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Objective: US Hispanics have several health disparities, greater tobacco/nicotine-related illnesses, lower access to smoking cessation, and lower rates of cessation. Understanding cultural constructs linked to tobacco/nicotine use may provide a greater understanding of future cultural adaptations of cessation interventions. This study used a multidimensional acculturation framework, with cultural practices, identity, and values, to test links between measures of acculturation stress, multidimensional acculturation (language-based enculturation and acculturation, cultural identity, familism), and tobacco/nicotine use, and interactions with gender. Design: Participants were 391 adult Latin American immigrants (69% women); 12% self-reported tobacco/nicotine use in the past six months. Results: Path analysis showed acculturative stress, β =.16, and acculturation, β =.20, were positively related to tobacco/nicotine use. Enculturation, familism, and Hispanic cultural identity were not related to tobacco/nicotine use. There were no significant acculturation by enculturation or gender interactions, but women were less likely to use tobacco/nicotine than men, β = −.36. Conclusion: Findings suggest that tobacco/nicotine cessation interventions for Latino immigrants may be enhanced with an emphasis on the mitigation of acculturative stress, attention to the adoption of US cultural practices, and gender. Future research should examine specific sources of acculturative stress or social norms related to tobacco/nicotine use. [ABSTRACT FROM AUTHOR]

Acculturative stress is an important factor that affects health for Latinx immigrants in the US, with multiple studies identifying a link between depression and acculturative stress in this population. However, far fewer studies have examined the specific role and relationship of acculturative stress on mental health service use in this population. Through the lens of Yang's 2016 Model of Immigrant Health Service Use, this study aimed to examine the role of acculturative stress in predicting mental health service use in a sample of Latinx immigrants in the Southeast US. We conducted a secondary data analysis from a longitudinal study of Latinx immigrant health (n = 391). Our study found that while total acculturative stress was not significantly associated with mental health service use in this sample, parenting stress was a significant predictor of mental health service use in the past six months when controlling for covariates (OR: 1.043, 95% CI [1.009, 1.078]). Additionally, important Predisposing and Need for Healthcare factors were significantly associated with mental health service use, specifically: males were less likely to utilize mental health services than females (OR: 0.401, 95% CI [0.166-0.968]), English language acculturation was positively associated with mental health service use (OR: 1.953, 95% CI [1.130, 3.377]), and depression was positively associated with mental health service use (OR: 1.107, 95% CI [1.027, 1.194]). These findings support the need for more culturally sensitive mental health services, and the need to develop strategies to engage males and less acculturated individuals in mental health services to promote health equity among Latinx immigrants. [ABSTRACT FROM AUTHOR]

Young adult college students experience a high risk for heavy alcohol use and resulting consequences. Symptoms of anxiety and depression increase this risk. Coping style has been associated with alcohol use and consequences, with approach coping being inversely related to use and consequences, and avoidance coping being directing related to use and consequences. The purpose of this study is to examine whether coping style moderates or mediates the relationship between anxiety/depression and alcohol use and consequences. 250 young adult college students ages 18 to 25 years (Women = 85, 34%) anonymously self-reported anxiety, depression, coping style, alcohol use and consequences. Path analysis showed that avoidance coping was positively related to alcohol use (β = 0.33, p < 0.05), social consequences (β = 0.39, p < 0.05), and personal consequences (β = 0.26, p < 0.05), while approach coping was inversely related to use (β = −0.20, p = 0.005). Coping did not moderate the relationship between anxiety and depression and alcohol use or consequences. Avoidance coping mediated the relationship between depression and alcohol use (β = 0.14, p < 0.05), social consequences (β = 0.16, p < 0.05), and personal consequences (β = 0.11, p < 0.05). Findings build on alcohol use and consequences research, and support further research into implementing coping-based alcohol use interventions. Interventions aimed at reducing avoidance coping and increasing approach coping may be beneficial for young adult college students. [ABSTRACT FROM AUTHOR]

Background: Young adult college students have high rates of substance use, theoretically related to social norms. Behavioral norms refer to the quantity of substances that students think others use, and attitudes refer to how much students or others approve of substance use. Prior research has shown a relationship between behavioral norms, student attitudes, and perceived parental attitudes and alcohol and marijuana use. However, the relationship between social norms and use of club drugs (e.g., MDMA) has not been studied.Objective: The purpose of this cross-sectional study was to expand knowledge about young adult college student social norms and club drug use.Methods: 200 young adult undergraduates (Women = 97, 49%) were recruited from a campus recreational facility on a large private Southeastern university in April 2019. Students self-reported behavioral norms, student attitudes, parental perceived attitudes, club drug use during a typical week and during music week, and substance use consequences.Results: Logistic and negative binomial regressions showed that student attitudes were significantly related to club drug use in a typical week (OR = 2.07, p =.005), during music week (OR = 2.08, p =.001), and consequences of use (RR = 1.23, p <.001), but behavioral norms and perceived parental attitudes were not.Conclusions: Findings build on social norms research with alcohol and marijuana use. Attitudes may be more important to consider than behavioral norms or perceived parental attitudes for interventions to reduce club drug use. Young adults (18-25 years old) have a high risk for substance use; both alcohol and drug use increase throughout adolescence and peak in young adulthood.1–3 Young adults have high heavy episodic drinking (35% past month) and illicit drug use (25% past month), with greater MDMA use (10% vs 7%) and marijuana use (35% vs. 15%) than other adults.4 Alcohol and marijuana use has been linked to many negative consequences, such as blackouts, physical injuries, unprotected sex, and even death.5,6 Club drug use is also linked to negative consequences, such as memory lapse, headaches, loss of energy, trouble sleeping, depression, confusion, anxiety, irritability, nausea, and changes in heart rate and blood pressure.7,8 [ABSTRACT FROM AUTHOR]

Objective: To understand college students' experiences with substance use at electronic music events (EME), including harm-reduction strategies and receptivity to educational intervention. Participants: A purposeful sample of undergraduate students at a private Southeastern university was recruited from April 2019 to May 2019 using online advertising and in-person tabling. Methods: A qualitative, descriptive research design utilizing semistructured focus groups. Results: Five focus groups were conducted (n = 18). A thematic analysis revealed three main themes: substance use is commonplace; substance use and protective behaviors; and universities' role in substance education. Additional categories and subcategories were identified within each theme. Conclusion: Substance use at EME is a common experience for college students. Several challenges and opportunities exist for universities working to promote harm reduction practices. Prevention efforts should be event-specific, incorporate student input to engage learning more effectively, and work to reduce barriers that deter students from taking safety precautions when using substances. [ABSTRACT FROM AUTHOR]

We tested relationships between three substances – alcohol, marijuana, and club drugs (hallucinogens, LSD, and MDMA) – and willingness to intervene as bystanders in potentially high-risk situations. Self-reported substance use was assessed during a typical week and during a week with multiple electronic music events. Two hundred undergraduate students were asked about substance use during specific days with a calendar method to promote recall. Willingness to intervene within peer group was measured with a 5-item scale. Willingness to intervene was relatively high (M= 4.27, SD = 0.74, range 1–5). Multiple linear regression showed heavy drinkers or club drug users had lower group willingness to intervene than non-users of either substance (β = −.16, −.21, respectively). Gender and event attendance were not related to willingness to intervene and did not moderate links with heavy drinking or club drug use. Although overall undergraduates reported being willing to intervene to protect group members, heavy drinkers or club drug users had lower willingness to intervene. Future research should assess actual behavior. Programs addressing high-risk situations and bystander interventions might benefit from adding strategies that focus on heavy drinkers or club drug users. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop the Hispanic Optimism and Personal Expectancy (HOPE), a measure of optimism related to the concept of the American Dream. This measure assesses beliefs that are shared by Hispanic/Latinx immigrants and non-immigrants about opportunities for advancement in the United States. Based on focus groups consisting of both immigrant and non-immigrant Hispanic/Latinx participants (n = 93), twenty four (24) items for the measure were created from qualitative interviews. Separate exploratory (n = 174) and confirmatory (n = 181) factor analysis supported three factors: Hope for a better life, for freedom & security, and for economic opportunity. Results provided empirical support for the HOPE. A final set of sixteen (16) items are included in the HOPE measure. This measure can benefit researchers or counselors who work with Hispanic/Latinx immigrants to understand individual expectancies and barriers toward achieving their American Dream. We discuss implications for research and potential conceptions of U.S. meritocracy as a potential myth for minority and immigrant groups. [ABSTRACT FROM AUTHOR]

Background: Having a child in the intensive care unit (ICU) is a stressful event that can cause negative mental health outcomes for parents, but little is known about the experience of parental stress among members of racial/ethnic minority groups. Objective: To examine the stress and coping process in a racially/ethnically diverse sample of mothers of a child who was acutely admitted to an ICU. Methods: Participants (N = 103) completed a cross-sectional self-report survey; 86.4% completed it within a week of their child's ICU admission. Analysis of variance was used to examine racial/ethnic differences in perceived ICU-related stressors, coping behaviors, and distress level. Linear regression was used to examine the moderating effects of race/ethnicity on the relationships between stressors, coping behaviors, and distress. Results: Mothers across racial group experienced similar stressors during the acute phase of their child's ICU admission. African American mothers reported greater overall use of coping behaviors, particularly avoidance coping, and experienced higher levels of distress than did Hispanic or non-Hispanic White mothers. Hispanic mothers experienced the least distress. The interaction of race/ethnicity and emotion-focused coping moderated the stress and coping process. Conclusions: Racial and ethnic diversity in sampling should be a priority in future studies of the stress and coping process of mothers with a child in an ICU. Critical care nurses should minimize known stressors for these mothers and encourage and support their preferred coping behaviors, recognizing that these may differ across racial/ethnic groups. [ABSTRACT FROM AUTHOR]

Mothers' mental health or substance use disorders impact the behaviours of their children both short‐term and long‐term. There is increased concern for mothers with mental health or substance use disorders to effectively handle parenting challenges. Children of these mothers are at risk for emotional and behavioural adjustment problems as well as poor academic performances. Parenting self‐agency refers to parents' perceptions of their confidence and ability to overcome barriers and manage issues in parenting. Examining the factors that predict parenting self‐agency aids in understanding how nurses can assist mothers and families. The purpose of this study was to explore predictors of parenting self‐agency among mothers who are impacted by mental health or substance use disorders. A secondary analysis was conducted using the baseline assessment data of a randomized trial that examined the efficacy of a nurse‐led family‐strengthening home‐health intervention. The data were obtained from 172 mothers who were receiving outpatient treatment for substance use or other mental health disorders and had children under 18. A multivariate linear regression analysis was conducted to find predictors of parenting self‐agency among participating mothers. The authors found that increased children's externalizing problems and intensity of hassle predicted lower parenting self‐agency, and family cohesion predicted higher parenting self‐agency. The authors conclude that treatments need to address family as a whole to increase mothers' parenting self‐agency, thus assisting these mothers in raising their children in the best possible environment. [ABSTRACT FROM AUTHOR]

This study examined cutoff scores on the new (2014) US-AUDIT (Alcohol Use Disorders Identification Test), adapted for U.S. standard drinks. No studies have examined optimal cutoff scores on the US-AUDIT for college students. 250 undergraduates (65% men) completed the US-AUDIT. At-risk drinkers reported at least four binge drinking episodes per week. Likely alcohol use disorder was assessed with a self-report diagnostic measure. Using the Youden method, the ideal cutoff to identify at-risk drinkers for the US-AUDIT was 5 for men (sensitivity =.93, specificity =.96) and 6 for women (sensitivity =.77, specificity =.86); and to identify likely alcohol use disorder was 13 for men (sensitivity =.69, specificity =.81) and 8 for women (sensitivity =.83, specificity =.80). Cutoffs were lower than the original AUDIT. Different US-AUDIT cutoffs for men and women should be used for likely alcohol use disorder, which may reflect differences in drinking quantity and frequency. Empirical guidelines for alcohol screening with the new US-AUDIT may be used to enhance research or identification of at-risk drinkers in college settings, or for college students in primary care or other health care settings. [ABSTRACT FROM AUTHOR]

Barriers in advanced practice nurses' work environment impede effective use in acute care settings, reduce job satisfaction, and increase intent to leave. Fostering psychological ownership for work through improved work design has increased satisfaction, motivation, and productivity, and lowered turnover in other fields, and may have similar effects for advanced practice nurses. This multilevel cross-sectional survey study examined the relationship between advanced practice nurse work environment and psychological ownership using data from a survey of advanced practice nurses and nurse executives in Florida hospitals. Barriers in scope of practice and exclusion from hospital governance were common. Advanced practice nurses reported good relations with physicians and moderate organizational climate but poor relations with administrators and limited control over work. Organizational climate had a strong positive relationship with psychological ownership. Fostering advanced practice nurse psychological ownership could improve job satisfaction and decrease turnover leading to increased effectiveness in acute care settings. [ABSTRACT FROM AUTHOR]

Little is known about relationships between child maltreatment and adulthood intimate partner violence (IPV), depression, and risky drinking in Latinas. 548 Latinas in a sexual health randomized control trial (RCT) self-reported childhood physical, sexual, and emotional abuse, IPV, depression, and risky drinking. Childhood abuse was related to adulthood IPV, OR = 1.27, depression, OR = 2.02, and high-risk drinking, OR = 2.16. Childhood emotional abuse was linked to depression, OR = 2.19; childhood physical abuse to risky drinking, OR = 2.62; and childhood sexual abuse to depression, OR = 2.78 and risky drinking, OR = 2.38. Results may inform prevention/intervention efforts for mental health nurses. [ABSTRACT FROM AUTHOR]

This article provides a preliminary evaluation of a campus sleep health program for undergraduate university students. In this study, 5 focus groups with 38 undergraduates assessed perceptions about sleep in relationship to college experiences. Additionally, 35 undergraduate students participated in campus sleep improvement workshops, and completed a brief self-report survey before and after the workshop. Results showed five themes emerged from focus groups: (a) Sleep and its impact on academics, (b) Understanding of the importance of sleep, (c) Procrastination and its impact on sleep, (d) Stress, and (e) Sleep and extracurricular/social activities. Based on self-report surveys, there was no improvement in perceived sleep importance, but perceived sleep confidence of undergraduate student-participants increased significantly after the workshop. The sleep health program for undergraduates showed promising results, and should be evaluated using a larger, more rigorous design in future studies. [ABSTRACT FROM AUTHOR]

Objectives:Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study’s objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors. Design: Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors. Results:Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR = 2.15) and better HIV/STI knowledge (β = −.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR = 1.76) and worse HIV/STI knowledge (β = .37). Conclusions:Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women’s health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women. [ABSTRACT FROM PUBLISHER]

Hispanic and Spanish-speaking college students are under-represented in alcohol intervention and prevention research. There is a need for brief, empirically validated Spanish versions of measures related to alcohol use and consequences. The objective of this study was to translate the 8-item College Alcohol Problems Scale (CAPS) into Spanish and evaluate the psychometric properties of this measure compared to the original English. Bilingual experts in interventions for Hispanic college students and youth used a translation back-translation process. 125 Hispanic undergraduate students from a large southeastern public university completed the CAPS and a heavy drinking measure in Spanish. The two-factor model had acceptable model fit in Spanish, χ2 (df=19)=27.60, p=0.091; CFI=0.966 RMSEA=0.060. Internal consistency of the personal problems subscale was 0.76, and the social problems subscale was 0.73. The two latent factors explained 24-66% of variability in items. Personal problems and social problems were both significantly correlated with heavy drinking, r=0.61, p<0.001, r=0.59, p<0.001, respectively. This Spanish version of the CAPS is a reliable and valid measure of consequences of alcohol use, and has similar psychometric properties to the original English version. This measure may be useful for future research, intervention, and prevention with samples of U.S. Hispanic college students or Spanish-speaking students in other nations. [ABSTRACT FROM AUTHOR]

Immigration often results in the separation of families, and in particular transnational parenting, which is the separation of mothers from children. Transnational mothers may have greater risks for poor mental health and behavioral conditions such as substance abuse, violence, sexual risk, and depression. This study was a secondary analysis of self-reported data from 425 Hispanic mothers (328 with no separations, 60 separated from an adult child, and 37 separated from a minor child) enrolled in a randomized trial of a sexual health group intervention in South Florida (USA). Separations were related to mother’s age, years in the United States, family income, number of people living on income, acculturation to the United States, occupational/economic stress, immigration stress, and lifetime exposure to abuse. A follow-up analysis described the types of childhood or adulthood abuse experienced by mothers with separations. These findings provide new information for nurses about the experience of immigrant mothers. [ABSTRACT FROM AUTHOR]

In early adolescence, Hispanics self-report higher drug use rates compared to White and African American peers. Among adolescent users, heavy users have more negative behavioral and health consequences. The purpose of this cross-sectional study is to examine whether psychiatric symptoms, parental attachment, and reasons for use predict heavy alcohol and illicit drug use (more than 10 times in the past three months) among Hispanic adolescents.Methods:This study examines baseline data from a study evaluating a family based substance abuse treatment program for Hispanic adolescents. Participants were 14–17 years old (N= 156, 44% female). Adolescent reports on the Diagnostic Interview Schedule for Children Predictive Scales measured psychiatric symptoms of major depressive disorder, attention deficit hyperactivity disorder, conduct disorder, and anxiety. The Personal Experiences Inventory measured type and amount of drug use, as well as perceived social and psychological benefits of drug use. The Inventory of Parent and Peer Attachment measured trust, communication, and alienation between adolescents and their mothers. Logistic regression identified correlates of heavy alcohol use and heavy illicit drug use among Hispanic adolescents.Results:Higher social benefits were associated with increased likelihood of heavy alcohol use. Conduct disorder, higher levels of maternal attachment, lower levels of acculturation, and higher levels of psychological benefits of use were associated with an increased likelihood of heavy illicit drug use.Conclusion:These findings support the assumption that substance use treatment among Hispanic adolescents must be capable of addressing co-occurring psychiatric disorders, familial relationships, and the individual reasons/motivators to use. [ABSTRACT FROM PUBLISHER]

Motivation is a prominent target for substance use interventions because it is theorized to increase engagement in therapy and predict treatment outcomes. Establishing the validity of measures relevant to motivation among Hispanic/Latino adolescents will improve the resources available for screening and measuring change processes in a multicultural population. We examined the structure of the Problem Recognition Questionnaire (PRQ; Cady, Winters, Jordan, Solberg, & Stinchfield, 1996) with Hispanic/Latino adolescents. Participants were adolescents (n=191) in a randomized controlled trial for substance abuse. Data were collected during a baseline pre-treatment time point and post-treatment time point that was four-months post-baseline. Confirmatory factor analysis (CFA) showed that the three-factor structure proposed by Cady et al. (1996) had a poor fit with pre-treatment data. Follow-up exploratory analyses with principal axis factoring identified an alternate three-factor structure with pre-treatment data (problem recognition, readiness, and treatment resistance). A second CFA showed this three-factor model fit data from participants at the post-treatment time point (n=155). The results provide preliminary evidence for using our proposed factor structure for the PRQ subscales with Hispanic/Latino adolescents. We discuss the dimensions we identified in the context of similar measures and the implications for measuring problem recognition, readiness, and treatment resistance. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to confirm the substance abuse, violence, HIV, and depression syndemic among Hispanic men, and to test whether stress and sociocultural factors, including acculturation, family support, and sexual orientation, predict this syndemic.Method: A cross-sectional survey was administered to 164 Hispanic men using standardized measures for Hispanic Stress (Cervantes, Padilla, & Salgado de Snyder, 1991), substance abuse (Kelly et al., 1994), violence (Peragallo et al., 2005), risk for HIV (González-Guarda, Peragallo, Urrutia, Vasquez, & Mitrani, 2008), and depression (Center for Epidemiologic Studies Scale, CES-D; Radloff, 1977).Results: Results from Structural Equation Modeling (SEM) supported the syndemic factor among Hispanic men. While family/cultural stress and homosexual identity were risk factors for the syndemic factor, family support was protective.Conclusions: More longitudinal research is needed to identify influences on the syndemic factor among diverse Hispanic communities. Interventions that address stress and enhance family supports may show promise in addressing and preventing syndemics among Hispanic men. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Prescription opioid use has grown rapidly, but few studies examined whether users have similar treatment responses as heroin users. Participants were 1,648 opioid users in Florida Access to Recovery (2004-2007). Participants engaged in methadone or buprenorphine maintenance had better retention than those in nonmaintenance treatment. Heroin only users (HO) had better engagement in nonmaintenance treatments and had worse retention than prescription opioid only users (PO). In methadone maintenance, PO were more likely to report opioid abstinence during treatment than heroin and prescription opioid users (H&P). Future research should focus on understanding and improving the treatment experience of opioid use subgroups. [ABSTRACT FROM AUTHOR]

The article discusses a study to evaluate the relationship of acculturation, defined with a dimensional measure, to Spanish-language the Center for Epidemiological Studies-Depression Scale (CES-D) in a sample of Spanish-speaking Hispanic women. It highlights the randomized trial that used the Americanism subscale of the Bidimensional Acculturation Scale. It is inferred that less acculturated women responded more positively to "People were unfriendly," than did more acculturated women.

The article discusses a study which examined the underlying syndemic factor comprising of substance abuse, violence, HIV risk, and depressive symptoms amongst Latinas in the United States. It offers information on the study methods and results, and discusses the measures and variables used, including socioeconomic disadvantage, violence and risk for human immunodeficiency virus (HIV). Also mentioned are the goals of the Healthy People 2010 and the Syndemic Model for Hispanics.

Drug abuse has serious consequences for the wellbeing of persons with HIV/AIDS but suboptimal rates of client engagement limit the efficacy of interventions. The present study examines and compares client characteristics that predicted engagement (defined as attendance at two or more sessions) in a family intervention (SET) and a group intervention within a randomized trial aimed at preventing relapse and improving medication adherence for 126 predominantly African American HIV+ women in drug abuse recovery. Intervention engagement (60% overall) was not significantly different across the two interventions. Fewer physical and mental symptoms (malaise) ( P < 0.05), living independently ( P < 0.05), living with children ( P < 0.05), and readiness to change ( P < 0.05) were associated with engagement across the two interventions. Results from this study can be used to inform outreach and engagement approaches for women dually affected by drug abuse and HIV/AIDS. [ABSTRACT FROM AUTHOR]