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This paper describes a national survey of Master of Social Work (MSW) program leaders' religious and spiritual beliefs and practices across the United States. Of the 257 eligible MSW programs primary contacts, 119 (46.8%) responded to the survey, with 90 completing the items related to religion and spirituality (RS). Specifically, those RS items assessed participants' religious affiliation, intrinsic religiosity, frequency of religious service attendance and private religious activities, the degree to which the respondent is religious or spiritual, and their RS practices. Among our respondents, 80 (88.9%) held a position of leadership (e.g., dean/chair, associate dean, or program director). The results indicated that these MSW program leaders consider religion and spirituality to be important, are engaging in various RS practices, and over half reporting elements of intrinsic religiosity. Additionally, we compared this sample's responses to these items with a national sample of clinical social workers and another sample of adults across the United States. Interestingly, a number of differences emerged between MSW program leaders' RS with LCSWs and US adults. This paper addresses the implications of these findings, particularly in light of the sample being predominantly MSW program leaders, including how leaders' RS may influence the implicit and explicit curricula. [ABSTRACT FROM AUTHOR]

This paper explores the use of withdrawal as a harm reduction approach to adolescent pregnancy prevention and its association with condom use. Data come from a baseline survey of a randomised controlled trial to test the effectiveness of FLASH, a sexual health education curriculum. Study participants completed electronic self-report surveys in health classes in their first or second year of high school (age range 14.1–17.9, mean 15.3 years). One-hundred and ninety-one students (12% of full sample) reported engaging in vaginal intercourse in the 3 months prior to the survey; of these, 66.0% reported using withdrawal as a birth control method, without significant differences by race, gender, region or birth control beliefs. Withdrawal was often used in combination with condoms (55.5%), periodic abstinence (40.0%) and birth control pills (13.4%). The effectiveness of withdrawal and its prevalence suggest an opportunity to reflect on how withdrawal is taught – moving from avoiding its use to a harm reduction approach to help sexually active youth avoid risk, reduce risk and reduce potential harm associated with sexual behaviours. Rather than focusing on withdrawal as risky, youth-serving professionals should acknowledge young people's efforts to prevent pregnancy and recognise the social and relational contexts of contraceptive choices. [ABSTRACT FROM AUTHOR]

Background: Though college students have high rates of heavy drinking, few studies have examined the various pathways through which risks affect drinking and whether this varies by institution. We examined whether alcohol expectancy mediates the relationship between social factors (i.e., hooking up, friends drinking, Greek affiliation, entitlement) and drinking behavior comparing college students from one Midwestern and one Southeastern university.Methods: In the 2013–14 academic year, 1,482 college students (51% female) enrolled in undergraduate courses at two public universities completed a paper and pencil survey of attitudes and experiences about dating, sexuality, and substance use. Multiple group path analysis was used to compare two institutions.Results: Drinking behavior was positively associated with hooking up more often, Greek affiliation, being male, having close friends who consume more alcohol, and greater alcohol expectancies. We found unique differences in the mediating pathways for the two campuses.Conclusion: This study provides a more nuanced understanding of risk factors for heavy drinking. Moreover, it adds to the scarce body of literature concerning entitlement and drinking and the unique pathways between two college campuses. Finally, the results could lead to the development of more specific intervention strategies to reduce risky drinking among U.S. college students. [ABSTRACT FROM PUBLISHER]

Background: The correlates of alcohol misuse among female Veterans are not well understood. The present study explored associations among alcohol misuse, demographic/military-related characteristics, interpersonal violence exposure, and posttraumatic stress disorder (PTSD) and depression symptom severity. Method: Participants were 369 female Veteran patients of the VA New England Healthcare System. Participants completed a paper-and-pencil mail survey that included validated assessments of alcohol misuse, interpersonal violence, and psychological distress. Results: Younger age, adulthood physical abuse, military sexual trauma, past-year psychological aggression by an intimate partner, and PTSD and depression symptom severity showed significant univariate associations with alcohol misuse (as indicated by unsafe drinking levels, presence or incipience of an alcohol use disorder, intrapersonal alcohol-related concerns, and/or interpersonal alcohol-related concerns). A couple of these associations remained significant when examined in logistic regression models. Conclusions: Findings suggest that female Veterans who are at risk for alcohol use disorders and/or are experiencing alcohol-related problems may benefit from screening and intervention efforts that take into account interpersonal violence exposures and mental health symptoms on a case-by-case basis. Results also suggest the importance of future research examining correlates and risk factors for substance misuse among female Veterans. [ABSTRACT FROM AUTHOR]

This study used a novel survey instrument to evaluate the hypothesis that U.S. agricultural producers have significantly different stress and recovery experiences following acute-onset natural disaster compared to their non-agricultural counterparts. Participants were recruited through local organizations and targeted email and social media in communities in Arkansas and Nebraska that had experienced violent tornadoes in 2014 and/or severe flooding in 2019. The survey instrument incorporated the Brief Resilience Scale, the Revised Impact of Event Scale referencing two time points, the Posttraumatic Growth Inventory-Short Form, and original questions. Demographic, exposure, stress, and recovery measures were analyzed in SAS with Chi-square tests, t-tests, Wilcoxon tests, and multiple linear regression modeling to test for differences between agricultural and non-agricultural groups in resilience, event exposure, stress symptoms in the week after the event, stress symptoms in the month before the survey, a calculated recovery ratio, and posttraumatic growth. Analysis sample (N = 159) contained 20.8% agricultural occupation, 71.1% female, and 49.1% over age 55. No significant differences were found between agricultural and non-agricultural participants when comparing resilience, stress, or recovery ratio measures. Unadjusted posttraumatic growth score was significantly lower in the agriculture group (P =.02), and an occupation group by sex interaction was significantly associated with posttraumatic growth score (P =.02) when controlled for number of initial posttraumatic stress symptoms in the adjusted model, with agricultural women showing lower growth. Overall, there was no evidence of significant difference in disaster stress and recovery between agricultural and rural, non-agricultural groups in this study. There was some evidence that women in agriculture may have lower levels of recovery. Data indicated that rural residents continue to experience posttraumatic-type symptoms up to 8 years beyond the acute-onset natural disaster events. Communities should include strategies to support mental and emotional health in their preparedness, response, and recovery plans with intentional inclusion of agricultural populations. [ABSTRACT FROM AUTHOR]

Background: The number of Accountable Care Organizations (ACOs) in the U.S. has been rapidly increasing during the past decade. Despite the growth of Accountable Care Organizations (ACOs), little is known about the factors that are associated with hospital leadership of ACOs that contract with public and private payers. Purpose: Using a resource dependency framework, this study examines the organizational characteristics and environmental factors that are associated with hospitals who are leading an ACO. Methodology: We used the data from the American Hospital Association (AHA) Annual Survey of Hospitals for 2018, the Area Health Resources Files and the Medicare Cost Reports. A multiple logistic regression was used to test associations of the independent variables with the hospital leadership of ACOs. Results: We found that nearly one third of the hospitals studied were leading an ACO. System affiliated and not-for-profit hospitals were more likely to be the leaders. Hospitals that lead an ACO offer more clinical services and have better financial performance. Metropolitan core-based statistical areas and per capita income were significantly positively associated with leading an ACO. However, the proportion of population aged 65 and over and the percentage of Medicare advantage penetration were significantly negatively associated with leading an ACO. Conclusions: Hospitals vary in leading an ACO, which may provide critical resources for them by creating an infrastructure that enables accountable care, extends their services into population health and value-based care programs increasingly promoted by public and commercial payers. [ABSTRACT FROM AUTHOR]

With advances in the treatment of HIV, people living with HIV (PLWH) are now expected to have a near-normal life expectancy, but challenges remain in the form of substantially poorer health-related quality of life (HRQoL) than the general population. Being overweight or obese may pose an additional burden in PLWH, but few studies have evaluated the relationship between body mass index (BMI) and HRQoL in PLWH. This study aimed to evaluate and describe the association between HRQoL and BMI among PLWH in the US. Data were obtained from the 2018 and 2019 US National Health and Wellness Survey, an online, self-reported, general population survey. Analyses included 575 PLWH who self-reported a physician diagnosis and prescription use for the treatment of HIV, as well as 1725 propensity score matched non-HIV controls. After adjusting for age, sex, race, and comorbidities, higher BMI was associated with poorer physical (β = −0.18, p = 0.005) and general (β = −0.42, p = 0.014) HRQoL among PLWH. Additionally, PLWH reported poorer mental, physical, and general HRQoL than non-HIV controls; these relationships were not moderated by BMI. The potential negative impact of higher BMI on patients' humanistic outcomes should be considered in HIV management, including selection of treatment. [ABSTRACT FROM AUTHOR]

Immigrant populations are more likely to suffer a significant amount of distress caused by type 2 diabetes mellitus (T2DM). Mobile health applications (mHealth apps) make T2DM self-care knowledge and tools more accessible, which holds promise to improve diabetes outcomes among immigrants. The social distancing protocol and concerns about virus spread in healthcare facilities during the COVID-19 pandemic further highlights the value of mobile technology to facilitate T2DM self-care management among underserved populations. This study examined Chinese and Hispanic immigrants' acceptability for adopting a mHealth app to facilitate T2DM self-management. This study used an embedded mixed methods design. Surveys were completed by 118 participants to understand their status quo of using mobile technology. Smartphones were used by 72.88% of respondents, and among them, the frequency of use was almost every day. Half participants had not used technology for health-related purposes. Then, semi-structured interviews with sixteen Chinese and eight Hispanic participants were completed to delve into intentions, facilitators, and barriers for adopting a T2DM app for tracking self-management. Performance expectancy and effort expectancy appeared to influence participants' intention to use the app. Family to provide technical support was an essential facilitator, while poor eyesight was a major barrier. These findings showed that Chinese and Hispanic immigrants were conditionally accepting a mobile application for T2DM self-management. Developing smartphone apps meeting performance and effort expectancies and addressing the technical support and eyesight issues are critical to adoption of mHealth to reduce T2DM disparities among Chinese and Hispanic immigrants. [ABSTRACT FROM AUTHOR]

Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers' understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur. [ABSTRACT FROM AUTHOR]

Non-binary and genderqueer (NBGQ) individuals do not identify with a binary gender identity. Some but not all NBGQ individuals identify as transgender, and it is currently unclear on which aspects of mental and sexual well-being NBGQ and binary transgender individuals may differ. To compare NBGQ, binary transgender and cisgender individuals on variables related to mental well-being, sexual well-being, and sexual self-concept discrepancies. We conducted an online questionnaire study in 125 transgender men, 72 transgender women, 78 NBGQ individuals, 98 cisgender men, and 107 cisgender women. For most variables, NBGQ individuals did not differ from binary transgender individuals. These two groups differed only on gender dysphoria and transgender specific body image worries, which were both lower in the NBGQ group. Compared to the cisgender group, NBGQ individuals scored higher on gender dysphoria, actual/ought sexual self-concept discrepancies, and actual/ideal sexual self-concept discrepancies, and lower on general life satisfaction and sexual esteem related to body perception. These results offer a first quantitative analysis of sexual well-being in NBGQ individuals, and highlight that – while both groups face unique challenges – NBGQ individuals encounter similar difficulties concerning mental and sexual well-being as binary transgender individuals. [ABSTRACT FROM AUTHOR]

Purpose: Research suggests social support may protect sexual minorities from the harmful effects of victimization that undermine mental and sexual health wellness; however, this relationship has been underexplored among a diverse youth population. We examined the association between lifetime homonegative victimization, perceived stress in the last month, and resilience factors among a diverse sample of adolescent sexual minority males. Methods: Data were collected between June 2018 and April 2020 as part of the MyPEEPS Mobile study, a multi-site randomized controlled trial evaluating the effectiveness of a mobile behavioral HIV prevention intervention for adolescents living in the U.S. We analyzed baseline survey data from 542 sexual minority males, aged 13–18 years. We used bivariate analyses to examine relationships among variables and multivariable linear regression models to determine if resilience factors attenuated the association between homonegative victimization and perceived stress. Results: Perceived stress was positively associated with younger age, internalized homophobia, experiencing verbal victimization, threats of being outed, and threats of physical violence. Relying on online friends for support and having good family relations both attenuated the relationship between verbal victimization and perceived stress. However, neither of these resilience factors significantly weakened the associations between perceived stress, threats of physical violence, and being outed. Conclusion: Resilience factors, including peer and family support, may play an attenuating role in the relationship between homonegative victimization and perceived stress among adolescent sexual minority males. ClinicalTrials.gov Identifier: NCT03167606 [ABSTRACT FROM AUTHOR]

There has been a dramatic increase in the rate of truancy cases throughout the United States, and despite truancy reduction efforts, truancy rates remained constant. Truancy is frequently associated with youth's high-risk behaviors and negative academic and life outcomes. Given the negative impact of truancy, conducting research on school attendance is critical to the success of youth over the life course. The current study examined a sample of 23,459 students referred to the Truancy Assessment and Service Centers (TASC) program to understand the characteristics of elementary school children at risk for truancy by exploring gender differences in the service needs reported by truant children and their families. Results indicate the leading risk factors for truancy include child behavioral problems, educational issues, and parental practices. Also, there were no significant differences between boys and girls related to truancy risk factors nor the types of services children in the TASC program needed. [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]

Objectives: Examine the social influence of adult children on the cardiovascular-related health behaviors of older South Asian (SA) immigrants to inform lifestyle interventions. Design: This mixed-methods study used data from an ancillary study of social networks (2014–2018) in the Mediators of Atherosclerosis in South Asians Living in America cohort. Phase 1 was a quantitative analysis of self-reported diet and physical activity among SA adults (n = 448, mean age = 58 years, SD 8.4) who named at least one adult child to their social network. The Alternative Healthy Eating Index (AHEI) was used to measure parents' diet; higher numbers indicate a healthier diet (range 0–110). Phase 2 was a thematic content analysis of in-depth qualitative interviews from a subsample of these parents (n = 23, mean age = 55, SD 7.6). Results: Parents with an adult child in their network who consumed uncooked vegetables daily had mean parental AHEI score 1.5 points higher (adjusted p-value = 0.03) than those who had a child in the network who ate uncooked vegetables less often. When at least one adult child in their network ate fresh fruit daily compared to less frequently or when at least one child ate non-SA food daily compared to less frequently, mean parental AHEI scores were higher by 2.0 (adjusted p-value = 0.01) and 1.6 (adjusted p-value = 0.03) points respectively. Parents with an adult child in their network who exercised at least weekly were more likely to meet guideline-recommended physical activity levels than parents with children who exercised less often (76% v. 56%, adjusted p-value = 0.02). Adult children provided social support and were seen as 'role models' for healthy behavior, especially when adopting Western health behaviors. Conclusion: Positive role modeling and support from adult children were important facilitators of healthy behavior change in older SA immigrants and can inform health behavior interventions for SA adults. [ABSTRACT FROM AUTHOR]

Over 390,000 child sexual abuse victims in the United States have not yet been identified. Due to the increased prevalence of Internet-driven child-sex offenders (e.g., child pornographers and travelers), detection becomes more elusive, and disclosure elicitations are more challenging for law enforcement. The current retrospective study examines an innovative, investigative method of voice stress analysis use, and describes its possible utility in identifying previously undetected sexual offending within these two offender populations. In the total sample of 82 arrestees with no known history of "hands-on" sexual offending, 0% initially admitted to sexually abusing at least one child. However, coinciding with voice stress analysis procedures, 40.2% of the suspect pool (57.1% of child pornographers and 36.7% of travelers) provided admissions to hands-on offenses. Also, 80.5% admitted to at least one sex crime offense during the pre and posttest stages of the investigation. All voice stress analysis "Stress Indicated" examinations resulted in verifiable disclosures (of victims and sex crimes). Critically, as a result of voice stress analysis procedures, 87 previously undiscovered live victims were identified. Finally, this study's description of specific characteristics and predictive qualities of victimizers vs. non-victimizers in each offender-type should benefit future investigators, researchers, and therapists alike. [ABSTRACT FROM AUTHOR]

Understanding the determinants of pre-exposure prophylaxis (PrEP) adherence is integral to reducing HIV incidence in the United States, especially for those at highest risk. To this end, the present study explored demographic, psychosocial, and behavioral factors related to adherence among 43 Southern, predominately Black, men who have sex with men (MSM). During the study months, 46% of the sample reported being nonadherent to PrEP. Those with more sexual partners (p =.05), greater self-efficacy for taking PrEP (p =.03), and those who felt condoms were less important (p =.02), were more likely to be adherent to PrEP at six-month follow-up. Further interventions that consider perceived sexual risk, condom use, and adherence self-efficacy are needed to improve PrEP adherence among Southern MSM. [ABSTRACT FROM AUTHOR]

While hope is an established strength within the catalog of positive psychology virtues and a theoretically established concept in economic development (Lybbert & Wydick, 2018), little applied research has considered the role of positive social institutions in maintaining hope under duress, especially among financially marginalized populations. Mattering is a social-psychological construct defined as an awareness that we are a significant part of the world around us (Elliott, Kao, & Grant, 2004). The authors tested the relationship between hope, spirituality, and three-dimensions of mattering (awareness, importance, and reliance), with adults experiencing income volatility while participating in an urban economic mobility intervention. Results indicate that subjects experiencing economic marginalization were more hopeful when they felt others chose to rely on them, even after taking personal spirituality into account. These findings suggest the importance of relationships and specific types of social connectedness in the expression of hope for economically marginalized individuals. [ABSTRACT FROM AUTHOR]

Objectives: Community, school, family, and individual factors protect against mental illness in general samples of adolescents. How these assets apply to Somali youth resettled to the United States (U.S.), a group with significant trauma exposure, remains unclear. We aimed to quantify which protective factors are associated with lower prevalence of depressive symptoms, suicidality, and self-injury among Somali youth in the U.S. compared with their non-Hispanic white peers. Design: Participants consisted of 8th, 9th, and 11th grade respondents to the 2016 Minnesota Student Survey, an anonymous school-administered statewide survey with 85.5% school district participation, who identified as Somali ethnicity (n = 1552) or as non-Hispanic white (n = 80,583). Multivariable logistic regression assessed odds of depressive symptoms, suicidal ideation and attempts, and self-harm, using eight protective factors (i.e. internal developmental assets, school engagement, empowerment, and family and teacher connectedness, caring adults and after-school activity frequency and quality) as independent variables. Models were run separately for Somali and white youth. Results: Somali youth reported similar rates of depressive symptoms, but lower levels of suicidal ideation or attempts and self-harm behaviors than their white peers (p < 0.001). All eight protective factors were associated with outcomes in the expected direction for white youth. For Somali youth, internal developmental assets (aOR 0.79, 95% CI: 0.65–0.97), empowerment (aOR 0.58, 95% CI: 0.45–0.73), family connectedness (aOR 0.60, 95% CI: 0.51–0.71), perception of caring adults in the community (aOR: 0.84, 95% CI: 0.76–0.92), and quality of after-school activities (aOR: 0.72, 95% CI: 0.61–0.86) were protective against depressive symptoms, with similar patterns for other outcomes. Other school factors protected Somali youth less consistently. Conclusions: Previously established protective factors against mental illness, particularly school factors, do not universally apply to Somali youth. Interventions that strengthen individual, family, or community factors, or that increase the relevance of school factors, should be explored for these youth. [ABSTRACT FROM AUTHOR]

This research aims to conduct a cross cultural study of Mainland Chinese and the United States (U.S.) seniors' personality traits and identify how they affect motivation, preferences, sociodemographic, and travel-related characteristics. Using samples of 496 Mainland Chinese and 532 U.S. senior responses, this research determined that three personality traits (psychocentric, midcentric, and allocentric) described U.S. senior participants and two personality traits (psychocentric and midcentric) described Mainland Chinese senior participants. Using a series of analytical tools including one-way ANOVA, regression, independent sample t-test, and chi-square tests, differences between senior tourists' personality traits and other variables were determined across U.S. and Mainland Chinese senior samples and across the measurement constructs. Practical implications are discussed and recommendations for future research are provided. [ABSTRACT FROM AUTHOR]

To (1) investigate the association between sprint power and aerobic power output (POpeakGXT) during a graded peak exercise test (GXT); and (2) validate the prediction models of POpeakGXT based on sprint power and personal and lesion characteristics. Wheelchair users with tetraplegia (N = 35) and paraplegia (N = 58) performed a 30 s-Wingate test and GXT on an asynchronous arm-crank ergometer. Data were split into samples to develop and validate the model. Sprint power (POmeanWingate and POpeakWingate, respectively) and POpeakGXT were determined. Regression analyses were performed to develop POpeakGXT prediction models. Candidate independent variables included POmeanWingate or POpeakWingate, age (years), sex, body mass (kg) or BMI (kg/m2), time since injury (TSI, years) and lesion level (tetraplegia/paraplegia). The best model was validated by comparing the predicted POpeakGXT with measured POpeakGXT. The best model (R2 = 0.76) to predict POpeakGXT included POmeanWingate, BMI and all other independent variables. No significant difference was found between measured (68 ± 35 W) and predicted POpeakGXT (68 ± 30 W, p = 0.97). The ICC was excellent (0.89 with 95% confidence intervals: 0.75–0.95). The 95% limits of agreement for the Bland–Altman plots were wide (−30 to 31 W). Strong associations were found between POmeanWingate and POpeakGXT. Although relative agreement was excellent, absolute agreement was low. There is a strong relationship between peak aerobic power output and sprint power output, both tested on an arm-crank ergometer, in people with spinal cord injury. A prediction model for peak aerobic power output, based on sprint power output and personal and lesion characteristics, showed a high explained variance. The predictive model can give a guideline for choosing the right graded exercise test protocol but should be used with caution. [ABSTRACT FROM AUTHOR]

Background: This study examined the moderating role of social support in the acculturation-obesity/central obesity relationship in Mexican American (MA) men and women. Methods: Data from NHANES 1999–2008 were used. Acculturation derived from language use, country of birth and length of residence in the U.S. Social support assessed emotional and financial support. BMI (≥30) and waist circumference (≥88 cm for women; ≥102 cm for men) measured obesity and central obesity, respectively. Weighted multivariate logistic regression models were used to describe associations. Results: Compared to less acculturation, more acculturation was associated with higher odds of obesity (ORs 2.48; 95% CI 1.06–5.83) and central obesity (2.90; 1.39–6.08) among MA men with low/no social support, but not among MA men reporting high social support. The modifying effects was not observed among women. Conclusion: Higher amounts of social support appeared to attenuate the risk of obesity/central obesity associated with acculturation. Interventions enhancing social support maybe effective among acculturated MAs, particularly among men. [ABSTRACT FROM AUTHOR]

A considerable portion of the US population still lacks access to technology, which causes challenges for marginalized communities to access information and services. Research on the digital divide exists in various contexts, but few have examined it in the context of human services. This study examines the impact of socioeconomic status on the methods of communication used when searching for service-related information. We analyzed both quantitative and qualitative data collected from 63 low-income and/or current human service users in Albany, New York. Education showed positive associations with smartphone ownership and personal computer use. Income was found only significant for tablet use. Non-whites were more likely to use mobile apps to web browsers compared to whites. Qualitative analysis revealed three key themes (i.e., availability, ease of use, and usefulness) as influencers of individual preference of methods. Our findings suggest that the digital divide is not merely about the income level but also educational background and culture. Human service professionals need to consider multiple channels to reach targeted populations for service delivery. Particularly, the collaboration between service providers and public libraries is worth examining to ensure the physical access and skills training for those who experience the digital divide at multiple levels. [ABSTRACT FROM AUTHOR]

Focused on the health literacy of two subgroups of Asian immigrants, Korean (N = 118) and Vietnamese (N = 105), this study examines the interrelationships among demographics, health literacy, self-perceived health status, and quality of life using structural equation modeling. Findings suggest that, although often labeled as Asian immigrants as an aggregate in the health literature, immigrants from Korea and Vietnam report significant differences in areas of demographics (age, citizenship, time in the US, education, marital status, English proficiency, and health insurance), utilization of health services (mammogram screening, pap smear, colorectal screening, visit to doctors), health literacy, and self-perceived health status, representing their own unique ethnic and immigration status. As hypothesized, for both Korean and Vietnamese immigrants, demographics (especially English proficiency) influence health literacy, which in turn affects self-perceived health status and quality of life. Self-perceived health status also directly affects quality of life. Therefore, health communication and interventions should focus on improving health literacy and alleviating health literacy disparities, which could increase the well-being and QOL among subgroups of Asian immigrants. [ABSTRACT FROM AUTHOR]

Evidence-based practice (EBP) implementation has been associated with quality health care outcomes, yet only a small proportion of occupational therapists implement EBP. We conducted a cross-sectional survey measuring EBP implementation, skill and knowledge, self-reflection behavior, and practice demographics to clarify implementation of EBP and factors acting as supports. A random sample of occupational therapists practicing in the U.S. was invited to participate; 578 surveys were included in the final analysis. Participants implemented EBP less than 1 time over the previous 8weeks; EBP use was highest in those with a doctorate (p = .002) and high self-reflection behavior (p = .001); EBP use was marginally higher in those with organizational support (p = .008; p = .009), time for EBP (p = .009), and access to full text articles (p = .006). Further investigation of how reflective practice and levels of doctoral education support EBP use are recommended. [ABSTRACT FROM AUTHOR]

This study sought to examine gendered variations in determinants of depression and anxiety symptoms among African immigrants in the United States. Data were drawn from a cross-sectional survey of first and second-generation immigrants from African countries living in the United States (N = 409). Ordinary Least Squares (OLS) regression results revealed gendered differences in factors that influence depression and anxiety symptoms. Second-generation immigrants showed decreased depression and anxiety symptoms among men, while income and marital status showed significant effects on depression and anxiety symptoms for women. Loneliness and discrimination were found to negatively impact the mental health of both female and male immigrants. Additionally, we found that gender did not moderate the effects of loneliness on depression and anxiety symptoms. Findings highlight the need for practitioners to better understand the unique risk and protective factors affecting female and male African immigrants in their efforts to provide effective mental health services to members of this population. [ABSTRACT FROM AUTHOR]

Background: Numeracy is one's ability to use numbers in context and influence's decision making and perceptions of health risk. Worry about lung cancer is an indicator of perceived risk (PR) and is related to interest in cessation and cancer screening. Purpose: The analysis sought to explore underlying relationships among worry about lung cancer, smoking-related disease risk perceptions, and numeracy in a web-based panel. Methods: A Web-based survey, including a numeracy measure, was completed by 1,682 participants aged 18–65 recruited in 2014. Former and current smokers were asked about LC worry and current smokers were asked their PR of diseases associated with smoking. Results: Females (m = 25.64, 95% CI [24.67, 26.61]), respondents aged 45–65 (m = 26.15, 95% CI [24.89, 27.41]), those who worry "all the time" about LC (m = 27.62, 95% CI [25.66, 29.58]), and respondents perceiving a higher risk of LC compared to other smokers (m = 28.84, 95% CI [27.66, 30.01]) expressed significantly higher PR means. Higher household income (OR = 1.20, 95% CI [1.08, 1.34]), age (OR = 0.86, 95% CI [0.77, 0.98]), and comparative LC risk (OR = 2.52, 95% CI [2.01, 3.17]) were significantly associated with greater worry about LC. As PR increases by one unit, the probability of worrying increases by 4.6%. For numeracy scores, odds ratio showed that as scores increased by one unit, the probability of worrying decreased by 11.9%. Discussion: In this study, we have shown that PR has a positive association with LC worry and that numeracy has a negative association with LC worry. Translation to Health Education Practice: This information can be used to target subpopulations with low PR and numeracy about their risks for lung cancer and to develop tailored messages to educate these people. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) [ABSTRACT FROM AUTHOR]

We assessed the attitudes, perceptions, and stereotypes toward Latino immigrants among 247 mental health professionals across 32 U.S. states. We also randomly presented two versions of an attitude measure that varied in their references to immigrants (“illegal aliens” or “undocumented immigrants”). Participants reported that they did not agree with the anti-immigration law Arizona SB 1070 and other similar bills. Also, greater multicultural awareness was related to positive attitudes and fewer stereotypes toward immigrants. Furthermore, participants who were asked to think about “undocumented immigrants” viewed Latino immigrants more positively than those who were asked think about “illegal aliens.” Findings show the continued need for multicultural awareness and competence training for mental health professionals, which align with the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (i.e., Principle E: Respect for People’s Rights and Dignity and Standard 3.01: Unfair Discrimination). Limitations and future directions for research are discussed. [ABSTRACT FROM AUTHOR]

This study tested the effect of Spanish-accented speech on sentence comprehension in children with different degrees of Spanish experience. The hypothesis was that earlier acquisition of Spanish would be associated with enhanced comprehension of Spanish-accented speech. Three groups of 5-6-year-old children were tested: monolingual English-speaking children, simultaneous Spanish-English bilingual children, and early English-Spanish bilingual children. The children completed a semantic judgment task in English on semantically meaningful and nonsensical sentences produced by a native English speaker and a native Spanish speaker characterized by a strong Spanish accent. All children were slower to respond to foreign accented speech, independent of language background. Monolingual and early bilingual children showed reduced comprehension accuracy of accented speech, but only for nonsensical sentences. Simultaneous bilingual children performed similarly to other groups for meaningful contexts, but were not as strongly affected by accent for nonsensical contexts. Together, the findings suggest that children’s language background has only a minor influence on processing of accented speech. [ABSTRACT FROM AUTHOR]

To address job satisfaction, and therefore employment retention, of hospice social workers, this study examined how relationships with other members of the interdisciplinary hospice team and perceptions of hospice leadership may be associated with job satisfaction of hospice social workers. The sample of 203 hospice social workers was recruited by e-mailing invitations to hospice social workers identified by hospice directors in three states, use of online social media sites accessed by hospice social workers, and snowball sampling. Study measures included professional experience, hospice characteristics, interdisciplinary collaboration, perception of servant leadership, and intrinsic and extrinsic job satisfaction. Variables significant in the model for intrinsic satisfaction were perception of servant leadership, interdisciplinary collaboration, and feeling valued by the hospice physician. Variables significant in the model for extrinsic satisfaction were perception of servant leadership, interdisciplinary collaboration, feeling valued by the hospice physician, and number of social workers at the hospice. Interdisciplinary collaboration was more important for intrinsic job satisfaction and leadership style was more important for extrinsic job satisfaction. Profit status of the hospice, experience of the social worker, caseload size, and other variables were not significant in either model. These results support previous findings that leadership style of the hospice director and relationships with hospice colleagues are important for hospice social workers’ job satisfaction. Such low-cost modifications to the hospice work environment, albeit not simple, may improve job satisfaction of hospice social workers. [ABSTRACT FROM AUTHOR]

Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers’ attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey. The results indicated that over one-half of the participants supported PAS legislation and is consistent with previous research on social workers across the country. While there was a range of perceived preparedness for implementation, a majority felt moderately to very prepared. Professional and personal values as well as professional experience influenced their perceived preparedness. Few social workers had accurate awareness of PAS legislation in their state or had attended workshops/events for further education or as a policy advocate. To practice competently and advocate at all levels of practice, hospice and palliative care at end-of-life social workers’ need to understand their own attitudes and values toward PAS and pursue additional education around this ethical issue. [ABSTRACT FROM AUTHOR]

Menopausal transition, in which biological and psychosocial changes are caused due to estrogen fluctuations, has been reported to increase cardiovascular risk among midlife women. The purposes of this study were to identify the clusters of midlife women by cardiovascular symptoms and to examine racial/ethnic differences in the clusters. This was a secondary analysis, in which hierarchical cluster and multinomial logistic analyses were conducted with the data (N = 966) collected in two previous studies. Three clusters were adopted: Cluster 1 (high vasomotor and low cardiorespiratory), Cluster 2 (low vasomotor and high cardiorespiratory and high discomfort/pain), and Cluster 3 (high discomfort/pain and high indigestion). [ABSTRACT FROM AUTHOR]

Objective: Latinos are disproportionately affected by diabetes and people with diabetes experience frequent hospital admissions and readmissions. Care transition interventions can help reduce rates of readmission; however, there are many barriers to recruiting Latinos for participation in intervention research. Exploring reasons for study refusal furthers understanding of low research participation rates to help researchers address barriers. Design: This study presents a cross-sectional, descriptive analysis of reasons for study refusal and attrition drawing from data collected as part of a randomized controlled trial conducted to test the effectiveness of a transitions intervention for diabetic Latino discharged from the hospital to home. Reasons for refusal were elicited from participants, transcribed, and coded. Descriptive statistics and bivariate analyses were used to compare those who completed the study and those who did not complete the study. Results: Reasons for study enrollment refusal and loss to follow-up ranged from difficulty locating the patient to homelessness to patient reluctance to having providers in the home. Study completers were more likely than non-completers to reside with family members (p = .03) and have a spouse as a primary caregiver (p = .08). Conclusions: Inner city, monolingual Latinos may be difficult to enroll and engage in home-based interventions. Although not representative of all Latino populations, barriers encountered highlight the need for targeted research to improve transitional care among Latinos. Researchers and clinicians should take into consideration the unique barriers that Latinos face in participating in research and intervention studies. [ABSTRACT FROM PUBLISHER]

Calcium intake has been consistently, modestly inversely associated with colorectal neoplasms, and supplemental calcium reduced adenoma recurrence in clinical trials. Milk products are the major source of dietary calcium in the United States, but their associations with colorectal neoplasms are unclear. Data pooled from three colonoscopy-based case-control studies of incident, sporadic colorectal adenoma (n= 807 cases, 2,185 controls) were analyzed using multivariable unconditional logistic regression. Residuals from linear regression models of milk with dietary calcium were estimated as the noncalcium, insulin-like growth factor 1-containing component of milk. For total, dietary, and supplemental calcium intakes, the adjusted odds ratios (ORs) comparing the highest to the lowest intake quintiles were 0.94 (95% confidence interval [CI] 0.69–1.30), 0.86 (CI 0.62–1.20), and 0.99 (CI 0.77–1.27), respectively. The corresponding ORs for consumption of total milk products, total milk, nonfat milk, total milk product residuals, and nonfat milk residuals were, respectively, 0.99, 0.90, 0.92, 0.94, and 0.95; all CIs included 1.0. For those who consumed any whole milk relative to those who consumed none, the OR was 1.15 (CI 0.89–1.49). These results are consistent with previous findings of modest inverse associations of calcium intakes with colorectal adenoma, but suggest that milk products may not be associated with adenoma. [ABSTRACT FROM PUBLISHER]

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Objectives:As the opposite end of the continuum from social integration, social isolation may put individuals at a greater risk of poor mental health. Conceptualizing living alone as an objective and structural indicator of social isolation and loneliness as subjective perceptions of social isolation, the present study hypothesized that the relation between living alone and depressive symptoms would be mediated by the feelings of loneliness. Using older Korean Americans as the target population, the mediation model was examined in consideration of the contextual factors such as demographics (age, gender, education, perceived income, and length of stay in the USA), health (chronic conditions and functional disability), and general social integration (size of social network and community social cohesion). Method:Date were drawn from surveys with 209 older Korean Americans in Central Texas (Mage= 69.6, SD = 7.5). Multivariate regression models of depressive symptoms were entered in the following order: (1) demographics, (2) health, (3) living alone, (4) social network/community social cohesion, and (5) loneliness. The mediation effect of loneliness in the relationship between living alone and depressive symptoms was separately examined using the bootstrapping method. Results:Loneliness was found to mediate the relation between living alone and depressive symptoms (indirect effect = 1.03, 95% CI = .05–2.08). Conclusion:The results suggest that subjective perceptions of loneliness may explain the mechanism through which objective social isolation presents risks for depressive symptoms in older Korean Americans. [ABSTRACT FROM AUTHOR]

We examined the cultural influence on perceived body weight and the level of health practices at a national and individual level. At a national level, we found that Japanese women (n = 80) overestimate body weight more than Korean (n = 82) and American (n = 63) women. At an individual level, individuals with interdependent self-construal were more prone to overestimate weight than those with independent self-construal (N = 182; American women). Based on the data, we identify that the relationship is mediated by self-criticism, and, importantly, it is self-criticism rather than perceived overweight that predicts the level of health activities. Health practitioners and campaign designers across cultures are recommended to concentrate on promoting positive body esteem instead of encouraging engagement in corrective health behaviors for weight loss. [ABSTRACT FROM AUTHOR]

Diseases of obesity have become a major cause of morbidity and mortality among people with schizophrenia and bipolar disorder. Childhood adversity has been associated with adult obesity in the general public, but has not been examined among people with mental illness. This study used a secondary analysis to examine childhood adversity and body mass index in people with schizophrenia and bipolar disorder. Among females, a history of physical abuse from parents or paternal emotional neglect was associated with an increased risk for obesity (OR = 3.34 and 2.44, respectively). [ABSTRACT FROM AUTHOR]

In 2009, the Food and Drug Administration (FDA) officially expanded approval of the Gardasil vaccine to include human papillomavirus (HPV) vaccination for boys and men, and in 2011, the Centers for Disease Control and Prevention (CDC) issued a formal recommendation for routine vaccination for this population. Despite these efforts, HPV vaccination rates for boys and men continue to fall short of public health targets. While news was breaking about the benefits of the HPV vaccine for boys and men, public attention shifted as a result of political debates concerning the vaccine. This study examines a pivotal time period for public health in which the vaccine became officially recommended for boys and men and at the same time became the center of political controversies in the lead-up to the 2012 presidential campaign. The current study extends previous research and presents a content analysis of newspaper articles (N = 154) about the HPV vaccine for the year 2011. Results indicate that the lack of comprehensive coverage of HPV and the HPV vaccine found in previous studies continued in this year. Results shed light on key political events that may have functioned to overshadow the recommendation of the HPV vaccine for boys and men. The implications of this pattern of news coverage can inform public health efforts to address low rates of HPV vaccination uptake among boys and men in present day. [ABSTRACT FROM PUBLISHER]

Education about how to administer eye drops may improve a patient's ability to instill his or her eye drops correctly. Our objectives were to (a) document the methods providers use to educate glaucoma patients about eye drop technique; (b) determine whether eye drop technique education varies by provider and patient characteristics; and (c) evaluate whether education predicts improved patient technique. We conducted an 8-month longitudinal study of 279 glaucoma patients and 15 providers in which we recorded on videotape the content of glaucoma office visits at two time points (baseline and 4- to 6-week follow-up) and videotaped patient eye drop technique at three time points (baseline, 4- to 6-week followup, and 8-month follow-up). Mann-Whitney rank sum tests were used to determine whether education was associated with improved patient eye drop technique over time. Ninety-four patients (34%) received technique education at either visit; 31% received verbal education and 10% received a technique demonstration. Only 24 patients (47%) who were new to eye drops received technique education at the baseline visit. Patients who were new to drops at baseline (p = .008) and patients who asked a question about drops (p < .001) were more likely to receive technique education. Education was not associated with improved technique. Eye drop technique education occurs infrequently during glaucoma office visits. Future studies should compare the effectiveness of different educational methods, such as patient demonstration versus provider verbal instruction, to determine which method is best at improving patient eye drop technique. [ABSTRACT FROM AUTHOR]

Background:Consumers are exposed to obesogenic environments on a regular basis. Building nutrition literacy is critical for sustaining healthy dietary habits for a lifetime and reducing the prevalence of chronic disease.Purpose:There is a need to investigate the impact of content-based network (CBN) technologies on perceptions of nutrition literacy because use of content-based networks has increased indefinitely.Methods:A quantitative survey analyzed by structural equation modeling was used to examine 3 CBN characteristics: serendipitous nutrition discovery, nutrition information management, and social modeling in relation to nutrition self-efficacy and perceptions of nutrition literacy among a sample of undergraduate students (N = 349).Results:Users of the website Pinterest, the most popular CBN, provide support that perception of the CBN's ability to provide access to new and interesting nutrition content impacts feelings of self-efficacy when making dietary decisions.Translation to Health Education Practice:Content-based networks such as Pinterest may serve as a viable tool for increasing nutrition literacy by enhancing self-efficacy around nutrition. [ABSTRACT FROM PUBLISHER]

Background: Cocaine and opioid co-use is a notable public health concern, but little is known about correlates of this behavior. Most prior findings come from treatment samples and concern cocaine and heroin. Findings from a nationally representative sample involving primarily prescription opioid misuse would expand knowledge. Methods: Past-12-month cocaine and/or opioid users in Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) formed the sample (N = 839). Cocaine-only, opioid-only, and cocaine/opioid co-users were compared regarding sociodemographics, other substance involvement, psychiatric, and medical conditions/events. Results: Opioid-only users were the largest group (n = 622), followed by cocaine-only (n = 144) and co-users (n = 73). The vast majority of opioid misuse was of prescription opioids (1.4% with past-12-month use of heroin). Notably, co-users did not differ from single drug users in frequency of use of either drug. Co-users did not have significantly greater incidence of any psychiatric conditions, medial conditions, or events. In preliminary analyses, co-users were more likely than either single use group to report several classes of other drug use. However, for most comparisons, opioid use did not add substantial risk beyond cocaine use. Differences on multiple sociodemographic variables suggested opioid-only users were at lowest risk of negative outcomes. These results may relate to a finding that opioid-only users were less likely to have sought treatment. Conclusions/importance: This sample of past-12-month cocaine and/or opioid users had greater involvement with other substances, more psychiatric and medical conditions compared to the general population. Co-users had greater involvement with other substances than opioid-only users in particular. [ABSTRACT FROM AUTHOR]

Background:Understanding the interrelationships between risky health behaviors is critical for health promotion efforts. Conceptual frameworks for understanding substance misuse (e.g. stepping-stone models) have not yet widely incorporated other risky behaviors, including those related to sexual health.Objectives:The goals of this study were to assess the relationship between early sexual debut and cannabis use, examine the role of licit substance use in this association, and evaluate differences by gender and race/ethnicity.Methods:Data came from the National Comorbidity Survey-Replication (NCS-R). Primary analysis was restricted to respondents who reported sexual debut at ≥12 years (n= 5,036). Age at sexual debut was categorized as early (<18 years), average (18 years) and late (>18 years). Logistic regression was used to assess the relationship between age at sexual debut and cannabis use. Interaction terms were used to evaluate effect modification by gender and race/ethnicity.Results:Later age of sexual debut was associated with lower odds of cannabis use relative to the average age of debut (AOR = 0.50, 95% CI = 0.37–0.66). For every year that respondents delayed their sexual debut, the relative odds of lifetime cannabis use declined by 17%. After accounting for alcohol and tobacco use the association between early sexual debut and cannabis was attenuated (AOR = 0.90, 95% CI = 0.68–1.20), while later age of debut remained protective (AOR = 0.57, 95% CI = 0.42–0.78). Results were generally consistent across race/ethnicity and gender.Conclusions:Multifactorial intervention strategies targeting both sexual health and substance use may be warranted. [ABSTRACT FROM PUBLISHER]

Primary objective: To examine differences between thebaseline-referencedandnorm-referencedapproaches for determining decrements in Automated Neuropsychological Assessment Metrics Version 4 TBI-MIL (ANAM) performance following mild traumatic brain injury (mTBI). Research design: ANAM data were reviewed for 616 US Service members, with 528 of this sample having experienced an mTBI and 88 were controls. Methods and procedures: Post-injury change scores were calculated for each sub-test: (1) normative change score = in-theater score – normative mean and (2) baseline change score = in-theater score – pre-deployment baseline. Reliable change cut-scores were applied to the change and the resulting frequency distributions were compared using McNemar tests. Receiver operator curves (ROC) using both samples (i.e. mTBI and control) were calculated for the change scores for each approach to determine the discriminate ability of the ANAM. Main outcomes and results: There were no statistical differences,p< 0.05 (Bonferonni-Holm corrected), between the approaches. When the area under the curve for the ROCs were averaged across sub-tests, there were no significant differences between either thenorm-referenced(0.65) or baseline-referenced (0.66) approaches,p> 0.05. Conclusions: Overall, the findings suggest there is no clear advantage of using thebaseline-referencedapproach overnorm-referencedapproach. [ABSTRACT FROM AUTHOR]

Objective. Little is known about diabetes status among US blacks by nativity. This study aims to measure differences in diabetes among US blacks by region of birth and examines potential explanations for subgroup differences. Design. Data from 47,751 blacks aged 25–74 pooled from the 2000–2013 waves of the National Health Interview Survey were analyzed. Logistic regression models predicted self-reported diabetes. The roles of education, income, body mass index (BMI), smoking, and duration of US residence were explored. Results. Compared to the US-born, foreign-born blacks had significantly lower reported diabetes prevalence (8.94% vs. 11.84%) and diabetes odds ratio [OR: 0.75; 95% confidence interval (CI): 0.62, 0.89], adjusting for socio-demographic characteristics. Further inclusion of education, income, household size, and smoking did not appreciably change the OR (0.77; 95% CI: 0.61, 0.86). Including an adjustment for BMI entirely eliminated the foreign-born advantage (OR 0.93; 95% CI: 0.78, 1.11). The foreign-born from the Caribbean/Americas had similar diabetes odds compared to the African-born. Among the foreign-born, an increased duration of US residence was associated with a higher diabetes odds, but these associations did not reach statistical significance (p > 0.05). Conclusion. The healthy immigrant advantage extended to diabetes among US blacks, a finding that is explained by lower levels of overweight/obesity among the foreign-born compared to the US-born. Nonetheless, more than 71.4% of the foreign-born were overweight or obese. Understanding the mechanisms through which exposure to the US environment leads to higher obesity and diabetes risk may aid prevention efforts for the rapidly growing foreign-born black subpopulation. [ABSTRACT FROM AUTHOR]

Background: Among Hispanics in USA, lower acculturation level has been found to be protective against alcohol abuse and depression. However, this relationship may not hold within at-risk samples. The prevalence and co-occurrence of hazardous drinking and depressive symptoms and their relationship to acculturation were examined among Hispanics enrolled in a study to reduce heavy drinking. At enrolment, all the participants reported past-month heavy drinking (one or more occasions of >4/5 drinks for females/males, and average weekly consumption >7/14 drinks per week). We explored whether gender moderated the effects of acculturation on hazardous drinking and depressive symptoms.Methods: Participants (N = 100) completed measures at baseline.Results: Eighty-nine percent of participants met criteria for hazardous alcohol use as assessed by the AUDIT and of those, 55% (n = 49) also reported elevated depressive symptoms. Of those who reported elevated depressive symptoms, nearly all (94%) met AUDIT criteria for hazardous drinking. Acculturation was not related to hazardous drinking or depressive symptoms in the full sample. Highly acculturated women reported more hazardous drinking than less acculturated women. Acculturation was not associated with hazardous drinking in men, but less acculturated men reported higher levels of depression than highly acculturated men.Discussion: Depression should be assessed in alcohol interventions for Hispanics. Alcohol interventions should be tailored for acculturation level and gender to improve relevance and efficacy. Clinical Trial Registration #NCT01996280. [ABSTRACT FROM AUTHOR]

Background: The "Why Try" phenomenon, a consequence of self-stigma, is a sense of futility that occurs when people believe they are unworthy or incapable of achieving personal goals because they apply the stereotypes of mental illness to themselves. Aims: This study examines a four-stage model of self-stigma (aware, agree, apply, and self-stigma harm) and examines the "why try" effect as a result. We do that by testing a measure of "why try." Method: Two hypothetical path models were tested. In the first, applying stereotypes to oneself leads to diminished self-respect and a sense of "why try". In the second, the effect of applying stereotypes on "why try" is mediated by diminished self-respect. Participants completed the "why try" measure along with measures of self-stigma, public stigma, recovery, and empowerment. Results: Results show application of stereotypes to oneself predicts diminished self-respect and "why try". "Why try" was significantly associated with agreement with public stigma, depression, and diminished sense of personal recovery. Conclusions: Findings from this study reveal the complex impact of self-stigma demonstrating its emotional and behavioral consequences. Implications for impacting self-stigma are discussed. [ABSTRACT FROM AUTHOR]

This study examined race and gender differences in use of specific types of protective behavioral strategies (PBS) and the moderating effects of race and gender on the relationship between PBS use and alcohol problems, controlling for alcohol use, among a large sample of Asian, Black, and White college drinkers. There were significant racial and gender differences in the types of PBS used. Moderation analyses indicated that PBS were more protective for women than men against experiencing alcohol-related problems. There were no significant race effects or race-by-gender interaction effects on alcohol problems. Implementing PBS may be beneficial for all college students. [ABSTRACT FROM AUTHOR]

Objective. Shift workers regularly report sleep problems, fatigue, and the need for recuperative rest between shifts (intershift recovery). We sought to characterize intershift recovery among emergency medical services (EMS) workers and the role of worker demographics and work-related factors. Methods. We combined cross-sectional survey data from two studies of EMS shift workers who completed standardized instruments, including the Occupational Fatigue Exhaustion Recovery (OFER) scale. A multivariable regression identified demographic and work factors most strongly associated with intershift recovery. Results. Mean intershift recovery among 450 EMS workers varied by clinical setting, general health status, length of work shift, sleep quality score, fatigue score, and daytime sleepiness. Recovery was better for EMS workers who report greater satisfaction with their schedule, higher for shift schedules >12 hours, and lowest for individuals who usually work 12-hour shifts. Conclusion. In this sample of EMS workers, greater recovery between shifts is associated with satisfaction with scheduling and longer shift length. There were weaker associations of recovery with health status, sleep quality, and workplace fatigue. Future studies should address the relationship of intershift recovery with time off between shifts, workload, and workplace safety and performance. [ABSTRACT FROM AUTHOR]

Background The human papillomavirus (HPV) is the precursor and the single, most important risk factor for cervical cancer. It is also the most commonly sexually transmitted infection in the United States. An estimated 20 million persons are currently infected with the virus, with an estimated 6 million new infections occurring annually and 12 000 new cervical cancer cases and 4 000 cervical cancer deaths annually. The HPV vaccine is thus an especially important preventive measure for racial/ethnic groups who bear an unequal burden of cervical cancer mortality. Purpose This study aimed to develop a culturally and linguistically appropriate intervention to educate and empower Latino and Korean American parents to make an informed HPV vaccination decision for their minor children. Methods A parent-focused HPV vaccine education DVD was developed through focus groups and cognitive interviews with Latino and Korean American parents of children ages 11–17. A randomized controlled efficacy trial was subsequently conducted with 708 Latino and Korean American parents to assess knowledge gains, decisional conflict, decision self-efficacy, and informed decision-making resulting from viewing the intervention DVD. Results Differences between treatment and control groups for pre-post changes in knowledge, informed decision-making, and decisional conflict were statistically significant among the parents exposed to the education intervention DVD. Conclusion The study demonstrated that a culturally and linguistically appropriate intervention DVD designed to educate parents about the risks and benefits of the HPV vaccine promoted informed decision-making regarding HPV vaccination among at-risk populations. [ABSTRACT FROM AUTHOR]

Primary objective: To characterize an acute stress reaction (ASR) following an improvised explosive device (IED) blast-related mild traumatic brain injury (mTBI). Research design: Participants were male, US military personnel treated in Afghanistan within 4 days following an IED-related mTBI event ( n = 239). Methods and procedures: Demographics, diagnosis of ASR, injury history and self-reported mTBIs, blast exposures and psychological health histories were recorded. Main outcomes and results: In total, 12.5% of patients met ASR criteria. Patients with ASR were significantly younger and junior in rank ( p < 0.05). Patients with ASR were more likely to experience the IED-blast while dismounted, report a loss of consciousness (LOC) and higher pain levels ( p < 0.05). Adjusting for age and rank, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.405; 95% CI = 1.105-1.786, p < 0.01). Adjusting for mechanism of injury (dismounted vs. mounted), LOC and pain, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.453; 95% CI = 1.132-1.864, p < 0.01). Prior blast exposure and past psychological health issues were not associated with ASR. Conclusions: A history of multiple mTBIs is associated with increased risk of ASR. Future research is warranted. [ABSTRACT FROM AUTHOR]