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Recent declines in life expectancy in the US, especially for middle-aged White persons, have called attention to mortality from deaths of despair – deaths due to alcohol, drugs, and suicide. Using data from the Centers for Disease Control and the U.S. Census Bureau, this paper examined deaths of despair by race/ethnicity, age, cause of death, birth cohort, and sex in Missouri. We focused on Area Agencies on Aging as geographic units of interest to increase usefulness of our findings to public administrators. Deaths of despair began trending up for all age groups beginning in 2007–2009, with the sharpest increases occurring for Black or African American non-Hispanics beginning in 2013–2015. The most dramatic increases occurred for the population age 50–59 in St. Louis City and Area Agency on Aging regions in southern Missouri. For older adults, considerable variation in rates, trends, and cause of deaths of despair is evident across the state. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to understand the gaps in college students’ knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper about their experience. The papers were analyzed using conventional content analysis for information that was new to participants by looking for key words that suggested learning took place. Results: The findings indicated that the majority of participants learned new information. Most learning occurred regarding sexually transmitted infections (ie, types, symptoms, prevalence, treatment, testing) and correct condom use. There were also demographic differences regarding reported new information. Conclusions: Findings can be used to develop future sex education programs for college students by providing college educators with an understanding of where students lack knowledge of sexual health. [ABSTRACT FROM PUBLISHER]

Although the historical impact of racial segregation and ongoing health and economic inequities between older Black and White adults is well documented, little is known about the relationships among race, individual- and neighborhood-resources, and formal volunteering in later life. This study explores this intersection. Individual-level data from 268 respondents aged 55+ were collected in the St. Louis metropolitan area through paper-based mail surveys. Objective neighborhood data were obtained at the zip code level from secondary sources and matched with respondents. Using exploratory factor analysis, we constructed a 14-item environmental scale with 3 neighborhood dimensions (economic, social, and built environment). Older Black adults had lower levels of education; had fewer financial assets; lived in neighborhoods with less economic resources and lower built environment scores; and fewer formally volunteered when compared to older White adults. Individual resources (financial assets, health) and neighborhood resources (social and built environment) were positively associated with formal volunteering among older Black adults. Only individual resources (age, marital status, financial assets, health) were associated with formal volunteering among older White adults. A coherent set of policies that bolsters individual and environmental capacities may increase the rate of volunteerism among older black adults. [ABSTRACT FROM AUTHOR]

This study explored the experiences of older adult volunteers who pivoted from in-person tutoring to letter writing and online tutoring during the COVID-19 pandemic. Sixty-one older adult volunteers were surveyed in the beginning and end of the school year about their experiences, including their perceived benefits, challenges, and feedback on the pandemic transition. Eleven of the surveyed volunteers participated in focus groups at the end of the school year. Perceived benefits included having a positive impact on a child's life and meaningful engagement during the pandemic, and perceived challenges included difficulty engaging students and lack of control over learning environments. The participants also suggested increasing opportunities for informal interactions with staff and students, technology training, and peer support between volunteers. There was agreement that the remote volunteering experience was not a substitute for in-person tutoring, but it was better than no volunteering at all. [ABSTRACT FROM AUTHOR]

The specific aim was to characterize retail purchases of red and processed meat and other major protein-rich foods in the U.S. and by state. Supermarket scanner data from grocery stores, supermarkets, and big box stores collected from 2017-2019 (NielsenIQ, New York, NY) was used to characterize retail purchases of red meat, processed meat, and other protein-rich foods in thirty-one states representative of US retail food sales. Red meat, processed meat, poultry, seafood, eggs, other meats, and non-meat foods (beans, nuts, seeds, meat alternatives) by weight accounted for 25.9%, 20.4%, 25.8%, 5.9%, 12.6%, 1.3%, and 10.1%, respectively of total sales in 2017-2019. Mean per capita purchases of red meat by weight was 30.1 g/d, ranging from 45.4 g/d in Mississippi to 21.9 g/d in New York. Mean per capita purchases of processed meat by weight was 23.8 g/d, ranging from 36.6 g/d in Mississippi to 15.2 g/d in California. We observed statistically significant correlations between red and processed meat purchases with cardiovascular mortality and colorectal cancer by state. Per capita retail purchases of red and processed meat appear to reflect a dietary pattern that is not consistent with current national and international dietary recommendations. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of adding cognitive strategy training to task-specific training (TST), called Cognitive Oriented Strategy Training Augmented Rehabilitation (COSTAR), compared with TST on activity and participation for chronic stroke survivors in an outpatient occupational therapy setting Materials and methods: We conducted an exploratory, single-blind, randomized controlled trial. Participants were randomized to TST or COSTAR protocol. Our primary outcomes measured activity and participation after stroke: the Stroke Impact Scale (SIS), Canadian Occupational Performance Measure (COPM), and Performance Quality Rating Scale (PQRS). Results: Forty-four participants were randomized. The COSTAR group had an attrition rate of 50% and an average of 9.8 of 12 sessions were completed; the TST group had an attrition rate of 25% and an average of 10.7 sessions were completed. Generally both groups improved on the majority of primary and secondary outcomes. There is little evidence to support a beneficial effect of COSTAR over TST for improvement of primary measures of activity performance or secondary measures. Conclusion: Negligible findings may be attributed to an inadvertent treatment group equivalency. Further, the research design did not allow for adequate measurement of the effect of each intervention on participants' ability to generalize learned skills. Stroke rehabilitation is largely based upon the principles of task-specific training, which is associated with improvements in upper extremity motor performance; however, TST requires a heavy dosage and lacks generalization to untrained activities. Cognitive strategy use has been associated with improved generalization of treatment to untrained activities and novel contexts however, it is often not used in TST protocols. The results of this preliminary study found no clear advantage between task-specific training and strategy-adapted task-specific training on trained and untrained activities when both interventions targeted activity performance. Task-specific training, if focused at the activity performance level rather than the impairment reduction level, may have a stronger effect on improving in individual's ability to participate in everyday life activities even without the use of cognitive-strategies. Incorporating cognitive strategy-use into TST would likely produce the greatest effect on generalization and transfer of the treatment effects to other activities and contexts rather than solely on activity performance of trained activities. [ABSTRACT FROM AUTHOR]

This interpretive study investigated how residents from socioeconomically challenged communities in North St. Louis understand and make meaning of environmental change and its impact on their well-being. Based on these localized data, we argue that racial minorities facing socioeconomic challenges may experience some environmental issues as less of an immediate concern than violence and racism. However, race and racism shape both the realities of environmental threats as well as residents' perceptions about environmental injustice in their communities. This study informs ecosocial work practices such as educating communities on local environmental issues and mobilizing community members toward environmental decision-making. [ABSTRACT FROM AUTHOR]

Human Papilloma Virus (HPV) is associated with various forms of cancer and is preventable with vaccination. Nurses are in a unique position to directly influence a person's decision to receive the HPV vaccine. A statewide sample of both school and public health nurses was used to assess knowledge and attitudes related to the HPV vaccine as well as nurse's behaviors and behavioral intentions toward educating parents and recommending the vaccine. Positive attitudes and adequate knowledge levels were found, however, the majority of school nurses did not provide information and resources to parents. Targeted health promotion programs for school nurses are recommended. [ABSTRACT FROM AUTHOR]

Ferguson, Missouri became the center of the nation’s attention when an unarmed African American teenager was killed by a Caucasian police officer. Civic unrest continued for weeks. The aim of this study was to learn how older adults experienced the social unrest. Ten focus groups were conducted with 73 participants. Eight themes were identified. Issues related to safety were most commonly discussed. Participants reported a breakdown in intergenerational communications and expressed a desire for more exchange. Findings are being discussed with relevant organizations to increase the involvement of older adults in on-going community development efforts and to provide opportunities for intergenerational dialogue. [ABSTRACT FROM AUTHOR]

Background:Many medical schools have developed admission policies and clinical training programs designed to address the rural physician workforce shortages in their state. Aim:To enhance medical student rural clinical training experiences, and assist in preparing students for living and working in rural communities. Methods:As part of their Rural Track Clerkship (RTC) Program, the University of Missouri School of Medicine developed the Community Integration Program (CIP). Students, individually or in groups, voluntarily identify a health need and implement a community-based project to meet that need. Results:From 2007 to 2013, 80 (53%) students participated in the CIP and 86% completed the 11-item post-experience questionnaire. After the experience, participants reported a deeper understanding of the broad impact of a rural physician and the impact of rural culture on physician interactions. Participants reported they felt more integrated into the community, had a greater understanding of community health needs and resources, and were more likely to participate in future community service activities. Conclusions:The CIP exposes students to rural culture and helps them understand community health needs. Replication of this program can increase student interest in rural medicine and better prepare students for rural practice. [ABSTRACT FROM AUTHOR]

Finding methods to facilitate efficient assimilation of relevant health care information is important for quality outcomes, including promoting maximal wellness and optimal patient outcomes in vulnerable populations. The Internet is a promising information resource that can be used to reach those suffering from depression, but evidence of its efficacy in this population is lacking. This study was designed to examine The Stress Gym intervention, a web-enhanced behavioral self-management program (WEB-SM) consisting of nine modules focused on the management of stress and depression. The effect of the Stress Gym intervention on depressive symptoms, stress, and attention was examined, from pre- to post-intervention, in participants with stress and in participants who were experiencing both stress and depressive symptoms. A statistically significant decrease in depressive symptoms and stress was observed and there was a statistically significant increase in attention after the Stress Gym intervention, on average, for all participants. This study supports the efficacy of Stress Gym as a tool to reduce depressive symptoms, stress, and attentional difficulties. There were significant improvements in participants overall and for participants when they were segregated into two groups, those with stress only and those with depressive symptoms and stress. With many patients choosing to explore health concerns online, it is important to have evidence-based programs available online that can help them manage their symptoms. [ABSTRACT FROM AUTHOR]

This article explores the congregation as a conduit for civic engagement. Specifically examined are the effects of participation in congregations engaged in faith-based community organizing (FBCO). Civic engagement is examined by comparing FBCO-affiliated congregation members to non-FBCO-affiliated congregation members, local school participants, neighborhood association members, and those without such affiliations. Findings reveal that those engaged in FBCO evidence higher rates of civic engagement than members of the other groups. Implications for the field and future study are discussed. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters. Method: A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile. Results: Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps <.05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made. Conclusions: Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents' prior history of stressful events. [ABSTRACT FROM AUTHOR]

Although alcohol use continues to be a major problem, when high-risk users enter social services, they are not provided with empirically supported treatments (ESTs). This study investigates predictors of successful implementation in agencies not specializing in addiction services. Fifty-four frontline workers in six organizations were enrolled in the study. After completing self-administered surveys of organizational culture and climate and attitudes toward ESTs, workers were trained to implement a brief intervention. The results indicate that organizational factors and attitudes may not be related to implementation. Although high implementers had similar traits, further research is needed to characterize successful EST implementers. [ABSTRACT FROM AUTHOR]

Bisphenol A is a chemical used to make certain types of plastics and is found in numerous consumer products. Because scientific studies have raised concerns about Bisphenol A’s potential impact on human health, it has been removed from some (but not all) products. What many consumers do not know, however, is that Bisphenol A is often replaced with other, less-studied chemicals whose health implications are virtually unknown. This type of situation is known as a potential ‘regrettable substitution’, because the substitute material might actually be worse than the material that it replaces. Regrettable substitutions are a common concern among policymakers, and they are a real-world manifestation of the tension that can exist between the desire to avoid risk (known possible consequences that might or might not occur) and ambiguity (second-order uncertainty), which is itself aversive. In this article, we examine how people make such trade-offs using the example of Bisphenol A. Using data from Study 1, we show that people have inconsistent preferences towards these alternatives and that choice is largely determined by irrelevant contextual factors such as the order in which the alternatives are evaluated. Using data from Study 2, we further demonstrate that when people are informed of the presence of substitute chemicals, labelling the alternative product as ‘free’ of Bisphenol A causes them to be significantly more likely to choose the alternative despite its ambiguity. We discuss the relevance of these findings for extant psychological theories as well as their implications for risk, policy and health communication. [ABSTRACT FROM AUTHOR]

Delayed retirement incentives can promote employee retention. Survey data results (N= 261) were used to explore factors associated with retirement and participation in Missouri’s Deferred Retirement Option Provision (BackDROP), using a social stratification framework. Logistic regression analyses found that older age for full-retirement benefit eligibility increased the odds of delayed retirement, as did working more years for the state of Missouri. Longer length of work for Missouri increased the likelihood of being aware of one’s eligibility for BackDROP and of taking the BackDROP option, while working for pay in a non-state position decreased the odds of awareness and selection. Those who retired to do other things (rather than for health reasons or disliking the work) were also more likely to be knowledgeable of their BackDROP eligibility status. Race, sex, education, and marital status were not significant predictors. These findings inform design and implementation of delayed retirement policies in other states. [ABSTRACT FROM PUBLISHER]

Mental health workers with favorable attitudes toward empirically supported treatments (ESTs) are more likely to break through implementation barriers. The Evidence-Based Practice Attitude Scale has been shown to be reliable for mental health workers, but it has not been validated with addiction workers. This study investigates the use of the scale with a convenience sample of addiction workers from 4 agencies in 1 city. Results show that compared to mental health providers, addiction workers were more likely to view ESTs favorably if they were mandated and intuitively appealing. They also tended to rely more heavily on practical experience in forming attitudes toward treatment options. These results might help addiction agencies understand which types of workers are more likely to implement ESTs and inform effective engagement approaches specific to addiction workers. [ABSTRACT FROM AUTHOR]

This study aims to increase understanding about the challenges and opportunities for graduate schools of social work to meet the educational needs of midlife and older adults. Interviews were conducted with alumni who received their MSWs when they were age 40 or older. The Alumni Office provided 170 alumni’s contact information; 61 (36%) alumni were reached and 60 (98%) agreed to participate. Most (62%) switched from the for-profit sector into the nonprofit sector after their MSW, whereas others (38%) advanced within the human and social service occupations. Volunteering and caregiving were pathways to the MSW. Graduate schools could reshape recruitment and programming to facilitate an increasing number of older students. [ABSTRACT FROM PUBLISHER]

While local television news is the number-one source among Americans for health information, little attention has been given to what viewers are actually watching in these newscasts. Toward this end, a content analysis of local television health news stories (n = 416) was conducted, to examine how local health news stories utilize gain and loss message frames, and whether there are differences in story topics, location, length, presence of self-efficacy methods, and conflict, according to the message frames. Results showed that health news stories that dealt with advancements in treatment or philanthropic events were mainly reported using gain frames, while loss frame health news stories most frequently reported on statistics and trends. The majority of the health news stories were less than 30 seconds among all frames, and conflict appeared more often for the loss frames than gain frames. Furthermore, while efficacy information was mostly absent across all types of frames, gain frames were more likely than loss frames to present efficacy methods. Finally, efficacy information appeared most frequently in health-related statistical reports and prevention messages, while discrimination and health-policy stories had the least efficacy information in them. [ABSTRACT FROM AUTHOR]

The purpose of this cross sectional study of clergy (N = 493) was to examine the likelihood of referral to formal mental health providers by those clergy who counsel older adults. Responding clergy completed a brief questionnaire that included information on the amount of counselling they do with older adults, the Attitudes towards Older Adults and Mental Illness (AOAMI) scale, their relationships with mental health professionals, their knowledge of resources for referring people for additional help, and basic demographic data, such as race, age, years in the clergy, and education level. In logistic regression analysis, respondents with more education, those who felt less prepared to provide counselling, and those with more positive attitudes based on the AOAMI indicated that they were more likely to refer, and no differences were found based on their denominational affiliation race, relationships with mental health professionals, or knowledge of resources for referring people for additional help. We believe that public-private partnerships should be formed to help clergy recognise when referrals are appropriate, and to help improve relationships between clergy and mental health professionals. [ABSTRACT FROM PUBLISHER]

Unresolved disenfranchised grief is a contributing factor in occupational stress, burnout, and compassion fatigue in hospice workers; yet, to date, there have been no studies that have investigated group music therapy as an intervention for grief resolution for this population. The purpose of this study was to examine the effect of a single-session group music intervention for grief resolution (GMI-GR) on feelings of disenfranchised grief as experienced by hospice workers. A secondary purpose was to determine if the GMI-GR could have a significant positive effect on hospice workers' risk for burnout and compassion fatigue, as well as perceptions of work environment 1 month after participation. Study participants (N = 68) were hospice employees who experienced direct patient contact as part of their job. This study used a quasi-experimental design with participants randomly assigned by group. Experimental group participants received an hour-long GMI-GR and control group participants received no intervention. The primary study finding was a significant pre- to post-condition decline for GMI-GR participants on the subscale measure personal sacrifice burden and a non-significant reduction for feelings of burden. There were no significant differences for secondary measures of burnout, compassion fatigue, or perceived work environment 30 days post-condition. Thematic analysis of participant-written songs and messages to patients revealed recurring themes that pertained to both negative and positive aspects of hospice work. The results of this study suggest that a GMI-GR may be an effective intervention for reducing personal sacrifice burden felt by hospice workers. [ABSTRACT FROM AUTHOR]