{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T17:08:43Z","timestamp":1765732123307,"version":"3.48.0"},"reference-count":53,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T00:00:00Z","timestamp":1684195200000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"College of Veterinary Medicine, Lincoln Memorial University","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,4,20]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The overdose epidemic was designated a \u2018Public Health Emergency\u2019 in the USA on 26 October 2017, bringing attention to the severity of this public health problem. The Appalachian region remains substantially impacted by the effects from years of overprescription of opioids, and subsequently opioid non-medical use and addiction. This study aims to examine the utility of the PRECEDE\u2013PROCEED model constructs (ie, predisposing, reinforcing and enabling factors) to explain opioid addiction helping behaviour (ie, helping someone who has an opioid addiction) among members of the public living in tri-state Appalachian counties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Rural county in the Appalachian region of the USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 213 participants from a retail mall in a rural Appalachian Kentucky county completed the survey. Most participants were between the ages of 18 and 30 years (n=68; 31.9%) and identified as men (n=139; 65.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Opioid addiction helping behaviour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The regression model was significant (\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>(6, 180)<\/jats:sub>\n                      =26.191, p&lt;0.001) and explained 44.8% of the variance in opioid addiction helping behaviour (R\n                      <jats:sup>2<\/jats:sup>\n                      =0.448). Attitude towards helping someone with opioid addiction (B=0.335; p&lt;0.001), behavioural skills (B=0.208; p=0.003), reinforcing factors (B=0.190; p=0.015) and enabling factors (B=0.195; p=0.009) were all significantly associated with opioid addiction helping behaviour.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PRECEDE\u2013PROCEED model constructs have utility to explain opioid addiction helping behaviour among individuals in a region greatly impacted by the overdose epidemic. This study provides an empirically tested framework for future programmes addressing helping behaviour related to opioid non-medical use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-066147","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T10:02:29Z","timestamp":1684231349000},"page":"e066147","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Predisposing, enabling and reinforcing factors associated with opioid addiction helping behaviour in tri-state Appalachian counties: application of the PRECEDE\u2013PROCEED model\u2013cross-sectional analysis"],"prefix":"10.1136","volume":"13","author":[{"given":"Amanda H","family":"Wilkerson","sequence":"first","affiliation":[{"name":"Department of Health Science, The University of Alabama, Tuscaloosa, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manoj","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Health, Department of Internal Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E","family":"Davis","sequence":"additional","affiliation":[{"name":"Substance Use and Mental Health Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip M","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA"},{"name":"Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, Lincoln Memorial University, Harrogate, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard W","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Animal and Human Health in Appalachia, College of Veterinary Medicine, Lincoln Memorial University, Harrogate, Tennessee, USA"},{"name":"Department of Physical Medicine and Rehabilitation, New York-Presbyterian Hospital, Columbia University Medical Center and Weill Cornell Medical Center, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Bhati","sequence":"additional","affiliation":[{"name":"Casualty Section, All India Institute of Ayurveda, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9693-7687","authenticated-orcid":false,"given":"Vinayak K","family":"Nahar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA"},{"name":"Department of Preventive Medicine, School of Medicine\/John D. 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