Non-family Members Research Articles

Loneliness and Health Status Among Omani Older Adults.

Despite advances in health care and increased life expectancy, many older adults are at high risk for poor health and loneliness. The current study examined loneliness and its association with health among Omani older adults (aged ≥60 years). This descriptive, correlational study used structured questionnaires to collect data from 113 Omani older adults. More than one half (67.3%) of participants felt moderate to severe loneliness. Hierarchical regression analyses revealed that being female, older age (≥85 years), living with non-family members, and being unemployed were significant predictors of loneliness. Loneliness was a significant predictor of poor mental health status when sociodemographic and environmental factors were controlled. Findings indicate a significant number of Omani older adults are experiencing loneliness. We suggest that RNs specialize or practice in the care of older adults, and that researchers and policy makers take prompt action to address this urgent health issue before the occurrence of severe adverse health outcomes among this population. [Journal of Gerontological Nursing, 51(2), 33-42.].

Family successor CEO and innovation investment: a study based on the theoretical upper echelons and conflict theory

PurposeGrounded in upper echelons theory (UET) and conflict theory, the purpose of this study is to analyzes the innovative behavior of family firms from the perspective of the cognitive differences between successors and senior managers.Design/methodology/approachThis research employed a sample listed family firms in China. The obtained results were subjected to hierarchical regression analysis, complemented by rigorous model robustness testing through propensity score matching and regression with substitution variables.FindingsSuccessors engender task conflicts with family members in the top management team (TMT) due to cognitive differences, thereby stimulating corporate innovation. Conversely, successors engender relationship conflicts with non-family members in the TMT, impeding innovation. Furthermore, the performance expectations and the gender of the successor CEO also influence the relationship between cognitive differences and innovation between the successor and the TMT.Originality/valueThis study's originality and value lie in its innovative application of UET and conflict perspectives to dissect the intricate layers of intergenerational cognitive differences and their impact on the innovative behavior of family firms. It augments our comprehension of how the internal dynamics within family firms shape strategic innovation decisions.

Effectiveness of dispatcher-assisted cardiopulmonary resuscitation in private home versus public locations for out-of-hospital cardiac arrest patients − A retrospective cohort study

BackgroundDispatcher-assisted cardiopulmonary resuscitation (DACPR) significantly improves the survival of out-of-hospital cardiac arrest (OHCA) patients. However, the effectiveness of DACPR may vary depending on the location of the cardiac arrest. This study compares DACPR outcomes in private homes versus public places. MethodsThis retrospective cohort study included all OHCA incidents with emergency medical service (EMS) activation in Taichung City, Taiwan, from May 1, 2021, to April 30, 2022. Trained dispatch reviewers analyzed audio recordings of the included cases to extract DACPR indicators. The primary outcome was the number of successful chest compressions performed. Secondary outcomes included the proportion of OHCA recognition, call-to-chest compression time, call-to-OHCA recognition time, reasons for failure to identify OHCA, and reasons for failure to perform chest compressions or complete instructions. A subgroup analysis examined the caller-patient relationship in both locations. ResultsThe study included 1,160 OHCA patients, with 1,009 cases occurring in private homes and 151 in public places. Patients in public places were younger (60 vs 75 years), more often male (81.5 % vs 59.9 %), and had a higher rate of witnessed collapse compared to those in private homes (40.4 % vs 26.7 %, p < 0.001). Chest compressions were less frequently administered in public places (41.1 % vs 65.5 %, adjusted odds ratio [aOR]: 0.48 [0.31 to 0.75]). Public place cases had a lower proportion of OHCA recognition (51.9 % vs 76.9 %) and longer call-to-OHCA recognition times (108 vs 79 s) than those in private homes. Callers in public places more often encountered hazardous environments or physical barriers (16.4 % vs 8.3 %) and refused to execute instructions (11.0 % vs 4.1 %), but faced fewer emotional or psychological obstacles (0 % vs 8.3 %). Family members in private homes had a higher proportion of chest compressions (67.1 % vs 53.8 %, aOR: 1.81 [1.15 to 2.83]) and shorter times to chest compression (160 s vs 171 s, adjusted beta: −30 s [-55.6 to −6.3]) compared to non-family members. ConclusionThis study demonstrated reduced DACPR effectiveness in public places compared to private homes, potentially influenced by caller factors, environmental conditions, and the caller-patient relationship. Developing location-specific strategies is essential to enhance DACPR effectiveness.

Family farm and family business: Distinction and transition between concepts

Objective: Explore the conceptual limits between the family farming unit and the agricultural family business to identify the elements that determine the transition from one figure to another. Methodology: The distinctive elements between both concepts were determined from the most relevant definitions reported in the literature. Subsequently, the transition from a family farming unit to an agricultural family business was illustrated based on the case study of an enterprise dedicated to the production and collection of barley in Hidalgo, Mexico. Results: Seven distinctive elements were identified between the family farming unit and the agricultural family business. Two elements (the scale of production and productive diversification) drive the transition, three are modified consequently (the source of labor, the priority destination of productive activity, and the strength of the link with agricultural land), and the remaining two are carried out infrequently (assignment of a non-family member as main head and disengagement of family members from community life). Limitations: The findings of the study lack statistical representativeness as they come from a case study. Conclusions: The seven distinctive elements between a family farming unit and an agricultural family business can be used to study the phenomenon of entrepreneurship around agriculture and to typify agricultural units to design differentiated strategies for political intervention.

Disclosure and Experiences of HIV-Related Stigma among Adolescents and Young Adults Living with HIV in South Africa

Social networks expand rapidly in adolescence, increasing HIV status disclosure considerations and concerns for young people living with HIV, especially in settings where HIV-related stigma is prevalent. This study examines HIV disclosure and enacted stigma among adolescents and young adults living with HIV in South Africa. This study uses survey data from a sample of 1186 youth living with HIV, aged 14–24, and enrolled in peer support groups led by community-based organizations in KwaZulu Natal and Gauteng provinces, South Africa. Study participants completed a questionnaire on sociodemographic details, physical health, school attendance, who knew the individual’s HIV status, and experiences of HIV-related mistreatment. Mixed effects logistic regression examined the association between experiences of HIV-related mistreatment and factors that may inadvertently disclose one’s status, such as poor physical health and missed school, and knowledge of an individual’s HIV-positive status by their caregiver, household, friends, educators, and most recent sexual partner. Almost a quarter of the sample reported an experience of HIV-related mistreatment in the past six months. After controlling sociodemographic characteristics, missed school due to illness (AOR = 1.75, 95% CI = 1.27–2.43), and knowledge of HIV status by non-family members (AOR = 2.19, 95% CI = 1.60-3.00) were significantly associated with HIV-related mistreatment. Findings suggest that experiences of enacted stigma are common among youth and linked to poor physical health and knowledge of HIV status outside the family. Effective community-level stigma reduction interventions are urgently needed. In the meantime, adolescents need individualized disclosure counseling and support managing their physical health to prevent further inadvertent disclosure and discrimination.

The factors associated with the provision of public access defibrillation in Japan − A nationwide cohort study

AimThe association between out-of-hospital cardiac arrest (OHCA) and the appropriate provision of public access defibrillation (PAD) remains unclear. This study aimed to evaluate the factors associated with whether or not PAD was provided. MethodsThis retrospective cohort study utilized the All-Japan Utstein and Emergency Transport Registries in 2021. We included OHCA patients who were applied to automated external defibrillators (AEDs) by bystanders and were deemed eligible for defibrillation by an AED. We defined PAD provided or no PAD provided based on bystander defibrillation. Multivariable logistic regression analysis with the Firth bias adjustment method was employed to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the exploratory evaluation of factors associated with PAD provided. Results1949 patients were eligible for analysis (PAD provided, n = 1696 [87.0%]; no PAD provided, n = 253 [13.0%]). Factors positively associated with PAD provided were male (AOR [95% CI], 1.61 [1.17–2.21]; vs. female), other public place incidence (AOR [95% CI], 10.65 [1.40–1367.54]; vs. public place), non-family member witnessed (AOR [95% CI], 2.51 [1.86–3.42]; vs. unwitnessed) and conventional cardiopulmonary resuscitation (CPR), (AOR [95% CI], 1.75 [1.17–2.67]; vs. hands-only CPR). Conversely, factors negatively associated with no PAD provided were over 65 years old (AOR [95% CI], 0.48 [0.28–0.80]; vs. 19–64 yr), night-time onset (AOR [95% CI], 0.61 [0.45–0.83]; vs. daytime), non-cardiogenic (AOR [95% CI], 0.43 [0.31–0.61]; vs. cardiogenic), home setting (AOR [95% CI], 0.33 [0.14–0.83]; vs. public place), healthcare facility setting (AOR [95% CI], 0.40 [0.23–0.66]; vs. public place), no bystander CPR (AOR [95% CI], 0.31 [0.14–0.71]; vs. hands-only CPR), and dispatcher-assistance (AOR [95% CI], 0.72 [0.53–0.97]; vs. no dispatcher-assistance). ConclusionMale patients, other public place onset, witnessed by non-family and conventional CPR were associated with PAD provide. Therefore, training skilled first responders to use AEDs appropriately is necessary.

The impact of perceived walking environment on social support for older adults

The idea of new urbanism advocates for promoting social support, defined as the network of care or help a person receives from non-family members, by improving the walking environment and other components of new urbanism. However, the impact of the walking environment on social support, especially from the perspective of older adults’ perceptions, remains unclear. In a rapidly aging urban environment, the demand for walkable living spaces has increased among older adults. One typical measure of the walking environment, walking accessibility, often focuses on travel time and/or distance to different urban opportunities but ignores travelers’ subjective feelings and experiences about the walking environment. These subjective factors are important for policymakers to design, implement, and regulate appropriate plans and strategies to enhance social interaction among older adults at the community level. This study examines how, in the Chinese context, the perceived walking environment is associated with social support, mediated by walking time and perceived level of safety, using generalized structural equation models with data from the 2021 Chinese General Social Survey (CGSS). The results show that, as compared to walking time, perceived safety is more likely to be influenced by the perceived walking environment, which positively correlates with social support. This suggests that older adults feel more socially supported by their neighbors when they perceive their living environment as safe and walkable. These findings provide new evidence for decision-makers to develop and implement targeted policies on walking accessibility for older adults with better understanding of the relationship between the perceived walking environment and social support.

Good parent-child relationship protects against alcohol use in maltreated adolescent females carrying the MAOA-uVNTR susceptibility allele.

Risk-allele carriers of a Monoamine oxidase A (MAOA) gene, short-allele (MAOA-S) in males and long-allele (MAOA-L) in females, in the presence of a negative environment, are associated with alcohol misuse. Whether MAOA-S/L alleles also present susceptibility to a positive environment to mitigate the risk of alcohol misuse is unknown. Thus, we assessed the association of the three-way interaction of MAOA, maltreatment, and positive parent-child relationship with alcohol consumption among adolescents. This prospective study included 1416 adolescents (females: 59.88%) aged 16 - 19 years from Sweden, enrolled in the "Survey of Adolescent Life in Västmanland" in 2012. Adolescents self-reported alcohol consumption, maltreatment by a family (FM) or non-family member (NFM), parent-child relationship, and left saliva for MAOA genotyping. We observed sex-dependent results. Females carrying MAOA-L with FM or NFM and a good parent-child relationship reported lower alcohol consumption than those with an average or poor parent-child relationship. In males, the interactions were not significant. Results suggest MAOA-L in females, conventionally regarded as a "risk", is a "plasticity" allele as it is differentially susceptible to negative and positive environments. Results highlight the importance of a good parent-child relationship in mitigating the risk of alcohol misuse in maltreated individuals carrying genetic risk. However, the interactions were not significant after adjusting to several environmental and behavioural covariates, especially parent's alcohol use, negative parent-child relationship, and nicotine use (smoking and/or snus), suggesting predictor and outcome intersection. Future studies and frameworks for preventive strategies should consider these covariates together with alcohol consumption. More studies with larger sample sizes are needed to replicate the findings.

Perspectives of relatives of patients with end-stage kidney disease on kidney sources, commercial kidney donation, and barriers to living kidney donation in Nigeria: a qualitative study.

Kidney transplantation is the best mode of kidney replacement therapy. However, the shortage of organ donations has been a major challenge globally. Relatives of patients with end-stage kidney disease (ESKD) are potential kidney donors. We explored their perspectives about kidney donation, kidney commercialisation, and barriers to kidney donation. In-depth interviews were conducted among 28 relatives of ESKD patients across the six geopolitical zones and Federal Capital Territory of Nigeria. The interview focused on potential sources of kidney donors, kidney commercialisation and barriers to kidney donation. ATLAS.ti version 9.0.22.0 was used for data analysis. Mean age of the study participants was 41.57 ± 14.55years; 54% were females, 60.7% were married, 93% had tertiary education and 75% were first degree relatives of ESKD patients. There were 7 themes and 28 subthemes generated in this study. The potential sources of kidney donors identified by the study participants included commercial, hospital, family and non-family member donors. While some opined that a family member is the best choice as a kidney donor, others preferred a commercial donor. The majority of those interviewed do not believe that it is wrong to purchase a kidney, and would be willing to do so. Identified factors that promote kidney commercialisation were unwillingness of a family member to donate, having the financial capacity to purchase a kidney, non-fitness of family members to donate. Identified barriers to kidney donation were age, poor health status, polygamy, perceived poor expertise of the medical team, perceived risk of the procedure, parental influence and religious beliefs. The majority of participants lacked correct information about kidney donation. Implementation of educational programpolicies and laws regulating and reinforcing ethical principles of kidney donation and transplantation should be ensured.

Comparing Static-99R and STABLE-2007 profiles of people convicted of sexual offences in Hong Kong to Western normative data

ABSTRACT This study investigates cross-cultural applications of Static-99R and STABLE-2007 in assessing sexual recidivism risk in Hong Kong. Comparing scores of 249 incarcerated individuals convicted of sexual offences in Hong Kong with Western norms, results show greater cultural similarities in STABLE-2007 than Static-99R items. Hong Kong offenders exhibit higher total risk scores than those reported in Western validation samples. Notably, they appeared to ‘specialise’ in non-contact offences like taking up-skirt pictures, were less criminally involved, and had more non-male strangers or non-family members victims compared to Western validation samples. These findings underscore the importance of culturally sensitive risk assessment tools in diverse contexts. PRACTICE IMPACT STATEMENT In response to recent calls to examine the cross-cultural application of western-developed risk assessment tools, the present study examined the applicability of the Static-99R and STABLE-2007 among a sample of persons who had sexually offended in Hong Kong (HK). The research supported the Evaluation and Treatment Unit’s recent attempts to strengthen seamless continuation of care from custody and community, as the sentences of these individuals typically last for only a few weeks.

Sleep, Mental Health, and the Need for Physical and Real-Life Social Contact with (Non-)Family Members during the COVID-19 Pandemic: A Bayesian Network Analysis.

Background/Objectives: The forced social isolation implemented to prevent the spread of the COVID-19 virus was accompanied by a worsening of mental health, an increase in insomnia symptoms, and the emergence of 'skin hunger'-an increased longing for personal touch. This study aimed to enhance our understanding of the interconnection between sleep, mental health, and the need for physical (NPC) and real-life social contact (NRL-SC). Methods: A total of 2827 adults participated in an online survey during the second COVID-19 lockdown. A Bayesian Gaussian copula graphical model (BGCGM) and a Bayesian-directed acyclic graph (DAG) were estimated, and mixed ANOVAs were carried out. Results: NPC with non-family members (t(2091) = 12.55, p < 0.001, d = 0.27) and relational lifestyle satisfaction (t(2089) = 13.62, p < 0.001, d = 0.30) were lower during the second lockdown than before the pandemic. In our BGCGM, there were weak positive edges between the need for PC and RL-SC on one hand and sleep and mental health on the other. Conclusions: During the second lockdown, people craved less physical contact with non-family members and were less satisfied with their relational lifestyle than before the pandemic. Individuals with a greater need for PC and RL-SC reported poorer mental health (i.e., worry, depression, and mental fatigue).

Secure IoT Assistant-Based System For Alzheimer’s Disease

Alzheimer's disease is a neurological condition that gradually impairs a person's capacity for thought and memory. Gradually, it gets worse until it becomes a major hindrance to the way the person with the illness lives and functions in the world. The purpose of this research is to create a prototype for mild to moderate AD that provides safe information transmission and support services, allowing a family member to investigate it and safeguard the AD patient. The wearable prototype can distinguish between family and non-family members in recognized images and give a vocal communication with the individual's name. Additionally, the prototype makes it possible to track the AD person's location. The prototype makes their daily lives easier. Thus far, the prototype follows the individual with AD around and notifies caregivers of their whereabouts so that, if the patient leaves the house, they can securely return them home. Additionally, by detecting dampness, this prototype informs the patient's caregiver of their excrement. So, the prototype will help the patient in their daily life very efficiently.

“All employees are equal … but some are more equal than others”. Role identity and nonfamily member discrimination in family SMEs

PurposeThis paper aims to investigate if, under which conditions, and with which consequences, nonfamily members have the perception of being discriminated against as a consequence of nepotism and adverse selection practices. This research also aims to investigate whether the carried-out role influences the perception of being discriminated against among nonfamily member employees.Design/methodology/approachA quantitative approach was carried out by adopting a structural equation model (SEM) analysis. The survey investigated a sample of Italian family SMEs (participating companies N = 186, total questionnaires collected N = 838).FindingsDrawing on the multiple identities theory, findings show that role salience (RS) effectively contributes to reducing the unwanted effects of perceived discrimination (PD) among nonfamily member employees. In doing so, this study deepens the knowledge of nonfamily member employment conditions and their consequences on strategic outcomes such as organizational commitment (OC), organizational justice (OJ) and intention to quit (ITQ).Research limitations/implicationsBy adopting a self-categorization approach, this study also advances current theoretical literature, as this methodological lens could help scholars further understand diversity in family business.Practical implicationsThis study suggests it would be advisable to implement human resource management practices based on job rotation to promote cohesion and reduce perceived distances.Social implicationsSMEs are the most widespread type of firm in the world; as a consequence, avoiding PD among nonfamily member employees has general ethical relevance.Originality/valueThis study expands current literature by showing that RS plays an important role in determining levels of PD. This study also advances current literature by focusing on the impact of multiple identities on fairness and commitment at individual and group levels of analysis of family businesses.

SMEs fintech financing: does board governance matter?

The purpose of this study is to examine the board governance factors that influence a small and medium enterprise’s (SME’s) decision toward fintech financing. A structured questionnaire survey of 90 Malaysian SMEs was used and the data analyzed using the Heckman selection model and the marginal effect model. The results demonstrate that SMEs’ female board members, family board members, and the duality of their CEOs have a significant influence on their decision to obtain financing from fintech platforms. Professional services provided by experts have a negative influence on their decisions to engage in fintech financing. The SMEs’ board size, the length of their chairmen’s service, and non-family board members are negatively related to their decisions to apply for financing. The more male members that were on the board, the more likely the SME was to choose to apply for external financing during the survey year.

Relationship between health behavior compliance and prospect theory-based risk preferences during a pandemic of COVID-19

The outbreak of COVID-19 forced people to change their lifestyles. In this study, a questionnaire was administered to 1000 Chinese residents to investigate the effects of risk preferences based on prospect theory from behavioral economics, trust in a trust game, other people's expectations, and personal attributes on the adherence to quarantine measures during a pandemic.Factor analysis divided the preventive behaviors into (1) compliance for self-health care, (2) compliance for going outside, and (3) compliance for staying home alone. In Category 1, those who were more sensitive to gains than losses were more likely to have a health code, wash their hands longer, report instances of COVID-19, and disinfect often. In Category 2, they avoided volunteering at large hospitals, avoided trips to see acquaintances, avoided public walks, avoided meeting strangers, avoided going to garden centers, and wore masks when out and about. On the other hand, those more sensitive to 'losses' than 'gains' were found to work from home and socialize with non-family members in Category 3.Based on prospect theory, it was found that whether one values gains or losses has a strong influence on preventative behavior. In particular, the fact that those who place greater value on gains than on losses tend to be more proactive in preventative behavior is expected to shed new light on future government guidance for citizens and subtle nudges or prompts to influence behavior.

How family business practices are created, maintained, and transformed across generations from a community of practice lens

ABSTRACT We conceptualize the family business as a community of practice to advance an understanding of how individuals involved in family businesses collectively learn about family practices and how such practices are created, maintained, and transformed across generations. We utilize an in-depth case study of an 86-year-old family business, spanning three generations, drawing upon 50 interviews, 673 archival documents, and 25 observational instances across a 14-year period. Our findings reveal how practices are transferred across generations to family and non-family members, redefining how we view ‘family business’ based on shared practices.

The digitalization of family life: A multilevel conceptual framework

AbstractThe internet and digital technologies have penetrated all domains of people's lives, and family life is no exception. Despite being a characterizing feature of contemporary family change, the digitalization of family life has yet to be systematically theorized. Against this backdrop, this article develops a multilevel conceptual framework for understanding the digitalization of family life and illustrates the framework by synthesizing state‐of‐the‐art research from multiple disciplines across global contexts. At a micro level, as individuals “do” family online, digitalization influences diverse aspects of family practices, including family formation, functioning, and contact. How individuals “do” family online is not free‐floating but embedded in macro‐level economic, sociocultural, and political systems underpinning processes of digitalization. Bridging the micro–macro divide, family‐focused online communities serve as a pivotal intermediary at the meso level, where people display family life to, and exchange family‐related support with, mostly nonfamily members. Meso‐level online communities are key sites for forming and diffusing collective identities and shared family norms. Bringing together the three levels, the framework also considers cross‐level interrelations to develop a holistic digital ecology of family life. The article concludes by discussing the contributions of the framework to understanding family change and advancing family scholarship in the digital age.

Attitudes of Family Members and Caregivers Regarding Alzheimer's Disease Pre-Symptomatic Screening.

In recent years, studies have examined the acceptability and attitudes that influence the intention to early screen for Alzheimer's disease (AD) in the general population, older people, carers, and asymptomatic individuals who report a family history of AD. However, it remains unclear what specific factors promote or reduce the acceptability of pre-symptomatic screening. The aim of this study is to explore the attitudes of family and non-family members as well as caregivers and non-caregivers toward the pre-symptomatic screening of AD. A total of 213 participants completed the Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening (PRE-ADS) Questionnaire. Group comparisons using t-test and one-way ANOVA were used to examine differences in attitudes toward pre-symptomatic screening regarding age, family history, knowing someone with AD, influence of depression, and feelings of anxiety. The subscale "Acceptability of Screening" was developed to investigate the willingness to undergo pre-symptomatic screening. Participants with a family history showed greater acceptance of pre-symptomatic screening while both caregivers and non-caregivers had similar attitudes. People with a family history as well as those with personal connections to dementia indicate a greater need for knowledge. The findings suggest that younger adults appear to perceive less harm from testing, whereas those who experience higher levels of anxiety and depression seem to perceive more testing harms. Comparing the attitudes of people with and without a family history as well as caregivers and non-caregivers toward pre-symptomatic screening of AD is critical to understand the differences between these groups and develop comprehensive screening programs.

Positive, negative, and ambivalent dyads and triads with family and friends: A personal network study on how they are associated with young adults’ well-being

Although negative ties may cause stress and harm well-being, they are also considered fundamental in close and ongoing relationships. This study distinguishes positive, negative, and – when characterized by both valences – ambivalent ties. Analyzing almost 10,000 personal networks from the Swiss CH-X study shows that: (1) ambivalence among family members is more prevalent than among non-family members, (2) ambivalent family dyads or triads are not negatively associated with well-being, and (3) certain balanced family triads are associated with higher well-being and an unbalanced non-family triad is associated with lower well-being. These results suggest that conflicts are not necessarily detrimental to young adults’ well-being.

Patterns of cannabis use, perception of harm, and perceived impact of legislative change in an online sample of young adults from Lebanon: insight on recreational users versus dual motive users

BackgroundLebanon remains as one of the major sources of cannabis worldwide. In 2020, its government passed a legislation enabling the cultivation of local medicinal cannabis. This first study following the legislative change examines the overlapping use of cannabis for recreational/medicinal purposes and characteristics of the distinct cannabis user types.MethodsA total of 1230 young adults (18–24 years) filled an anonymous online survey in early 2020.ResultsYoung adults in the sample were distributed as follows: 33% 18–20 years; 60% males; 94% Lebanese; 75% students; and 89% living with family. The older young adults (21–24), males, those employed, living with non-family members, and who perceived themselves as being a little/lot richer than most were statistically significantly more present in the cannabis user subtypes (recreational only or recreational/medicinal) than non-cannabis users. When dual recreational/medicinal users are compared to recreational users only, the latter seemed to have a more conservative profile of behaviours, attitudes, and perceptions and acts of harm. The prevalence ratio comparing the prevalence of users supporting consuming cannabis “once or twice” in dual motive users vs. recreational users only was 1.13 for “once or twice”, 1.25 for “occasionally”, 1.64 for “regularly”, and 2.4 for “daily”. Any other illicit drug use was reported by 1% of the non-cannabis users, 36% of the recreational users only, and 58% of the recreational/medicinal users (p-value < 0.01). Similarly, any prescription drug use was reported by 3% of the non-cannabis users, 16% of the recreational users only, and 28% of both recreational/medicinal users (p-value < 0.01).ConclusionThe interface between recreational and medicinal cannabis use is complex. Dual motive users may warrant special attention as a subpopulation of cannabis users. This is relevant to contexts experiencing medicinal cannabis legislation changes, such as Lebanon, as policymakers and implementers should be sensitized to the emerging evidence for more data-informed policy changes.