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      Assessing understandings of substance use disorders among Norwegian treatment professionals, patients and the general public

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          Abstract

          Background

          Beliefs about substance use disorder (SUD) shape how patients, treatment professionals and the general public view addiction and its treatment. A U.S. developed scale exists to assess such beliefs, but it has never been tested in Norway nor normed on any general population sample.

          Methods

          The Short Understanding of Substance Abuse Scale (SUSS) was translated from English to Norwegian and used to assess beliefs about the nature of addiction among addiction treatment professionals ( N = 291), patients with SUDs ( N = 133) and respondents from the general public ( N = 216). The disease and psychosocial model subscales of the SUSS were examined with a multigroup factor analysis to confirm that the constructs were invariant across the studied groups. We also controlled for demographic covariates in a multiple indicator multiple cause model.

          Results

          The multigroup confirmatory factor analysis of the SUSS yielded a partial scalar invariant model and thus, we were able to compare latent means between groups. In unadjusted comparisons, patients and the general public reported significantly higher endorsement of disease model beliefs than did professionals. However, the difference between professionals and the general public disappeared when the comparison was adjusted for covariates (i.e., age, gender, education). In both unadjusted and adjusted analyses, the general public group but not the patient group scored significantly lower than professionals on the psychosocial belief scale.

          Conclusion

          The SUSS is useable with slight adaptations in Norwegian samples. Norwegian treatment professionals have different views of substance use disorder than do patients and the general public. This may create opportunities for dialogue and mutual learning, but also presents risk of miscommunication and distrust.

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          Most cited references44

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          Social contagion theory: examining dynamic social networks and human behavior.

          Here, we review the research we have conducted on social contagion. We describe the methods we have employed (and the assumptions they have entailed) to examine several datasets with complementary strengths and weaknesses, including the Framingham Heart Study, the National Longitudinal Study of Adolescent Health, and other observational and experimental datasets that we and others have collected. We describe the regularities that led us to propose that human social networks may exhibit a 'three degrees of influence' property, and we review statistical approaches we have used to characterize interpersonal influence with respect to phenomena as diverse as obesity, smoking, cooperation, and happiness. We do not claim that this work is the final word, but we do believe that it provides some novel, informative, and stimulating evidence regarding social contagion in longitudinally followed networks. Along with other scholars, we are working to develop new methods for identifying causal effects using social network data, and we believe that this area is ripe for statistical development as current methods have known and often unavoidable limitations. Copyright © 2012 John Wiley & Sons, Ltd.
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            Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations

            Background Research questionnaires are not always translated appropriately before they are used in new temporal, cultural or linguistic settings. The results based on such instruments may therefore not accurately reflect what they are supposed to measure. This paper aims to illustrate the process and required steps involved in the cross-cultural adaptation of a research instrument using the adaptation process of an attitudinal instrument as an example. Methods A questionnaire was needed for the implementation of a study in Norway 2007. There was no appropriate instruments available in Norwegian, thus an Australian-English instrument was cross-culturally adapted. Results The adaptation process included investigation of conceptual and item equivalence. Two forward and two back-translations were synthesized and compared by an expert committee. Thereafter the instrument was pretested and adjusted accordingly. The final questionnaire was administered to opioid maintenance treatment staff (n=140) and harm reduction staff (n=180). The overall response rate was 84%. The original instrument failed confirmatory analysis. Instead a new two-factor scale was identified and found valid in the new setting. Conclusions The failure of the original scale highlights the importance of adapting instruments to current research settings. It also emphasizes the importance of ensuring that concepts within an instrument are equal between the original and target language, time and context. If the described stages in the cross-cultural adaptation process had been omitted, the findings would have been misleading, even if presented with apparent precision. Thus, it is important to consider possible barriers when making a direct comparison between different nations, cultures and times.
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              Applied multivariate statistics for the social sciences

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                Author and article information

                Contributors
                +47 381 32 600 , john-kare.vederhus@sshf.no
                thomas.clausen@medisin.uio.no
                knh@stanford.edu
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                13 February 2016
                13 February 2016
                2016
                : 16
                : 52
                Affiliations
                [ ]Addiction Unit, Sørlandet Hospital HF, P.b. 416, 4604 Kristiansand, Norway
                [ ]Norwegian Center for Addiction Research, University of Oslo, Oslo, Norway
                [ ]Veterans Health Administration, Palo Alto, California USA
                [ ]Stanford University School of Medicine, Stanford, California USA
                Article
                1306
                10.1186/s12913-016-1306-9
                4752790
                26873360
                f517bd6a-dfed-4536-aae0-bfc54ae164f4
                © Vederhus et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 May 2015
                : 10 February 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                substance-related disorders,attitudes of health personnel,professional-patient relations,patient-centered care,health services research,alcoholics anonymous

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