Gastrointestinal Endoscopy, 1996

Our academic hospital center operates an open access endoscopy service that allows referring phys... more Our academic hospital center operates an open access endoscopy service that allows referring physicians to directly schedule patients for outpatient esophagogastroduodenoscopy and colonoscopy without having them first seen in the GI clinic. Although patients from the GI clinic have an opportunity to meet the endoscopist and discuss their procedures directly beforehand, patients who are scheduled to undergo endoscopy through our open access service receive only a brief telephone call from a GI fellow or nurse that is made to screen for contraindications to the procedure and to give instructions. Our objective was to find out whether patients who used our open access service were more anxious about their procedures than those referred from the GI clinic. On arrival to our endoscopy center, consecutive patients from the open access service (n = 142) and the GI clinic (n = 85) completed a questionnaire that included three measures of anxiety. After completion of the endoscopic procedure, the attending endoscopist rated patient cooperation. Patients also completed a phone questionnaire on the day after their procedures assessing their experience with endoscopy. We found no difference between patients from the open access service and those from the GI clinic in any of the measures of preprocedure anxiety, in scores measuring cooperation during procedures, or in patient ratings of their experience with endoscopy as assessed on the day after procedures. Patients who used our open access service were no more anxious about their procedures or less cooperative during them than patients first seen in the GI clinic. In both groups, procedure-related anxiety was decreased in patients who had previously undergone endoscopy.

Drug and Alcohol Dependence, 1999

Although most alcohol abusers are dependent on nicotine, studies of such individuals have been sc... more Although most alcohol abusers are dependent on nicotine, studies of such individuals have been scarce. Consequently, little information is available for advising clients who wish to consider resolving both problems. Clients entering an outpatient alcohol treatment program who were also current smokers were asked about their temporal preferences for changing their alcohol and cigarette use. Over three-quarters of alcohol abusers who were also smokers when asked said they would be willing to consider stopping smoking during or after treatment for an alcohol problem. Individuals who were interested in quitting smoking cigarettes while in treatment for an alcohol problem were different from those who did not want to stop smoking, and such differences may influence their ability to successfully address both problems together. Compared to those who preferred to change their drinking first then address their smoking, those who said they would be willing to address both problems (i.e. smoking and drinking) together in treatment were not only considerably more likely to think that quitting smoking would affect quitting drinking, but also more likely to be planning to quit smoking in the next six months. These results suggest that some individuals whose alcohol problems are not severe and who also smoke cigarettes will be more receptive to a dual recovery approach than others. In the absence of research findings, health care practitioners who encounter individuals who drink heavily and smoke cigarettes should at a minimum explore the option of dual cessation with their clients. The clinical and research implications of the present results are discussed.

Behaviour Research and Therapy, 2000

Assessing con®dence to resist drinking in high risk situations is an important part of behavioral... more Assessing con®dence to resist drinking in high risk situations is an important part of behavioral treatments for alcohol problems. The present study assessed the reliability and validity of the original 100-item Situational Con®dence Questionnaire (SCQ) and of an 8-item brief version (BSCQ). Using a visual analog scale, the BSCQ asked respondents to report their con®dence to resist urges to drink heavily using the original eight SCQ subscales (e.g., pleasant times with others, social pressure). Data were collected from 120 adult problem drinkers who voluntarily entered an outpatient alcohol treatment program. The comparability of the BSCQ and the SCQ-100 was evaluated through intraclass correlations between the eight subscales and comparison of both instruments' underlying factor structures. Correlation coecients for the subscales ranged from 0.56 to 0.80. Both instruments showed similar, but not identical factor structures. The present results indicate that the BSCQ provides comparable information to the SCQ-100. Limitations, as well as the clinical advantages, of using the BSCQ over longer versions are discussed. 7

Alcoholism: Clinical & Experimental Research, 2003

Alcoholism: Clinical and Experimental Research, 2002

Alcoholism: Clinical and Experimental Research, 2002

Background: By using a public health approach to the treatment of alcohol problems, this study an... more Background: By using a public health approach to the treatment of alcohol problems, this study analyzed the efficacy and cost analysis of two versions of a community-level mail intervention to promote self-change among alcohol abusers who had never sought help or treatment.

Addictive Behaviors, 1996

This paper describes the rationale and design for a recently implemented study involving a commun... more This paper describes the rationale and design for a recently implemented study involving a community-based intervention designed to foster self-change for individuals who otherwise would be unlikely to seek formal help or treatment for their alcohol problem. The study is based on research examining natural recovery processes with alcohol abusers and on clinical trials using a Guided Self-Change model of treatment with problem drinkers. Advertisements and mailed pamphlets are used to solicit individuals who wanted to change their drinking on their own using self-help materials. Respondents are screened and, if eligible, are randomly assigned to two conditions: Guided Self-Change (GSC) or Educational Materials Control (EMC) (projected N = 788). All subjects complete and mail in several brief assessment forms. Subjects in the GSC group receive advice and personalized feedback based on their assessment answers. Subjects in the EMC group receive educational pamphlets prepared for general medical and mental health settings. Subject characteristics and drinking-related history variables for the first 10% of the sample are presented. Subjects will be followed up at 12 months following the intervention.

Addictive Behaviors, 2008

When assessing individuals with alcohol use disorders, measurement of drinking can be a resource ... more When assessing individuals with alcohol use disorders, measurement of drinking can be a resource intensive activity, particularly because many research studies report data for intervals ranging from 6 to 12 months prior to the interview. This study examined whether data from shorter assessment intervals is sufficiently representative of longer intervals to warrant the use of shorter intervals for clinical and research purposes. Participants were 825 problem drinkers (33.1% female) who were recruited through media advertisements to participate in a community-based mail intervention in Toronto, Canada. Participants' Timeline Followback (TLFB) reports of drinking were used to investigate the representativeness of different time windows for estimating annual drinking behavior. The findings suggest that for aggregated reports of drinking and with large sample (e.g., surveys), a 1-month window can be used to estimate annual consumption. For individual cases (e.g., clinical use) and smaller samples, a 3month window is recommended. These results suggest that shorter time windows, which are more time and resource efficient, can be used with little to no loss in the accuracy of the data.

Acta Psychiatrica Scandinavica, 2006