Show simple item record

Specialty substance use disorder services following brief alcohol intervention: a meta‐analysis of randomized controlled trials

dc.contributor.authorGlass, Joseph E.en_US
dc.contributor.authorHamilton, Ashley M.en_US
dc.contributor.authorPowell, Byron J.en_US
dc.contributor.authorPerron, Brian E.en_US
dc.contributor.authorBrown, Randall T.en_US
dc.contributor.authorIlgen, Mark A.en_US
dc.date.accessioned2015-08-05T16:47:40Z
dc.date.available2016-10-10T14:50:23Zen
dc.date.issued2015-09en_US
dc.identifier.citationGlass, Joseph E.; Hamilton, Ashley M.; Powell, Byron J.; Perron, Brian E.; Brown, Randall T.; Ilgen, Mark A. (2015). "Specialty substance use disorder services following brief alcohol intervention: a meta‐analysis of randomized controlled trials." Addiction 110(9): 1404-1415.en_US
dc.identifier.issn0965-2140en_US
dc.identifier.issn1360-0443en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/112279
dc.description.abstractBackground and aimsBrief alcohol interventions in medical settings are efficacious in improving self‐reported alcohol consumption among those with low‐severity alcohol problems. Screening, Brief Intervention and Referral to Treatment initiatives presume that brief interventions are efficacious in linking patients to higher levels of care, but pertinent evidence has not been evaluated. We estimated main and subgroup effects of brief alcohol interventions, regardless of their inclusion of a referral‐specific component, in increasing the utilization of alcohol‐related care.MethodsA systematic review of English language papers published in electronic databases to 2013. We included randomized controlled trials (RCTs) of brief alcohol interventions in general health‐care settings with adult and adolescent samples. We excluded studies that lacked alcohol services utilization data. Extractions of study characteristics and outcomes were standardized and conducted independently. The primary outcome was post‐treatment alcohol services utilization assessed by self‐report or administrative data, which we compared across intervention and control groups.ResultsThirteen RCTs met inclusion criteria and nine were meta‐analyzed (n = 993 and n = 937 intervention and control group participants, respectively). In our main analyses the pooled risk ratio (RR) was = 1.08, 95% confidence interval (CI) = 0.92–1.28. Five studies compared referral‐specific interventions with a control condition without such interventions (pooled RR = 1.08, 95% CI = 0.81–1.43). Other subgroup analyses of studies with common characteristics (e.g. age, setting, severity, risk of bias) yielded non‐statistically significant results.ConclusionsThere is a lack of evidence that brief alcohol interventions have any efficacy for increasing the receipt of alcohol‐related services.en_US
dc.publisherOxford University Pressen_US
dc.publisherWiley Periodicals, Inc.en_US
dc.subject.otherAlcoholen_US
dc.subject.otherbrief interventionen_US
dc.subject.othertreatment utilizationen_US
dc.subject.othermeta‐analysisen_US
dc.subject.othertreatment initiationen_US
dc.subject.otherreferral to treatmenten_US
dc.titleSpecialty substance use disorder services following brief alcohol intervention: a meta‐analysis of randomized controlled trialsen_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelPsychiatryen_US
dc.subject.hlbsecondlevelPublic Healthen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/112279/1/add12950.pdf
dc.identifier.doi10.1111/add.12950en_US
dc.identifier.sourceAddictionen_US
dc.identifier.citedreferenceField C. A., Caetano R. The effectiveness of brief intervention among injured patients with alcohol dependence: who benefits from brief interventions? Drug Alcohol Depend 2010; 111: 13 – 20.en_US
dc.identifier.citedreferenceBegg C. Publication bias. In: Cooper H. M., Hedges L. V., editors. The Handbook of Research Synthesis. New York: Russell Sage Foundation; 1994, pp. 399 – 409.en_US
dc.identifier.citedreferenceHarbord R. M., Egger M., Sterne J. A. C. A modified test for small‐study effects in meta‐analyses of controlled trials with binary endpoints. Stat Med 2006; 25: 3443 – 57.en_US
dc.identifier.citedreferenceKuchipudi V., Hobein K., Flickinger A., Iber F. L. Failure of a 2‐hour motivational intervention to alter recurrent drinking behavior in alcoholics with gastrointestinal disease. J Stud Alcohol 1990; 51: 356 – 60.en_US
dc.identifier.citedreferenceBischof G., Grothues J. M., Reinhardt S., Meyer C., John U., Rumpf H. J. Evaluation of a telephone‐based stepped care intervention for alcohol‐related disorders: a randomized controlled trial. Drug Alcohol Depend 2008; 93: 244 – 51.en_US
dc.identifier.citedreferenceCopeland L. A., Blow F. C., Barry K. L. Health care utilization by older alcohol‐using veterans: effects of a brief intervention to reduce at‐risk drinking. Health Educ Behav 2003; 30: 305 – 21.en_US
dc.identifier.citedreferenceWutzke S. E., Conigrave K. M., Saunders J. B., Hall W. D. The long‐term effectiveness of brief interventions for unsafe alcohol consumption: a 10‐year follow‐up. Addiction 2002; 97: 665 – 75.en_US
dc.identifier.citedreferenceCherpitel C. J., Korcha R. A., Moskalewicz J., Swiatkiewicz G., Ye Y., Bond J. Screening, brief intervention, and referral to treatment (SBIRT): 12‐month outcomes of a randomized controlled clinical trial in a Polish emergency department. Alcohol Clin Exp Res 2010; 34: 1922 – 8.en_US
dc.identifier.citedreferenceBatel P., Pessione F., Bouvier A. M., Rueff B. Prompting alcoholics to be referred to an alcohol clinic: the effectiveness of a simple letter. Addiction 1995; 90: 811 – 14.en_US
dc.identifier.citedreferenceBernstein J., Heeren T., Edward E., Dorfman D., Bliss C., Winter M. et al. A brief motivational interview in a pediatric emergency department, plus 10‐day telephone follow‐up, increases attempts to quit drinking among youth and young adults who screen positive for problematic drinking. Acad Emerg Med 2010; 17: 890 – 902.en_US
dc.identifier.citedreferenceGentilello L. M., Rivara F. P., Donovan D. M., Jurkovich G. J., Daranciang E., Dunn C. W. et al. Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Ann Surg 1999; 230: 473 – 80 discussion 480–3.en_US
dc.identifier.citedreferenceCrawford M. J., Patton R., Touquet R., Drummond C., Byford S., Barrett B. et al. Screening and referral for brief intervention of alcohol‐misusing patients in an emergency department: a pragmatic randomised controlled trial. Lancet 2004; 364: 1334 – 9.en_US
dc.identifier.citedreferenceMonti P. M., Barnett N. P., Colby S. M., Gwaltney C. J., Spirito A., Rohsenow D. J. et al. Motivational interviewing versus feedback only in emergency care for young adult problem drinking. Addiction 2007; 102: 1234 – 43.en_US
dc.identifier.citedreferenceMonti P. M., Colby S. M., Barnett N. P., Spirito A., Rohsenow D. J., Myers M. et al. Brief intervention for harm reduction with alcohol‐positive older adolescents in a hospital emergency department. J Consult Clin Psychol 1999; 67: 989 – 94.en_US
dc.identifier.citedreferenceBarnett N. P., Murphy J. G., Colby S. M., Monti P. M. Efficacy of counselor vs. computer‐delivered intervention with mandated college students. Addict Behav 2007; 32: 2529 – 48.en_US
dc.identifier.citedreferenceCenter for Substance Abuse Treatment. Brief Interventions and Brief Therapies for Substance Abuse. Rockville, MD: US Substance Abuse and Mental Health Services Administration; 1999.en_US
dc.identifier.citedreferenceCherpitel C. J., Bernstein E., Bernstein J., Moskalewicz J., Swiatkiewicz G. Screening, Brief Intervention and Referral to Treatment (SBIRT) in a Polish emergency room: challenges in cultural translation of SBIRT. J Addict Nurs 2009; 20: 127 – 31.en_US
dc.identifier.citedreferenceGlass J. E., Kristjansson S. D., Bucholz K. K. Perceived alcohol stigma: factor structure and construct validation. Alcohol Clin Exp Res 2013; 37: E237 – 46.en_US
dc.identifier.citedreferenceMcCormick K. A., Cochran N. E., Back A. L., Merrill J. O., Williams E. C., Bradley K. A. How primary care providers talk to patients about alcohol: a qualitative study. J Gen Intern Med 2006; 21: 966 – 72.en_US
dc.identifier.citedreferenceAmaral‐Sabadini M. B., Saitz R., Souza‐Formigoni M. L. O. Do attitudes about unhealthy alcohol and other drug (AOD) use impact primary care professionals' readiness to implement AOD‐related preventive care? Drug Alcohol Rev 2010; 29: 655 – 61.en_US
dc.identifier.citedreferenceMcLellan A. T., Meyers K. Contemporary addiction treatment: a review of systems problems for adults and adolescents. Biol Psychiatry 2004; 56: 764 – 70.en_US
dc.identifier.citedreferenceNational Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help. NIH Publication no. 14–7974. Bethesda, MD: Department of Health and Human Services; 2014.en_US
dc.identifier.citedreferenceJonas D. E., Amick H. R., Feltner C., Bobashev G., Thomas K., Wines R. et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta‐analysis. JAMA 2014; 311: 1889 – 900.en_US
dc.identifier.citedreferenceOslin D. W., Lynch K. G., Maisto S. A., Lantinga L. J., McKay J. R., Possemato K. et al. A randomized clinical trial of alcohol care management delivered in Department of Veterans Affairs primary care clinics versus specialty addiction treatment. J Gen Intern Med 2014; 29: 162 – 8.en_US
dc.identifier.citedreferenceSaitz R., Cheng D. M., Winter M., Kim T. W., Meli S. M., Allensworth‐Davies D. et al. Chronic care management for dependence on alcohol and other drugs: the AHEAD randomized trial. JAMA 2013; 310: 1156.en_US
dc.identifier.citedreferenceSaitz R., Palfai T. P., Cheng D. M., Horton N. J., Dukes K., Kraemer K. L. et al. Some medical inpatients with unhealthy alcohol use may benefit from brief intervention. J Stud Alcohol Drugs 2009; 70: 426 – 35.en_US
dc.identifier.citedreferenceHopewell S., McDonald S., Clarke M., Egger M. Grey literature in meta‐analyses of randomized trials of health care interventions. Cochrane Database Syst Rev 2007; 2 MR000010.en_US
dc.identifier.citedreferenceScott C. K., Dennis M. L. Results from two randomized clinical trials evaluating the impact of quarterly recovery management checkups with adult chronic substance users. Addiction 2009; 104: 959 – 71.en_US
dc.identifier.citedreferenceSaitz R. Clinical practice. Unhealthy alcohol use. N Engl J Med 2005; 352: 596 – 607.en_US
dc.identifier.citedreferenceMokdad A. H., Marks J. S., Stroup D. F., Gerberding J. L. Actual causes of death in the United States, 2000. JAMA 2004; 291: 1238 – 45.en_US
dc.identifier.citedreferenceCenter for Disease Control and Prevention. Alcohol and public health: data, trends, and maps [internet]. 2014 (cited 3 July 2014). Available at: http://www.cdc.gov/alcohol/quickstats/binge_drinking.htm (Archived by WebCite® at: http://www.webcitation.org/6YWH25GOV) (accessed 13 May 2015).en_US
dc.identifier.citedreferenceRehm J., Mathers C., Popova S., Thavorncharoensap M., Teerawattananon Y., Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol‐use disorders. Lancet 2009; 373: 2223 – 33.en_US
dc.identifier.citedreferenceGrant B. F., Stinson F. S., Dawson D. A., Chou S. P., Dufour M. C., Compton W. et al. Prevalence and co‐occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 2004; 61: 807 – 16.en_US
dc.identifier.citedreferenceEdlund M. J., Unutzer J., Curran G. M. Perceived need for alcohol, drug, and mental health treatment. Soc Psychiatry Psychiatr Epidemiol 2006; 41: 480 – 7.en_US
dc.identifier.citedreferenceGlass J. E., Perron B. E., Ilgen M. A., Chermack S. T., Ratliff S., Zivin K. Prevalence and correlates of specialty substance use disorder treatment for Department of Veterans Affairs Healthcare System patients with high alcohol consumption. Drug Alcohol Depend 2010; 112: 150 – 5.en_US
dc.identifier.citedreferenceDawson D. A., Grant B. F., Stinson F. S., Chou P. S., Huang B., Ruan W. J. Recovery from DSM‐IV alcohol dependence: United States, 2001–2002. Addiction 2005; 100: 281 – 92.en_US
dc.identifier.citedreferenceDawson D. A., Grant B. F., Stinson F. S., Chou P. S. Estimating the effect of help‐seeking on achieving recovery from alcohol dependence. Addiction 2006; 101: 824 – 34.en_US
dc.identifier.citedreferenceEttner S. L., Huang D., Evans E., Ash D. R., Hardy M., Jourabchi M. et al. Benefit–cost in the California treatment outcome project: does substance abuse treatment ‘pay for itself’? Health Serv Res 2006; 41: 192 – 213.en_US
dc.identifier.citedreferenceFinney J. W., Wilbourne P. L., Moos R. H. Psychosocial Treatments for Substance Use Disorders. A Guide to Treatments That Work. New York: Oxford University Press; 2007, pp. 179 – 202.en_US
dc.identifier.citedreferenceFleming M. F., Mundt M. P., French M. T., Manwell L. B., Stauffacher E. A., Barry K. L. Benefit–cost analysis of brief physician advice with problem drinkers in primary care settings. Med Care 2000; 38: 7 – 18.en_US
dc.identifier.citedreferenceMiller W. R., Wilbourne P. L. Mesa Grande: a methodological analysis of clinical trials of treatments for alcohol use disorders. Addiction 2002; 97: 265 – 77.en_US
dc.identifier.citedreferenceMoos R. H., Moos B. S. Rates and predictors of relapse after natural and treated remission from alcohol use disorders. Addiction 2006; 101: 212 – 22.en_US
dc.identifier.citedreferenceZarkin G. A., Bray J. W., Aldridge A., Mills M., Cisler R. A., Couper D. et al. The effect of alcohol treatment on social costs of alcohol dependence: results from the COMBINE study. Med Care 2010; 48: 396 – 401.en_US
dc.identifier.citedreferenceBabor T. F., Ritson E. B., Hodgson R. J. Alcohol‐related problems in the primary health care setting: a review of early intervention strategies. Br J Addict 1986; 81: 23 – 46.en_US
dc.identifier.citedreferenceChafetz M. E., Blane H. T., Abram H. S., Golner J., Lacy E., McCourt W. et al. Establishing treatment relations with alcoholics. J Nerv Ment Dis 1962; 134: 395 – 409.en_US
dc.identifier.citedreferenceBabor T. F., McRee B. G., Kassebaum P. A., Grimaldi P. L., Ahmed K., Bray J. Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Subst Abuse 2007; 28: 7 – 30.en_US
dc.identifier.citedreferencePreventive U. S. Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement. Ann Intern Med 2004; 140: 554 – 6.en_US
dc.identifier.citedreferenceAmerican Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 4th revised edn. Washington, DC: American Psychiatric Association; 2000 xxxvii, p., pp. 943.en_US
dc.identifier.citedreferenceNational Institute on Alcohol Abuse and Alcoholism. Helping Patients Who Drink Too Much: A Clinician's Guide [internet]. Bethesda, MD; 2005. Available at: http://pubs.niaaa.nih.gov/publications/Practitioner/CliniciansGuide2005/clinicians_guide.htm (Archived by WebCite® at http://www.webcitation.org/6YWGq774x) (accessed 14 May 2015).en_US
dc.identifier.citedreferenceMoyer V. A., Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. preventive services task force recommendation statement. Ann Intern Med 2013; 159: 210 – 18.en_US
dc.identifier.citedreferenceKaner E. F., Beyer F., Dickinson H. O., Pienaar E., Campbell F., Schlesinger C. et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2007; 18 CD004148. 1 – 93.en_US
dc.identifier.citedreferenceKaner E. F., Dickinson H. O., Beyer F., Pienaar E., Schlesinger C., Campbell F. et al. The effectiveness of brief alcohol interventions in primary care settings: a systematic review. Drug Alcohol Rev 2009; 28: 301 – 23.en_US
dc.identifier.citedreferenceWhitlock E. P., Polen M. R., Green C. A., Orleans T., Klein J. Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2004; 140: 557 – 68.en_US
dc.identifier.citedreferenceWhitlock E. P., Green C. A., Polen M. R., Berg A., Klein J., Siu A. et al. Behavioral Counseling Interventions in Primary Care to Reduce Risky/Harmful Alcohol Use. Rockville (MD): Agency for Healthcare Research and Quality (US); 2004en_US
dc.identifier.citedreferenceAhmadi H., Green S. L. Screening, brief intervention, and referral to treatment for military spouses experiencing alcohol and substance use disorders: a literature review. J Clin Psychol Med Settings 2011; 18: 129 – 36.en_US
dc.identifier.citedreferenceMitchell S. G., Gryczynski J., O'Grady K. E., Schwartz R. P. SBIRT for adolescent drug and alcohol use: current status and future directions. J Subst Abuse Treat 2013; 44: 463 – 72.en_US
dc.identifier.citedreferenceYoung M. M., Stevens A., Galipeau J., Pirie T., Garritty C., Singh K. et al. Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: a systematic review. Syst Rev 2014; 3: 50.en_US
dc.identifier.citedreferenceSaitz R. Alcohol screening and brief intervention in primary care: absence of evidence for efficacy in people with dependence or very heavy drinking. Drug Alcohol Rev 2010; 29: 631 – 40.en_US
dc.identifier.citedreferenceBray J. W., Cowell A. J., Hinde J. M. A systematic review and meta‐analysis of health care utilization outcomes in alcohol screening and brief intervention trials. Med Care 2011; 49: 287 – 94.en_US
dc.identifier.citedreferenceMdege N. D., Fayter D., Watson J. M., Stirk L., Sowden A., Godfrey C. Interventions for reducing alcohol consumption among general hospital inpatient heavy alcohol users: a systematic review. Drug Alcohol Depend 2013; 131: 1 – 22.en_US
dc.identifier.citedreferenceSaitz R., Palfai T. P., Cheng D. M., Horton N. J., Freedner N., Dukes K. et al. Brief intervention for medical inpatients with unhealthy alcohol use: a randomized, controlled trial. Ann Intern Med 2007; 146: 167 – 76.en_US
dc.identifier.citedreferenceCucciare M. A., Coleman E. A., Timko C. A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature. Prim Health Care Res Dev 2014; 12: 1 – 14.en_US
dc.identifier.citedreferenceHiggins J., Green S., editors. Cochrane Handbook For Systematic Reviews Of Interventions [internet]. Chichester, England: The Cochrane Collaboration; 2011. Available at: www.cochrane‐handbook.orgen_US
dc.identifier.citedreferenceYuma‐Guerrero P. J., Lawson K. A., Velasquez M. M., von Sternberg K., Maxson T., Garcia N. Screening, brief intervention, and referral for alcohol use in adolescents: a systematic review. Pediatrics 2012; 130: 115 – 22.en_US
dc.identifier.citedreferenceEmmen M. J. Effectiveness of opportunistic brief interventions for problem drinking in a general hospital setting: systematic review. BMJ 2004; 328: 318 – 22.en_US
dc.identifier.citedreferenceBertholet N., Daeppen J.‐B., Wietlisbach V., Fleming M., Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta‐analysis. Arch Intern Med 2005; 165: 986 – 95.en_US
dc.identifier.citedreferenceMoher D., Liberati A., Tetzlaff J., Altman D. G., PRISMA Group. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. Ann Intern Med 2009; 151: 264 – 9 W64.en_US
dc.identifier.citedreferenceBlow F. C., Walton M. A., Murray R., Cunningham R. M., Chermack S. T., Barry K. L. et al. Intervention attendance among emergency department patients with alcohol‐ and drug‐use disorders. J Stud Alcohol Drugs 2010; 71: 713 – 19.en_US
dc.identifier.citedreferenceBaird J., Longabaugh R., Lee C. S., Nirenberg T. D., Woolard R., Mello M. J. et al. Treatment completion in a brief motivational intervention in the emergency department: the effect of multiple interventions and therapists' behavior. Alcohol Clin Exp Res 2007; 31: 71s – 75s.en_US
dc.identifier.citedreferenceArean P. A., Ayalon L., Jin C., McCulloch C. E., Linkins K., Chen H. et al. Integrated specialty mental health care among older minorities improves access but not outcomes: results of the PRISM‐E study. Int J Geriatr Psychiatry 2008; 23: 1086 – 92.en_US
dc.identifier.citedreferenceOslin D. W., Grantham S., Coakley E., Maxwell J., Miles K., Ware J. et al. PRISM‐E: comparison of integrated care and enhanced specialty referral in managing at‐risk alcohol use. Psychiatr Serv 2006; 57: 954 – 8.en_US
dc.identifier.citedreferenceYoung M. M., Stevens A., Porath‐Waller A., Pirie T., Garritty C., Skidmore B. et al. Effectiveness of brief interventions as part of the screening, brief intervention and referral to treatment (SBIRT) model for reducing the non‐medical use of psychoactive substances: a systematic review protocol. Systematic Reviews 2012; 1: 22.en_US
dc.identifier.citedreferenceMcKellar J., Austin J., Moos R. Building the first step: a review of low‐intensity interventions for stepped care. Addict Sci Clin Pract 2012; 7: 26.en_US
dc.identifier.citedreferenceStataCorp Stata Statistical Software: Release 13. College Station, TX: StataCorp, LP; 2013.en_US
dc.identifier.citedreferenceHiggins J. P. T., Thompson S. G. Quantifying heterogeneity in a meta‐analysis. Stat Med 2002; 21: 1539 – 58.en_US
dc.identifier.citedreferenceSackett D. L., Gent M. Controversy in counting and attributing events in clinical trials. N Engl J Med 1979; 301: 1410 – 12.en_US
dc.identifier.citedreferenceGlass J. E., Bucholz K. K. Concordance between self‐reports and archival records of physician visits: a case–control study comparing individuals with and without alcohol use disorders in the community. Drug Alcohol Depend 2011; 116: 57 – 63.en_US
dc.identifier.citedreferenceKilleen T. K., Brady K. T., Gold P. B., Tyson C., Simpson K. N. Comparison of self‐report versus agency records of service utilization in a community sample of individuals with alcohol use disorders. Drug Alcohol Depend 2004; 73: 141 – 17.en_US
dc.identifier.citedreferenceBalk E. M., Bonis P. A. L., Moskowitz H., Schmid C. H., Ioannidis J. P. A., Wang C. et al. Correlation of quality measures with estimates of treatment effect in meta‐analyses of randomized controlled trials. JAMA 2002; 287: 2973 – 82.en_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


Files in this item

Show simple item record

Remediation of Harmful Language

The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.

Accessibility

If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.