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This study focused on how adopted adults who have reunited with at least one birth family member experienced identity shifts related to their original birth certificates (OBCs). Framed by the Communication Theory of Identity (CTI), 50 adopted adults discussed their experiences related to their OBCs and how their identities are connected to this symbol through three of the layers of CTI, the personal, enacted, and relational layers. Participants discussed the presence of an ambiguous and unsolvable identity that interpenetrated with their other identity layers. Findings extend CTI to include an additional layer for adoptees – phantom identity – which can explain the life adoptees would have lived had they not been adopted. This identity was salient for participants as it manifested in ways such as expressing frustration with obstacles in gaining access to their OBC and refocusing their professional life to support other adopted adults. Moreover, findings offer implications for the examination into current adoption record practices in the United States, additional state mutual consent registries, and increased access to adoption-competent counselors for adoptees. [ABSTRACT FROM AUTHOR]

To identify and appraise the existing clinical practice guidelines, consensus statements and Cochrane systematic reviews for the management of adult and paediatric focal spasticity to generate a single synthesized guideline. Systematic review of 12 electronic databases. Clinical practice guidelines, consensus statements and Cochrane systematic reviews for focal spasticity in adults and children. Included studies were appraised according to the AGREE II criteria. A total of 25 papers were included in this review, comprising 12 clinical practice guidelines, nine consensus statements and four Cochrane systematic reviews. The areas most strongly endorsed were: (1) management to be provided by a multi-disciplinary team, (2) therapy should be goal-directed, (3) goals to be developed in conjunction with the patient and family, and (4) importance of follow-up evaluations. There was a greater focus on activity outcomes and classification in the paediatric papers. The guidelines varied considerably in their quality, with AGREE II scores ranging from 52.8 to 97.1%. This systematic review has synthesized the key elements regarding principles of focal spasticity management, outcome measures, physical interventions and educational recommendations into a single, readily applied guideline available for clinical use. Despite considerable variability in the quality of the guidelines, several strong themes emerged. Focal spasticity management should be multi-disciplinary, patient-centred and goal-directed. Routine measurement of impairment and activity are strongly endorsed. Botulinum toxin A injection should only be provided as part of an integrated approach to focal spasticity management. [ABSTRACT FROM AUTHOR]

Given the intense politicisation of education, many teacher educators are caught in the cross-hairs of government's reform agendas, university expectations and student teacher needs. This paper reports on a study of 28 literacy teacher educators in four countries (Canada, US, Australia and England). This paper reports on the broad question: How is politics affecting literacy teacher educators? Three specific aspects are considered: their pedagogies, identity and well-being. It describes how their pedagogy (goals and teaching strategies) has narrowed because of mandated curriculum and exit exams. It shows how their identity as academics is being complicated because they often do not have time for their research. And their well-being is compromised because of excessive external inspections and as their community in the university splinters. [ABSTRACT FROM AUTHOR]

Megaselia halterata (Wood) (Diptera: Phoridae) is a major pest of cultivated white button mushrooms, Agaricus bisporus (J.E.Lange) Emil J. Imbach (Agaricales: Agaricaceae), in the United States. The incidence and severity of M. halterata have been increasing in recent years, possibly due to the removal of certain chemical pesticides from tolerance by the EPA. Farmers' demand for alternative control measures resulted in a label extension of the fungal biopesticide BotaniGard® ES, which contains viable spores of Beauveria bassiana (GHA strain), for use in mushroom crops. Here we describe laboratory bioassays to evaluate the efficacy of the label recommended dose of the abovementioned commercial biopesticide for control of immature and adult stages of M. halterata. According to our results, eggs and larvae of M. halterata were not susceptible to infection by B. bassiana whereas pupae displayed a partial susceptibility with mortality reaching up to 65%. Concerning adults of M. halterata exposure for 60 min to a paper surface sprayed with the registered label application rate of BotaniGard® ES led to 100% mortality within a period of 16 days and a mean survival time of 8.13 days, which differed significantly from the control batch, but unlikely to result in meaningful control of phorid populations in the field. Further studies should be examined to increase efficacy of the formulated product against immature and adult stages of M. halterata. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic unfolds, every aspect of daily life is being altered in response to the virus. The pandemic has altered secondary education. Classes online, teachers struggling to learn Zoom and make lessons meaningful and relevant to students. Students struggling to make sense of this moment, struggling with mental health issues due to the loss of routine and in many cases contact with adult role models. Unfortunately, in times of crisis such as these some of the most disenfranchized people in society are completely overlooked and forgotten, such as refugees. However, if more teachers were to leverage the social studies potential of current events such as the Coronavirus, greater empathy would be felt for marginalized people more starkly impacted by the pandemic, leading ultimately to a heightened sense of civic engagement among the next generation. The purpose of this paper is to assist teachers in guiding their students through analyzing current events, such as COVID-19's impact on refugees, toward developing civic mindedness. In addition to this, the paper will discuss some of the broader societal impacts the virus is having within the United States, as well as ways in which this event may be viewed as a historical subject in the future. The paper will begin by building the content knowledge of high school social studies teachers through addressing the following question: "What is the difference between a refugee entering the United States now versus one year ago before the COVID-19 pandemic?" Following this, the authors will present an inquiry-based learning segment designed to teach the History correlated to the COVID-19 pandemic to a classroom of secondary education students. The inquiry template follows the standard C3 format utilized by the State of Connecticut. [ABSTRACT FROM AUTHOR]

This paper addresses families' perceptions of corporate influence in career and technical education (CTE) through market-driven policies that enable data extraction for student profiling and seek to align K-12 education with business-driven needs. Aligning education with business needs can offer early employment, however, accelerating technological developments risk subjecting hyper-specialised individuals to highly unpredictable labour markets and ultimately job insecurity. Using grounded theory, we conducted in-depth interviews with families across the United States, to obtain their views on the hyper-specialisation in CTE. The emerging discourse is that powerful corporations offer makeshift hyper-specialisation curricula that fit their business needs and do not necessarily reflect, or indeed, consider children's best interests. This research contributes to scholarship by elucidating the views of families affected by the corporate influence in CTE. The collected stakeholder accounts suggest the need for more in-depth research on individuals who rely on CTE for future employment. [ABSTRACT FROM AUTHOR]

This paper examines factors associated with the retention and mobility of teachers of colour in one state in the USA, with a special focus on beginning and novice teachers. We examine year-by-year retention and mobility rates for four time periods, beginning in 2015–16. We use logistic regression models to investigate the relationship between retention and mobility status and a number of variables thought to influence teacher retention and mobility. We find that full-time status and years of teaching experience consistently predict retention and mobility, with large differences in predicted probabilities. We also find statistically significant differences in the retention and mobility rates of Latinx teachers compared to Black teachers. The paper concludes with policy implications for teacher education and induction, and a call for more complex analyses of the retention and mobility of teachers of colour, including the expanded use of disaggregated data by individual racial and ethnic groups. [ABSTRACT FROM AUTHOR]

In this paper, we apply the reproductive justice framework to discuss how gendered racism disadvantages pregnant and parenting young Black women aging out of foster care. Specifically, we highlight the reversal of Roe v Wade as reflective of the United States' long legacy of efforts to control Black women's reproduction. We then discuss the structural factors contributing to the reproductive injustices of young Black women aging out of care, including a lack of access to sexual and reproductive health education, barriers to educational attainment, and foster care-based relational and placement deficits. We conclude with research, practice, and policy enhancements. [ABSTRACT FROM AUTHOR]

Purpose: Using a minority stress paradigm, this paper examines the relationship between anti-transgender discrimination, harassment, and violence among transgender adults. Methods: Data from the 2015 U.S. National Transgender Survey were used to examine twenty types of anti-transgender experiences/problems (e.g., harassment at work, problems with police officials, verbal and physical assaults) in a sample of 27,715 transgender Americans aged 18 or older. Binge drinking during the previous month was the dependent variable, and eight control measures were examined in the multivariate analysis. Results: Experiencing any of the twenty types of anti-transgender discrimination, harassment, or violence increased the odds of binge drinking by 48%. Experiencing many such problems increased the odds of binge drinking by 104%. Multivariate analysis showed that anti-transgender discrimination, harassment, and violence remains a predictor of binge drinking even when other key measures are taken into account. Younger people, racial minority group members, and persons who were not married or "involved" were at particularly great risk. Conclusions: Consistent with the minority stress paradigm, the more different types of anti-transgender experiences people had, the more likely they were to engage in binge drinking. Targeted intervention needs to help transgender persons to avoid anti-transgender discrimination, harassment, and violence to the greatest extent possible, and to develop resiliency skills whenever they are victimized. This is particularly true for transgender persons who are younger, minority, and not "involved" in a relationship. [ABSTRACT FROM AUTHOR]

This paper aimed to explore BDSM involvement and its effects on mental health. The study had four objectives: (1) quantify frequencies of BDSM self-labels, (2) describe patterns of BDSM involvement subtypes (i.e. fantasy, behaviour, and identity), (3) compare BDSM-related involvement among two samples: members of the National Coalition for Sexual Freedom (NCSF) and a non-NCSF sample of adults interested in or practicing BDSM, and (4) understand whether BDSM identity specialty interest group membership is associated with enhanced health (i.e. coping). Data were drawn from archival survey data on sexuality and health. Participants (N = 1036) completed BDSM identity and behaviour measures. The most common BDSM identities were 'dominant' and 'submissive'. NCSF members adopted BDSM identity labels more frequently compared to general adult BDSM practitioners. Dominant and submissive fantasy and behaviour varied by gender, sexual orientation, and relationship status. For example, cisgender men reported elevated patterns of dominant and lowered submissive BDSM involvement. Compared to non-NCSF members, NCSF members reported higher dominant and submissive fantasies and behaviours, and better mental health and emotion regulation. Finally, submissive fantasy involvement displayed statistically significant, but weak, positive associations with psychological health. Potential implications for public health practice, theory development, and future research are discussed. [ABSTRACT FROM AUTHOR]

As concerns about the effects of health misinformation rise, understanding why misbeliefs are accepted is increasingly important. People believe repeated statements more than novel statements, an effect known as truth by repetition, however this has not been examined in the context of tobacco information. Misbeliefs about tobacco are rampant and novel facts about tobacco are viewed as less believable. This paper examines how repetition of true and false tobacco statements affects truth perceptions. We recruited an online sample of 1,436 U.S. adults in May 2021. In an exposure phase, each participant rated their interest in 30 randomly selected statements about tobacco products and general knowledge trivia, half of them true and half false. The study had a two (tobacco product) by two (familiarity of statement claim) between-subjects design and a two (statement truth) by two (statement repetition) within-subjects design. During the testing phase participants rated the truthfulness of 24 repeated statements and 24 unseen statements. Repetition of true and false tobacco statements increased their subjective truth (diff=.20, p <.001), and the effect was larger for false claims compared to true claims. This underscores the importance of strategies to inoculate people against misinformation and calls for interventions that can stop the repetition of newly generated false claims. [ABSTRACT FROM AUTHOR]

Objective: This one-year pilot study investigated the effectiveness of a multimedia campaign, Heart Healthy U (HHU), to increase awareness about the link between unhealthy behaviors and risk for heart disease among emerging adults on a college campus. This paper describes the implementation of HHU. Participants: The HHU campaign was implemented from the Fall of 2019 through Spring 2020 and during this time there were approximately 15,043 enrolled students at the south eastern U.S. college campus. Methods: The HHU campaign employed print (e.g., banners, posters, and yard signs) and electronic formats (e.g., email, Instagram). We designed the methods across three phases: (1) relationship building and formative research, (2) campaign development, and (3) the Heart Healthy U campaign launch. Results: The HHU encountered challenges when the novel coronavirus (COVID-19 or SARS-co-V2) interrupted campus life, however we relied on the electronic formats to reach students during the state-wide lockdown/quarantine mandates. In addition, there were two changes to the HHU health messages. First, we updated the health messages to illustrate that eating healthy and engaging in physical activity supports immune function. Next, we developed new health messages to address effects of physical isolation and anxiety by promoting psychological well-being during this historic public health crisis. Conclusions: We asked whether a multimedia campaign on a college campus could encourage emerging adults to consume fruits and vegetables and engage in physical activity according to the federally-recommended guidelines. It is essential that interventions intended to reach today's emerging adults be presented in formats that they use (e.g., social media platforms), supported by campus administrators, and endorsed by peer influencers. In conclusion, more intervention studies are needed to counter the unhealthy social norm behaviors common to college campus life that increase heart disease risk, particularly among marginalized populations. [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) is highly prevalent among adults in the US and is associated with substantial personal and societal costs. Yet only a small percentage of adults with AUD initiate treatment, including those with severe AUD symptoms who are most in need of treatment. In this paper we use latent profile analysis (LPA) to describe differences in symptoms of AUD severity and alcohol-related consequences among untreated adults with severe AUD symptoms who were recruited from the community. Identification of such differences will result in better understanding of this population and will improve methods of treatment outreach. The LPAs were conducted on the baseline data of 403 (50% male, 77% White, M age = 40.74 with severe AUD recruited from the community and enrolled in a trial of an intervention designed to encourage treatment initiation. Participants reported no prior AUD treatment history. The LPAs were based on indicators of AUD severity, alcohol-related negative consequences, and self-reported intention to initiate AUD treatment. The LPAs revealed 4 profiles. Profile membership was predicted by baseline participant sex and whether they were living with a partner and was associated with baseline past 30-days alcohol consumption. The findings characterize and describe the variability among adults in the community with untreated severe AUD on variables that tend to motivate such individuals to seek treatment, which could significantly advance treatment outreach efforts. [ABSTRACT FROM AUTHOR]

This paper describes a research project conducted with international doctoral students documenting student and faculty members' experiences in a writing workshop. The purpose of this study was to understand the complexities associated with international students' academic writing competencies and develop a supportive culture as they pursue their education in the US. Participation in the writing workshop aided students in progressing through the four stages of Burch's learning model. The findings suggest that, intensive writing experiences improve writing abilities, perceptions of writing, and knowledge of when to pursue writing assistance. In addition, the workshop supported the researchers in gaining insight into their international students' experiences leading towards improved pedagogy for this student population. [ABSTRACT FROM AUTHOR]

In this paper, Teaching Expertise in Three Countries project is used as an example to show the significance and contribution of international comparative research and to think about the possible implications for policy in early childhood education. The project studied the development of expertise in preschool teaching in Japan, China, and the United States by employing 'video-cued multivocal ethnography' to explore how teaching expertise is defined in each of these countries and what processes help teachers acquire advanced teaching skills. This project has shown similarities and culturally specific notions, in what the participants have to say about characteristics of less and more experienced teachers. These research findings raise issues and challenges in early childhood education that resonate with the situation not only in the three countries but also possibly in other countries, such as problematizing the role of remembering and reflection in professional practice and the value of experience. [ABSTRACT FROM AUTHOR]

Background: As a result of the intergenerational trauma impact and experience, Native Americans continue to exhibit trauma-related issues such as high rates of substance use. After leaving high school, the pressures and stress of continuing an education, finding work/employment, and the responsibilities related to family and tribal community obligations result in the Native American young adult being more vulnerable to substance use. Objective: The purpose of this paper is to report findings of the Talking Circle intervention impact on the outcome variables of Native-Reliance, substance use, stress, and behavioural health, depression, and cumulative trauma. Methods: Native-Reliance was the theoretical underpinning for the study, demonstrating culturally safe research. A pre-test/post-test one-group design was utilised to examine how the Talking Circle intervention influenced the outcome variables. In total, 75 Native American participants, ages 18–24, participated in the Talking Circle intervention sessions. Baseline pre-intervention measures were completed and were repeated at 6-month post-intervention. Results: At 6-month post-intervention, Native-Reliance significantly revealed an increase of 40.55 (t = 22.13, p <.001), sources of stress (SS) revealed a significant decline of 3.68 (t = −18.39, p <.001), behavioural health issues (BH) showed a significant decline of 3.63 (t = −15.36, p <.001), substance-related issues (SR) showed a significant decline of 3.57 (t = −15.24, p <.001), depression (PHQ-9) showed a significant decline of 4.85 (t = −17.02, p <.001), and cumulative trauma revealed a significant decline of 2.77 (t = −13.39, p <.001). Conclusions: The use of a culturally safe Talking Circle intervention evidenced a research approach that resulted in a positive impact on reducing substance use and increasing the well-being of young Native American young adults. Impact Statement: Culturally safer intervention environments are conducive to results in outcomes that are positive and effective. [ABSTRACT FROM AUTHOR]

This paper empirically examines the relations between homicide rates by age (adults 18 to 24 and adults 25 or older), the tattoo shop density, on-site and off-site alcohol outlets, and disadvantage. It offers an additional explanation for the relation between alcohol outlets and homicide besides alcohol availability and consumption being facilitators of such lethal violence, suggesting that these businesses are a proxy for attracting those most prone to violent behavior. The analysis estimated linear pooled cross-sectional time series models to test the relations between age-specific homicide rates and tattoo shop density, on-site alcohol density, off-site alcohol density, and a multidimensional measure of disadvantage. These relations were examined among 88 of the largest cities in the United States for the years 1998 to 2006 (city-years = 792). The findings showed positive relations between homicides rates involving young adults 18 to 24 years of age, off-site alcohol outlets, tattoo shops, controlling for disadvantage. Findings suggest business establishments that attract young adults increase the likelihood of lethal violence not solely because of the availability and consumption of alcohol, but by increasing the convergence in space and time of motivated offenders and suitable targets, with limited or absent capable guardianship. [ABSTRACT FROM AUTHOR]

Completing a social work graduate degree can be an exciting and a challenging time for students, but the addition of a global pandemic is likely impacting their educational experiences. Using a modified version of Photovoice, a photography-based research methodology, and reflection essays, this exploratory study sought to elevate the voices of graduate students' (N = 16) perspective on learning during COVID in an American university. Findings from the qualitative analyses of the photographs and their captions and the reflective essays suggested that many students realized their inner strength by persevering when life got very hard. Themes from these analyses were slightly more positive (i.e. support from others; developing coping strategies; improved graduate experience) than negative (i.e. loneliness; emotional; being sick). Students' viewpoint on learning during COVID provides insight into how instructors can develop creative pedagogies and support students as they persist in their pursuit of a social work degree. [ABSTRACT FROM AUTHOR]

Long COVID is associated with many symptoms, including fatigue. As some with long COVID report remission of symptoms over time, previous long COVID has become increasingly prevalent. This cross-sectional study assessed differences in fatigue and somatic symptom burden among individuals with current, previous, and no history of long COVID symptoms. An online survey was conducted with United States adults (N = 2,872), with 2,310 reporting never experiencing long COVID, 183 reporting previously experiencing long COVID, and 379 reporting currently experiencing long COVID. Multivariable linear regression analyses were used to assess the association of long COVID status with fatigue and somatic symptom burden. Participants were an average age of 41.3, with the majority identifying as female (51.7%), White (87.6%), and non-Hispanic or Latino/e (87.6%). Both fatigue and somatic symptoms were significantly higher among those with both current (ps < 0.001; d = 1.24, 1.38 respectively) and previous long COVID (ps < 0.001; d = 0.42, 0.82 respectively) compared to those reporting never having long COVID. These differences remained after accounting for health behaviors (alcohol use, tobacco use, physical activity, sleep). Long COVID, regardless of current presence, may be associated with fatigue and somatic symptom burden. [ABSTRACT FROM AUTHOR]

Undertreatment of mental illness is associated with greater acute care and costs and worse mental and physical outcomes. Structural barriers may contribute to worse care. National Health Interview Survey data for 2011–2017 were used to examine associations of psychological distress and nine structural barriers with four health services, guided by the Andersen Behavioral Model of Health Services Utilization. Per the Kessler-6 Scale, United States adults 18–64 years of age (sample size = 172,209, estimated annual population = 189.4 million) were categorized as: no or low psychological distress (NLPD: 79.2%), moderate (MPD: 17.1%), and serious (SPD: 3.7%). Those with MPD and SPD had higher likelihoods of any mental health visit (Adjusted Odds Ratio: 3.53; 8.36, respectively), hospitalization (AOR: 1.16; 1.55), emergency room/department visit (AOR: 1.62; 2.23), and lower likelihood of office visits (AOR: 0.42; 0.64) in the past 12 months compared to NLPD (all p < 0.001). Psychological distress was the largest contributor of explained variation for mental health visits (67%), hospitalization (37%), and ER/ED usage (47%). Adults with SPD and MPD faced structural barriers at higher proportions. For example, reports of "had trouble finding general doctor" were: NLPD (2.2%), MPD (6.0%), and SPD (11.8%). Eight structural barriers were positively associated with ER/ED use and five barriers negatively associated with office visits. Barriers significantly associated with all four outcomes were: "Told health care coverage not accepted" and "Delayed care, couldn't get appointment soon." Innovative policy solutions coupled with comparable innovations in care delivery for complex patient populations could ensure equitable access to health services for individuals with psychological distress. [ABSTRACT FROM AUTHOR]

Studies suggest Black Americans have a lower prevalence of depression than White Americans despite greater exposure to risk factors for depression across the life course. We examined whether this paradox exists among students in higher education, and whether the paradox may be partly explained by racial differences in reports of impairment from depression, which is a required criterion for clinical diagnosis. We analyzed data from the Healthy Minds Study (2020–2021), restricting the sample to young adults (18–29) who identified as either Black or White. Using modified Poisson regression models to estimate risk ratios, we examined associations between race and depression impairment across five levels of depression severity, adjusting for age and gender. Approximately 23% of Black students reported depression impairment, which is significantly lower than the 28% of White students who reported depression impairment. For all students, greater depression severity was associated with greater probability of impairment; however, the relationship was more modest among Black students. At severe, moderately severe, and moderate depression levels, Black students had lower risk of depression impairment compared with White students. White students may be more likely than Black students to report significant impairment at high levels of depression. These findings open the possibility that racial differences in the impairment criterion of clinical diagnoses may explain some the racial depression paradox. [ABSTRACT FROM AUTHOR]

Suicide continues to be one of the leading causes of death in the United States and lesbian, gay, and bisexual (LGB) individuals are disproportionately at risk of suicide in comparison to heterosexuals. We examined data from adults participating for five waves (2015–2019) of the National Survey on Drug Use and Health. We first determined whether there is differential risk of suicidal thoughts, suicide plans, and suicide attempts (self-injurious thoughts and behaviors [SITBs]) in the past year according to current sexual orientation. We then estimated linear trends in prevalence of each SITB outcome stratified by each sexual orientation category. We estimate that compared to heterosexual men and women, gay and bisexual men and lesbian and bisexual women are at greater odds of past-year suicidal thoughts, suicide plans, and suicide attempts, respective to their sexes. Between 2015 and 2019, suicidal thoughts increased among bisexual men (by 34.3%, p = 0.037), lesbian women (by 18.4%, p = 0.033), and bisexual women (by 15.7%, p < 0.001). Prevalence of suicide plans increased among heterosexual men (by 15.3%, p = 0.017), gay men (by 28.5%, p = 0.037), and bisexual women (by 23.2%, p < 0.001). Suicide attempts increased among bisexual women by 26.6% (p < 0.001). Sexual minority identity is a risk factor for SITBs. Bisexual women in particular are not only at greater risk for SITBs, but estimated prevalence has increased in recent years. More attention needs to be paid to LGB populations regarding future suicide prevention efforts. [ABSTRACT FROM AUTHOR]

Gamma-hydroxybutyrate (GHB) was a somewhat prevalent club drug two decades ago, but research has been lacking regarding the current epidemiology of use. In this study, prevalence and correlates of past-year GHB use were estimated based on noninstitutionalized US adults participating in the 2015-2020 National Survey of Drug Use and Health (N= 241,675). An estimated 0.05% (95% CI: 0.04-0.07) of adults in the US have used GHB in the past year. Compared to those age 18-25, those age 35-49 were at increased odds for use (aOR = 2.28, 95% CI: 1.02-5.10), and compared to heterosexual men, gay men in particular were at high odds for use (aOR = 27.82, 95% CI: 11.09-69.80). Those identifying as bisexual men (aOR = 3.39, 95% CI: 1.17-9.82) and lesbian/bisexual women (aOR = 3.37, 95% CI: 1.44-7.90) were also at high odds for use. Despite all drugs examined being significant correlates of use in bivariable models (ps < .001), only past-year use of methamphetamine (aOR = 15.68, 95% CI: 7.40-33.25), ketamine (aOR = 8.52, 95% CI: 2.67-27.20), and ecstasy (aOR = 4.41, 95% CI: 1.80-10.75) was associated with increased odds of use in the multivariable model. Results suggest that GHB use is currently rare, but gay men and people who use other party drugs are at particularly high risk for use. [ABSTRACT FROM AUTHOR]

Eating pathology (EP) is reported at alarmingly high rates among transgender and nonbinary (TNB) people. The present study investigates key associations between experiences that are common in TNB populations and EP. TNB individuals located within the United States (N = 212) who self-identified as currently experiencing disordered eating or an eating disorder were recruited from social media outlets and completed an online survey that included measures of EP, discrimination-based trauma symptoms, internalized transphobia, and gender dysphoria. The average age of participants was just over 27 years old (SD = 6.22) and the majority of participants (68.9%) were nonbinary. Data were analyzed using IBM SPSS version 28 and PROCESS 4.0. Discrimination trauma [β =.27, t(211) = 3.90, p <.001] and internalized transphobia [β =.21, t(211) = 3.03, p =.003] were significant predictors of EP in a multiple regression model. Additionally, internalized transphobia partially mediated the association between discrimination trauma and EP. Findings reinforce the need for trauma-informed and multiculturally competent provision of services for TNB populations presenting with eating concerns. Results also highlight the complex role that previously unexplored variables play in the etiology of EP for TNB populations. Implications and clinical recommendations are discussed. [ABSTRACT FROM AUTHOR]

Exposure to microaggressions can have detrimental impacts on the mental health of LGBTQ + emerging adults. Positive social relationships are a well-documented protective factor that help to buffer the impact of adversity on mental health in this population. However, the role of social relationships with pets has received minimal attention in research on LGBTQ + mental health, despite the high prevalence of pets in U.S. households. This cross-sectional study examined whether the association between interpersonal microaggressions and depressive symptoms among LGBTQ + emerging adults varied as a function of attachment to pets across three domains: love, emotion regulation, and personal growth. We recruited 163 LGBTQ + emerging adults (18-21 years) who lived with a cat and/or dog within the past year (98.8% sexual minority, 47.2% gender minority, 37.4% racial/ethnic minority). We found that love and emotion regulation significantly moderated the positive association between interpersonal microaggressions and depressive symptoms. Specifically, this association was only significant when love and emotion regulation were at moderate or high levels. These findings have important implications for practice with LGBTQ + pet owners, as it suggests that high levels of pet attachment may amplify the relation between interpersonal microaggressions and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective: To examine the effect of an evidence-based curriculum on stress perceptions across time. Participants: Hispanic college students from a Hispanic-serving institution in a U.S. southern border city. Methods: A permuted block design with repeated measures was used. Participants were randomly assigned to treatment and control groups. The treatment group received the Coping with Work and Family Stress (CWFS) evidence-based curriculum while the control group did not receive any programming. Data were collected from both the groups at baseline, exit, and at 3-month follow-up. Results: Stress reduction was observed among program participants however an unintended negative consequence of the intervention was found among those who experience intimate partner violence. Conclusion: The CWFS evidence-based intervention may be appropriate to use in reducing general types of stress but perhaps not stress resulting from intimate partner violence. [ABSTRACT FROM AUTHOR]

Focus group data from 92 youths from Italy and the U.S.A. indicate that Italians and Americans differ in perceived threshold of acceptability of drinking to excess. Youth from the U.S.A. were more accepting of intoxication than Italian youth, reflecting features of each respective dominant drinking culture. Alcohol gender double standards existed in both countries and were conceptually connected to sexuality. However, the social construction behind such connections differed across the two groups: focusing on harms to the woman in the U.S.A. and the respectability of her social group in Italy. [ABSTRACT FROM AUTHOR]

Objective: This study investigated factors associated with frequent moderate-to-vigorous intensity physical activity among United States (US) adults with asthma. Methods: This retrospective cross-sectional study included US adults (≥18 years) with asthma in the 2019 Medical Expenditure Panel Survey data. Logistic regression models that added sequential groups of variables were used to assess associations between predisposing (age, gender, race), enabling (marital status, poverty level, education level, insurance coverage, employment status), and need (smoking status, co-morbidities, mental health, physical health, functional limitations) factors and doing ≥30 min moderate-to-vigorous intensity physical activity ≥ five times per week. The alpha level was 0.05. Results: The study included 2,410 individuals, of which 46.9% (95% confidence interval [CI] = 44.2–49.6) reported doing frequent moderate-to-vigorous intensity physical activity. In fully adjusted analyses, the following variables were associated with a greater odds of reporting frequent moderate-to-vigorous intensity physical activity: men vs. women (adjusted odds ratio [AOR] = 1.4, 95% CI = 1.1–1.7), white vs. other races (AOR = 1.3, 95% CI = 1.0–1.6), excellent/very good/good vs. fair/poor physical health (AOR = 2.3, 95% CI = 1.7–3.0), and functional limitations no vs. yes (AOR = 1.7, 95% CI = 1.3–2.2). Conclusions: The factors identified in this study (gender, race, health status, and limitation status) may be helpful to target interventions to raise awareness and increase physical activity among US adults with asthma. Studies that can demonstrate a temporal relationship are needed to further our understanding of this topic. [ABSTRACT FROM AUTHOR]

Objectives: Substance use disorders (SUD) among older adults have become a serious public health concern. The purpose of this study was to assess which states in the Southern U.S. are more responsive to SUD treatment needs of older adults.Methods: This study is a secondary data analysis of the N-SSATS-2019 dataset.Results: There were 1,215 substance treatment facilities in the five states. Kentucky had the highest number of substance use treatment facilities (n = 449, 37%), followed by Georgia (357, 29%), Alabama (153, 13%), Louisiana (146, 12%) and then Mississippi (110, 9%). Out of the 1,215 facilities, only 20% (n = 244) indicated that they had programs specifically tailored for older adults. Kentucky had the largest number of facilities per 1 million older adults while Mississippi had the highest number of facilities per 1 million older adults offering detoxification services. Alabama had the lowest number of services per 1 million adults in all categories examined.Conclusion: Across the U.S., most adults with SUD do not have access to substance use treatment; in the southeastern region of the country, higher rates of poverty, rural geography and stigma, and lack of treatment availability may further complicate individuals' ability to access substance use-related medical care. [ABSTRACT FROM AUTHOR]

The objective of this study was to provide initial validity evidence for responses to the newly developed Well-Being Actions Self-Efficacy (WBASE) scale from adults with obesity under an exploratory latent variable approach. Longitudinal data (Nbaseline = 667 and N30 days post-baseline = 550) from the Well-Being and Physical Activity study (ClinicalTrials.gov, identifier: NCT03194854), which deployed the Fun For Wellness (FFW) intervention, were analyzed. The a priori measurement model exhibited close fit to baseline data within an exploratory framework. Similarly, there was strong evidence for at least partial temporal measurement invariance for the a priori WBASE scale measurement model. Convergent (and divergent) correlations between concordant (and discordant) pairs of well-being actions scores at baseline and latent well-being actions self-efficacy factors at 30 days post-baseline were observed. There was mixed evidence for the effectiveness of the FFW intervention to exert a direct effect on latent well-being actions self-efficacy at 30 days post-baseline. [ABSTRACT FROM AUTHOR]

HIV testing rates among US youth aged 13–24 years are sub-optimal, with high rates of missed testing opportunities in emergency departments (EDs). We assessed barriers to routine HIV testing of youth in urban ED settings from the perspective of healthcare providers. Ten physicians and nurses were recruited from the pediatric and adult EDs at a high-volume hospital in New York City, USA to complete in-depth interviews to provide their perspectives on barriers to routine HIV testing of youth ages 13 to 24 in EDs. Interviews were conducted using a semi-structured interview guide with questions and probes. All interviews were conducted via Zoom due to the COVID-19 pandemic and were audio-recorded and transcribed verbatim. Transcripts were coded independently by two researchers using an inductive thematic analysis approach. Participants often offered HIV testing to youth in the ED based on their perceptions of patients' HIV risk, with pediatric providers sometimes discouraging adolescents they perceived to be at low HIV risk from testing. Participants cited other priorities, logistics of blood-based testing, and discomfort discussing HIV as other reasons for not offering HIV testing to all youth in the ED. Efforts are needed to encourage providers to offer HIV testing to all youth regardless of perceived risk, as the ED often serves as youths' only point of contact with the healthcare system. Emphasis on this and the importance of early detection, along with institutional change, clear guidance, and support for the testing process may help increase youth testing and avoid missed HIV diagnosis opportunities. [ABSTRACT FROM AUTHOR]

Trends in HIV incidence and prevalence vary between younger MSM (YMSM) and older MSM (OMSM). HIV prevention was revolutionized with the advent of pre-exposure prophylaxis (PrEP), but uptake of PrEP among OMSM is relatively unknown. Community connectedness among MSM is a strong driver of prevention. This qualitative study sought to explore similarities and differences between YMSM and OMSM's knowledge, perceptions, and barriers of HIV prevention and understand how intergenerational communication may enhance engagement in prevention, especially PrEP. Twenty semi-structured, in-depth interviews (ten YMSM and ten OMSM) were conducted with HIV-negative, non-monogamous MSM aged 18–24 and 55+ years. Interviews were transcribed and coded using NVivo 12 to identify themes within each age group and compare between age groups. YMSM expressed greater knowledge and more positive perceptions of PrEP than OMSM. OMSM felt that PrEP use increased engagement in sexual risk behavior. Both groups emphasized a need for more conversations between different age groups of MSM to educate each other about forms of prevention and reduce stigma. Intergenerational communication among MSM about HIV risk and prevention strategies may be an effective way to address the generational gaps in knowledge and perceptions and enhance engagement in HIV prevention. [ABSTRACT FROM AUTHOR]

Background: Smoking-related health disparities are prevalent in the Latinx community in the United States (US). Although Social Determinants of Health (SDoH) are known to contribute to a myriad of health problems among the Latinx population, there is relatively limited work expressly aimed at elucidating SDoH among Latinx smokers. Perceived racial/ethnic discrimination is one SDoH construct that may be especially relevant to understanding smoking-related cognition for Latinx smokers in the US. Smoking outcome expectancies, reflecting beliefs about the consequences of smoking, are established cognitive processes that have been linked to the maintenance and relapse of smoking. The purpose of the present work is to investigate perceived racial/ethnic discrimination in relation to smoking outcome expectancies amongst Latinx smokers in the US. Method: Participants included 338 English-speaking Latinx adult daily cigarette smokers from the US (Mage = 35.5 years; SD = 8.65; age range 18–61; 37.3% female). Results: Results indicated that perceived racial/ethnic discrimination was related to greater levels of negative reinforcement, positive reinforcement, and appetite-weight control expectancies, but not negative consequences expectancies. Discussion: Overall, the current findings provide novel insight into the relationship between perceived racial/ethnic discrimination and smoking outcome expectancies amongst English-speaking Latinx cigarette users in the US. [ABSTRACT FROM AUTHOR]

Associative memory involves the ability to encode and remember the relationship between individual items. This ability can become diminished when there is a high degree of similarity between stimuli that are being learned. Associative memory errors often stem from the fact that lures include a high degree of item familiarity as well as mnemonic similarity with the original associative episode. The current set of experiments examined how this overlap, in the form of within-category similarity, affects veridical and false retrieval in both younger and older adults. Across three experiments, results suggest that mnemonic overlap between targets and lures is detrimental to the ability to discriminate between highly similar information. Specifically, shared category membership for targets and lures led to increased false associative memories across age groups. These results have implications for scenarios where there is a high degree of overlap between target and lure events and indicate that these types of associative memory distinctions are difficult irrespective of age. [ABSTRACT FROM AUTHOR]

This study examined levels of substance-specific risk factors such as perception of harm from substance use among young adults in a range of cannabis-permissive environments. The main objective was to inform future preventive interventions aimed at reducing cannabis use in the context of increasingly permissive environments. Data came from the Community Youth Development Study (CYDS) collected in 2016 when participants were about 23 years old (n = 1,722 participants residing in 46 U.S. states). Young adults self-reported their perceptions about the harms related to cannabis, alcohol, and cigarette use; attitudes about and ease of access to cannabis and other substances; and perceived wrongfulness and social acceptability of cannabis, alcohol, and cigarette use and of selling of cannabis and other illegal drugs. Young adults in more permissive cannabis contexts reported higher levels of all cannabis-specific risk factors (e.g., greater access to and more favorable attitudes about cannabis use), except for perception of harm from regular cannabis use. However, permissiveness of the cannabis environment was not associated with heightened levels of risk factors for other substance use (such as alcohol, cigarettes, and opioids). Future preventive interventions for young adults living in more permissive cannabis contexts may need to focus on cannabis-specific risk factors in particular and go beyond considerations of harm from regular use. Future studies should replicate these findings with other samples. [ABSTRACT FROM AUTHOR]

Educational attainment is increasingly associated with family inequality in the U.S., but there is little understanding about whether and how education stratifies attitudes toward eldercare. Using the General Social Survey 2012 Eldercare Module, I test the association between educational attainment and attitudes toward eldercare provisions of Instrumental Activities of Daily Living (IADL) including different combinations of help and payment for help. IADLs are the most common care received by older adults and needs are projected to grow, so understanding attitudes toward this type of care is timely and relevant. Results show that adults with a bachelor's degree or graduate/professional degree, compared to adults with less than a high school degree, are more likely to support complete family IADL eldercare, where families provide the care and any payment necessary for care, compared to complete outside IADL eldercare, where outside institutions provide both care and payment. Educational attainment is an important axis of stratification in the U.S. and may explain potentially bifurcated policy solutions desired among different groups. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) is atypical in the United States, especially among young adults. We designed and evaluated the effectiveness of a brief intervention about the benefits of perceived control and planning for end-of-life. Participants (N = 188) were randomized into three conditions and completed a cross-sectional questionnaire. Participants who received the intervention were less likely to worry about not getting enough care and more likely to anticipate completing verbal and written ACP within three months than were comparison group participants. Findings suggest the potential of brief interventions to raise awareness about the benefits of ACP and enhance completion among young adults. [ABSTRACT FROM AUTHOR]

The use of electronic cigarettes (e-cigarettes) has been rising among adolescents and adults in the United States, including among Asian Americans. However, despite being one of the largest racial/ethnic minority groups, the specific trends and patterns of e-cigarette use among Asian Americans are understudied and unclear. This review aimed to summarize relevant information in the last two decades. This systematic review followed the a priori guide outlined by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were gathered from PsycINFO, PubMed, Sage Journals Online, ScienceDirect, and SpringerLink. Forty articles were reviewed and analyzed. Most articles reviewed only reported on the prevalence rate of e-cigarettes among Asian Americans and indicated regional differences. Results noted between- and within-group differences among racial/ethnic groups that warrant further examination. There is a dearth of information regarding health outcomes and correlates or predictors of e-cigarette use among Asian Americans. Despite its popularity and prevalence among Asian Americans, the use of e-cigarettes and related factors or outcomes deserves more nuanced studies and analyses. It is important to delineate subgroup differences by adjusting study designs and data analytic methods to glean meaningful information regarding Asian American's e-cigarette use in the future. [ABSTRACT FROM AUTHOR]

Discordance between physicians and patients' health beliefs can impede health communication efforts. However, little research considers physicians' perceptions of patient beliefs, despite the importance of perceptions in shaping communication. In the current work, we examine instances of actual and perceived discordance between physicians and U.S. adults' beliefs regarding the causes and controllability of type 2 diabetes. 229 family physicians completed an online survey measuring their health beliefs and perceptions of their patients' beliefs. Physicians' responses were contrasted against beliefs from a national survey sample of 1,168 U.S. adults. T-tests assessed whether (a) physicians' beliefs diverged from the national sample's beliefs (actual discordance), (b) physicians perceived that their health beliefs diverged from their patients' beliefs (perceived discordance), and (c) physicians' perceptions of patient beliefs diverged from the national sample's beliefs (accuracy of perceived discordance). Findings revealed evidence of actual discordance; compared to the national sample, physicians were more likely to attribute type 2 diabetes to genes (versus lifestyle factors) and perceived greater control over developing diabetes. Moreover, although physicians perceived discordance between their own and their patients' beliefs, data from the national sample suggested that these gaps were less substantial than physicians expected. In particular, findings showed that physicians generally overestimated discordance, expecting that people would be less likely to (1) attribute the development of diabetes to lifestyle factors (versus genes), and (2) perceive control over developing diabetes, than was actually reported. Implications of actual and perceived discordance for effective health communication and patient education are discussed. [ABSTRACT FROM AUTHOR]

Despite the detrimental effects of incivility in the workplace, relatively little research examines peer-level incivility in social work education. Incivility literature from multiple countries has established that within the academy, individuals' bad behaviors coupled with nonexistent, weak, and inconsistent institutional policies as causes of the problem. This study analyzes qualitative data (n = 164) drawn from a larger survey (n = 243) collected from faculty members in social work education programs in the United States. The study explores personal experiences with incivility among social work faculty. In addition to the professional and personal impact of workplace incivility, three other themes emerge from these data: a discussion on how incivility occurs, the causes of incivility, and the role power and hierarchies have in supporting environments where these behaviors thrive. This study finds that incivility within social work education has negative long-term outcomes with implications for future job prospects, hiring decisions, and tenure and promotion. These data also confirm that consequences of microaggressions in the workplace are as harmful as overt acts of incivility. The study concludes with opportunities for leaders in social work education to identify and address individual behaviors while also assessing and addressing institutional oversight and response systems. [ABSTRACT FROM AUTHOR]

When the focus of the accreditation process for social work programs in the United States shifted to competency-based student achievement in 2008 the overall student experience in a program seemed to be sidelined. Another shift in these standards in 2015 renewed attention on the student experience, through a required assessment of the implicit curriculum. This study examines student evaluation of the implicit curriculum of more than 50 undergraduate and graduate social work programs using the Social Work Educational Assessment Package (SWEAP) Exit Instrument. Individual student and program characteristics were explored for their relationship to student assessment of the implicit curriculum. This quantitative, non-experimental, secondary data analysis utilized descriptive, bivariate and regression analyses of over 1400 individual student responses. Findings indicate that age, race, gender, and disability are all characteristics that have significant relationships to student evaluation of various aspects of the implicit curriculum. Recommendations for attention to the implicit curriculum for social work programs are discussed in light of the findings. [ABSTRACT FROM AUTHOR]

Sleep's impact on quality of life and health among the general population is well documented. Meanwhile, there is a growing number of policies across the United States that criminalize homelessness by outlawing sleeping or sheltering in public, but there is little research about sleep quality among people experiencing homelessness within the context of larger systems. Using data (N = 484) collected to explore public health implications of criminalization of homelessness, this study describes sleep among people experiencing homelessness in Denver, Colorado through an ecological systems perspective. Participants reported an average of 3.6 hours of sleep in a 24-hour period and participants, on average, slept 2.87 hours without being interrupted. Race, disability status, and military status have statistically significant correlations with interrupted sleep, suggesting the systems and structures associated with these demographics may be related to poor sleep. Furthermore, there is a statistically significant correlation between amount of sleep and uninterrupted sleep and feelings of depression, experiencing images or hallucinations, and feeling sick. In building upon previous research which shows that people experiencing homelessness typically get less than the recommended amount of sleep, this study illuminates both the systemic and self-reported health and well-being implications that poor sleep has among people experiencing homelessness. [ABSTRACT FROM AUTHOR]

Loneliness is a public health problem causing morbidity and mortality. Individuals with substance use problems are often lonelier than the general population. We evaluate the longitudinal associations between social influences, substance use, and loneliness among adolescents and young adults recruited from an urban Emergency Department (ED). We use secondary data from a natural history study of N = 599 youth (ages 14–24) who used drugs at baseline and completed biannual assessments for 24 months; 58% presented to the ED for an assault-related injury and a comparison group comprised 42% presenting for other reasons. Measures assessed cannabis use, alcohol use, and loneliness. Using GEE models, we evaluated the relationships between social influences (peers, parents), substance use, and loneliness via longitudinal data, de-coupling within- and between-person effects. Men reported lower loneliness over time. At the between-person level, individuals with greater alcohol and cannabis use severity and negative peer influences had greater loneliness; positive parental influences were associated with less loneliness. At the within-person level, greater alcohol use severity, negative peer influences, and parental substance use corresponded to increases in loneliness; positive parental influences corresponded to decreases in loneliness. Youth with more severe alcohol and cannabis use had greater loneliness over time. Within individuals, peer and parental social influences were particularly salient markers of loneliness. An ED visit provides an opportunity for linkage to personalized, supportive interventions to curtail negative outcomes of substance use and loneliness. [ABSTRACT FROM AUTHOR]

Youth at-risk for HIV are also at-risk for mental health disorders and psychiatric hospitalization. Understanding the association between engagement in HIV prevention, concurrent risk behaviors, and psychiatric hospitalization may lead to improvements in integrated prevention and mental health treatment efforts. Youth at-risk for HIV, aged 14–24 years old, predominantly Black/African American and Latinx (75%) were recruited through youth-serving clinics and community sites in Los Angeles (n = 839) and New Orleans (n = 647). We compared youth with and without histories of psychiatric hospitalization on engagement in HIV prevention, concurrent risk behaviors, and demographic characteristics. We examined predictors of hospitalization using multiple imputations for missing data. Hospitalized youth (30%) were more involved in HIV programs, but were less likely to use PrEP/PEP or condoms than non-hospitalized youth. The odds of hospitalization were higher for transgender/gender nonconforming youth relative to cisgender youth; the OR was increased after adjustment for concurrent risk behaviors. Hospitalization was associated with homelessness, trauma, incarceration, substance use, and involvement in substance abuse treatment programs. There is a continuing need to integrate the diagnosis and treatment of mental health disorders into HIV prevention programs to better address multiple challenges faced by vulnerable youth. [ABSTRACT FROM AUTHOR]

The study's aim was to determine the association between school-based violence and being under the influence of drugs/alcohol during the last sexual intercourse among US high-school adolescents. A total of 3136 students from the 2019 Youth Risk Behavior survey were included. Multivariate logistic regression models were conducted to examine associations of exposure to school-based violence and being under the influence of drugs/alcohol during the last sexual intercourse, adjusting for demographics, early initiation of risky behaviors, mental health indicators, and good school performance. Adolescents who had been threatened/injured with a weapon on school property showed higher odds of engagement in being under the influence of drugs/alcohol during their last sexual intercourse (aOR = 1.49(1.05, 2.11)). Study findings highlight the substantial need for addressing associated factors for RSBs. Future research should explore the longitudinal association between school-based violence and risky sexual behaviors. [ABSTRACT FROM AUTHOR]

Adinkra symbols are ubiquitous cultural artifacts in Ghana, West Africa. This qualitative multiple case study examined how proverbial meanings of Adinkra symbols impacted the cultural identity development of five Ghanaian emerging young adults. Using semi-structured interviews and an Adinkra printmaking activity, this study revealed six major themes describing how Adinkra symbols and their meanings inform participants' cultural identity. These themes included: exposure to Adinkra symbolism; religion, spiritual, and moral guidance; cultural significance and grounding; meaning making through visual expression; Ghanaian identity expression; and respect for parents, elders, and community. This study has implications for understanding how explicit cultural messages contribute to positive cultural identity development of Ghanaian emerging young adults, and how printmaking can be used as a creative method to promote positive mental health. [ABSTRACT FROM AUTHOR]

In any month, administrative data collected by government agencies contain a fraction of the polity's adults, namely those who have interacted with government agencies in that month. For researchers and policymakers who want to evaluate questions that require a spatial location of the whole population of adults at a given time (e.g. job–residence spatial mismatch, impacts of local policies), these fragmentary records are insufficient. Combining administrative data from several agencies in the State of Washington, United States (US), we impute residential histories by parameterizing the 'decay' in maintenance of an observed address. This process yields an imputed population whose demography and geographic distribution matches well with survey estimates. This work uses driving licence, voter, social services, and birth records to append address locations to Unemployment Insurance data, a process that could be replicated with administrative records in other US states and countries with sporadic address data from various agencies. [ABSTRACT FROM AUTHOR]

Approximately a decade ago, Wright and colleagues published three studies probing the nature of the relationship between heterosexual U.S. adults' attitudes toward homosexuality and pornography consumption. Adopting an "effects" perspective (while acknowledging the nonexperimental nature of their data), they reasoned that pornography use could either lead to more antagonistic attitudes (by consumers viewing homosexuality through pornography's lens of traditional masculinity) or accepting attitudes (by consumers viewing homosexuality through pornography's lens of sexual liberalism). Results of all three studies aligned with the latter explanation. The present study evaluated whether the findings from these studies were replicable in the current U.S. sociocultural climate. No evidence of attitudinal reversal was found. Pornography use still directly predicted moral acceptance of homosexuality and support for same-sex marriage and indirectly predicted these outcomes via a more nontraditional attitude toward sex. Pornography use was neither directly nor indirectly related to attitudes toward civil liberties for gay persons in the more recent data, however. Additionally, contrary to the earlier findings, associations were unmoderated by education, sex, and ethnicity. Possible reasons for these discrepant results are discussed and the limitations to causal inference posed by correlational data are emphasized. [ABSTRACT FROM AUTHOR]

In order to inform understanding of the public's health information management during the COVID-19 pandemic, we applied a modification of TMIM from a serial mediation model to a conditional process model (moderated mediation). In doing so, the current study attempted to refine some of the relational propositions of the original TMIM with a focus on efficacy while addressing the distinction between a mediator and a moderator in a behavioral decision model. Findings from an online survey of U.S. adults (n = 488) demonstrated that anxiety can positively motivate evaluation of information seeking during the COVID-19 pandemic context, a unique context of application for TMIM. Efficacy was found to be qualified as an individual difference variable that moderates the relationships of uncertainty perception and health decision. Our newly proposed conditional process framework of the TMIM opens research directions in health information-seeking and encourages researchers to continuously incorporate updated methodological thought and approach in applying and building communication theory. [ABSTRACT FROM AUTHOR]

Objectives: Emerging adulthood—spanning 18–29 years of age—is associated with the highest risk for onset of certain behavioral health disorders (e.g. major depression, bipolar disorder, psychosis, substance use disorders) and high prevalence of many behavioral health disorders. Yet, rates of mental health service use remain low in this age range. Racial/ethnic minorities are particularly impacted by individual, cultural/linguistic, and community-level barriers to mental health care. This study examined community-level factors associated with mental health service use and investigated whether these associations varied by race/ethnicity. Design: This study analyzed individual- and county-level data for emerging adults in the United States (N=3,294) from the nationally representative Collaborative Psychiatric Epidemiological Surveys (CPES). Using the Andersen Model of Health Care Utilization, analyses examined predisposing, enabling, and need factors utilized in prior studies with adult samples as well as novel community characteristics hypothesized to impact service use among emerging adults of diverse racial/ethnic backgrounds. Past-year use of both specialty and any mental health services were assessed, controlling for individual- and community-level variables, and adjusting for presence of past-year mental health disorder, overall health status, and functional impairment. Differences between racial/ethnic minority groups and Non-Latino Whites were tested through a multilevel model incorporating random intercepts logistic regression, with analysis focusing on the interaction between race/ethnicity and community-level supply variables. Results: For past-year use of specialty mental health services, density of hospitals with child wellness programs was linked to service use among Black emerging adults, whereas density of hospitals with linguistic/translation services was linked to service use among Latino emerging adults. Conclusions: This study expands on previous research in behavioral health disparities to examine ways to improve behavioral health services for an emerging adult population with unmet service needs and identifies specific community-level factors that can improve mental health for racial/ethnic minority emerging adults. [ABSTRACT FROM AUTHOR]