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Objective: Anecdotal evidence suggests that the term "pollster" has, in recent years, become stigmatized in the United States. We explore this and a subsequent question as to whether negative perceptions of pollsters affect people's perceived trustworthiness of survey findings. Methods: Survey experiments were administered to national probability‐based samples after the 2016 and 2020 elections. Results: In each study, pollsters obtained significantly more negative ratings when compared to "survey researchers" and "public opinion researchers," suggesting that the general public views pollsters, who are more likely to be viewed as partisan, as being less honest/ethical. In line with social identity theory, interaction models revealed that those rating pollster critic Donald Trump most favorably had the most negative ratings of pollsters and public opinion researchers, compared to survey researchers. Yet, the vignette experiment showed that negative perceptions of pollsters did not affect the perceived trustworthiness of survey result reports. Conclusions: We conclude that while there appears to be a stigmatization of pollsters, those negative perceptions do not translate into less trust in the findings of public opinion. [ABSTRACT FROM AUTHOR]

United States (US) immigration policies have increasingly focused on national security resulting in universities experiencing declines in international student applications, constraints on international scholar employment, and complications facilitating international research collaborations. The COVID-19 pandemic brought additional travel restrictions, embassy closures, and health and safety concerns that exacerbated these challenges. Science mobility is critical for science education, training, competitiveness, and innovation. Using a representative sample of US and foreign-born scientists in three STEM fields, we explore how recent visa and immigration policies have shaped research collaborations, work with students and postdoctoral scholars, and intentions to leave. We use descriptive statistics, analysis of variance, and logistic regression and find academic scientists report disruptions from visa and immigration policies; negative impacts of immigration policies on US higher education; negative effects on recruitment and retention of international trainees; and increased intentions to leave the US driven by negative perceptions of immigration policy. [ABSTRACT FROM AUTHOR]

Background: Research on the impacts of exposure to workplace harassment (WH) is largely cross-sectional, and existing prospective studies generally are between two and five years of follow-up, with the longest US study being 10 years. However, the effects of exposure to WH may persist longer, particularly if exposure has been chronic. This study fills this gap by examining effects of prior exposure to chronic sexual and generalized WH on psychological distress and alcohol misuse over an approximately 25 year study period. Methods: Individuals originally recruited from a university-employed sample in the United States were surveyed at 8 time points from 1996–2007 and again in 2020–2021. A series of hybrid path analyses were tested on a sample of 2352 individuals, regressing recent outcomes on latent classes of harassment derived from earlier survey waves, controlling baseline outcomes and demographics. Model fit was assessed using a variety of fit statistics, and standardized regression coefficients were used to assess significance of individual pathways. Results: Prior exposure to chronic sexual harassment had significant direct associations with psychological distress, alcohol misuse, and recent stressors at follow-up. Prior exposure to chronic generalized harassment had significant direct associations with lower income and alcohol misuse. Both forms of WH were significantly indirectly associated with psychological distress through recent stressors at follow-up. Conclusions: Exposure to chronic WH is associated with long-term effects on psychological distress and alcohol misuse in a sample representing a wide variety of job types and racial/ethnic identities. Enforcement of anti-sexual harassment law and policies and enactment of policies and laws to prevent generalized harassment/workplace bullying are imperative for the protection of worker health. [ABSTRACT FROM AUTHOR]

This paper examines possible causes, consequences, and potential solutions for addressing vaccine hesitancy in the United States, focusing on the perspectives of academic scientists. By examining the experiences of scientists, who are arguably a critical community in US society, we gain deeper insights into how they understand the complexities of vaccine hesitancy and whether their insights and opinions converge with or diverge from the current literature. We present findings from a national survey of a representative sample of academic scientists from the fields of biology and public health regarding vaccine hesitancy and related topics. Empirical analysis using descriptive, bivariate, and multivariate analyses covers multiple topics, including vaccine controversy, trust in science, causes of vaccine hesitancy, preferred policy and regulatory approaches, risk perceptions, and scientists' ethics and perceived communication roles. The results highlight a diversity of opinions within the scientific community regarding how to improve science-society communication in regard to vaccines, including the need to be transparent and candid to the public about the risk of vaccines and their research. [ABSTRACT FROM AUTHOR]

This study reveals the existence of a paradox in how the public views polling within the democratic process. Specifically, even though the public believes that it can influence policymaking, it considers public opinion polls not as useful as other, less representative forms of public input, such as comments at town hall meetings. Analyzing data from multiple surveys conducted in the United States of America, we find no evidence for the democratic representation hypothesis with respect to polling. Comparisons across stakeholders (public, journalists, and politicians) demonstrate that general perceptions of inputs into the democratic process are similar, which confirms the citizen-elite congruence hypothesis. However, unlike members of the public, experts are more likely to believe that public opinion polls are the optimal method by which the public can successfully inform policymaking, a finding consistent with the legitimization hypothesis. With respect to perceptions of politicians, we found substantial differences regarding party registration with Democrats and Independents favoring public opinion polling and Republicans preferring alternative methods (e.g., town hall meetings) of informing policymakers. [ABSTRACT FROM AUTHOR]

We conducted qualitative semi-structured telephone interviews with the directors of the 10 National Institutes of Health Centers for Population Health and Health Disparities (NIH/CPHHD) to identify factors that were associated with the sustainability of 19 interventions developed to address cancer disparities and 17 interventions developed to address cardiovascular disease disparities in the United States. Interview transcripts were analyzed using the constant comparative method of analysis to identify key themes and synthesize findings. Directors at NIH/CPHHD reported that barriers to sustainability included uncertainty about future funding and insufficient resources to build and maintain diverse stakeholder partnerships. Strategies that helped to overcome these barriers included developing and engaging community partnerships with health care systems; early pursuit of multiple funding sources; and investments in infrastructure to address the social determinants [End Page 1212] of health. Sustainability planning should be incorporated during the early stages of intervention development to facilitate maintenance of successful programs that address health disparities. [ABSTRACT FROM AUTHOR]

This study examines the effects of legislatively mandated changes in terminology for National Health Interview Survey (NHIS) questions on proxy and self-reports of an important condition. Specifically, we examine changes from the use of the term "mental retardation" to "intellectual disability" that were mandated by what is now known as "Rosa's Law," an act signed by President Obama in October 2010. Our analyses focus on changes in national prevalence of measures of intellectual disability during the period 2011–2016, compared to 1997–2010, for the population as a whole and for demographic subgroups. Findings show that the change in question wording implemented in the NHIS after Rosa's Law produced a small, albeit statistically significant, increase in reporting of intellectual disabilities for adults and for children. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate cultural variations in the qualities that White Americans and Hispanic Americans believe power-holders should embody, and the situations in which these norms influence consumer satisfaction. Design/methodology/approach – Two experimental studies (n1=130 and n2=121) and one field study (n=241) were conducted with White American and Hispanic participants. Results were analysed using ANOVA and regression. Findings – White Americans are predisposed to apply to power-holders injunctive norms of treating others justly and equitably, whereas Hispanics are predisposed to apply injunctive norms of treating others compassionately. These cultural variations in the use of injunctive norms were more evident in business or service contexts in which power was made salient, and emerged in the norms more likely to be endorsed by White American and Hispanic participants (Study 1), their approval of hypothetical negotiators who treated suppliers equitably or compassionately (Study 2), and their evaluations of powerful service providers in a real-life, on-going and consequential interaction (Study 3). Research limitations/implications – This research suggests key implications for our theoretical understanding of the role of social norms in carrying cultural patterns, as well as for cross-cultural theories of consumer satisfaction with service providers. Practical implications – Marketers should pay attention to signals of fairness (compassion) in their services, as perceptions of fairness (compassion) by White American (Hispanic) consumers can boost satisfaction ratings. This is particularly important in service encounters that might be characterized by power differentials, such as those in health care and financial services. Originality/value – As consumer markets grow more culturally diverse, it is important for marketers to understand how distinct notions of power impact the attitudes and behaviors of consumers from different cultures. This research investigates the implications of distinct power concepts for multi-cultural consumers’ evaluations of service providers, an important and under-researched area with implications for global service management. [ABSTRACT FROM AUTHOR]

The current study focuses on three dimensions of treatment neighborhood environments that may influence treatment retention: neighborhood disadvantage, stability, and concentrated immigration. We examined treatment outcomes for a total of 9,319 individuals who were admitted for initial treatment in 56 outpatient clinics in Cook County, Illinois. Census-tract-level data were used to measure facility neighborhood environment. We found that neighborhood disadvantage was unrelated to individual treatment completion. Immigrant concentration was found to increase the likelihood of substance abuse treatment completion, although it was attenuated after controlling for patient problem severity and referral sources. Neighborhood stability was found to be positively related to treatment completion. These results suggest that knowledge of neighborhood context should be an important consideration when making placement decisions of new treatment facilities. Knowledge of neighborhood impact on treatment attrition should also be considered essential information to be used for client placement, treatment program design, and discharge protocols. [ABSTRACT FROM AUTHOR]

Web surveys are being increasingly incorporated into national survey data collection programs in the United States because of their cost/time-efficiencies. Yet, response rates and data quality issues in web surveys remain important challenges. As a basic study designed to better understand data quality in a mixed mode national survey, this article investigates the degree to which web versus mail survey modes affect unit and item responses. Findings indicate that the web survey mode produces a lower unit response rate compared to the mail mode. However, the web mode elicits higher data quality in terms of item responses to both closed- and open-ended questions. These mode effects on data quality remain after sociodemographic variables are held constant. Given the increasing integration of web survey questionnaires into mixed mode studies, additional research is necessary to understand and document the processes that underlie mode differences when responding to self-administered surveys. [ABSTRACT FROM AUTHOR]

The United States has been experiencing the most severe economic crisis since the Great Depression. This article presents the Life Change Consequences of the Great Recession (LCCGR), an instrument depicting work and personal life-related stressors reflecting the enduring effects of the Great Recession. A national sample of 663 respondents completed a mail survey including this instrument and measures of drinking outcomes. Multiple regression analyses addressed the links between the LCCGR and drinking. Economy-related stressors manifested significant effects on both male and female consumptions patterns, but most LCCGR subscales were more clearly related to problematic drinking patterns in men compared with women. [ABSTRACT FROM PUBLISHER]

Purpose: Low health literacy is a significant problem in the United States. At the same time written screening tools such as the American Urological Association symptom score are used more frequently at hospitals and clinics. We previously reported that many patients do not fully understand this tool and often provide inaccurate information. To combat this problem we developed a novel multimedia version of the American Urological Association symptom score. Materials and Methods: In this randomized, controlled trial we divided 232 patients into a control arm that self-administered the traditional written version of the symptom score and an experimental arm that self-administered the new multimedia version. Patients in each arm were later administered the tool a second time by an interviewer for comparison. Using multivariate analysis we measured disagreement between the self-administered and interviewer administered scores, and compared the 2 arms. Results: Patients assigned the written and the multimedia version showed an average error of 3.48 and 1.97, respectively (p <0.001), for a 43% decrease. Improvement was noted regardless of patient literacy. Errors by patients with low and high literacy decreased from 4.55 to 2.24 and 3.10 to 1.86 (p = 0.03 and <0.001, respectively). Conclusions: As a model, the American Urological Association symptom score multimedia version represents an exciting opportunity to improve many other written screening tools since it increased understanding and decreased scoring errors across all literacy levels, possibly allowing physicians to treat patients more effectively. [Copyright &y& Elsevier]

Although lesbians are believed to be at disproportionately high risk for smoking, few published studies have focused on smoking rates in this population. We examined and compared rates and demographic correlates of smoking among 550 lesbians and 279 heterosexual women in Chicago, Minneapolis/St. Paul, and in New York City in 1994-1996 using a self-administered survey questionnaire. African-American lesbians were more likely than African-American heterosexual women or White lesbians to be current smokers. For the sample as a whole, education was the most robust predictor of both current and lifetime smoking. Racial/ethnic minority lesbians with high school education or less were most likely to report both current and lifetime cigarette smoking. The study's limitations are noted. [ABSTRACT FROM AUTHOR]

Understanding the relationship between nonresponse processes and key research variables is central to evaluating if and how nonresponse introduces bias into survey estimates. In most telephone surveys, however, little information is available with which to estimate these effects. We report a procedure for examining the potential effects of nonresponse via analyses that (1) investigate the linkages between community-level (zip code) variables and survey nonresponse and (2) examine the associations between these community-level variables and key survey measures. We demonstrate these procedures using hierarchical modeling to analyze data from a state-wide telephone survey in Illinois. One zip code-level indicator of concentrated disadvantage--the percentage of the population below poverty level--was found to be positively associated with nonresponse and, among respondents, with both current physical disability status and lack of health insurance coverage, suggesting that both may have been underestimated in this survey. This inexpensive approach has the potential of enabling researchers to routinely evaluate nonresponse effects in their survey data. [ABSTRACT FROM AUTHOR]

Background: Nonresponse is a potentially serious source of error in epidemiologic surveys concerned with injury control and risk. This study presents the findings of a records-matching approach to investigating the degree to which survey nonresponse may bias indicators of violence-related and unintentional injuries in a random-digit-dialed (RDD) telephone survey. Methods: Data from a statewide RDD survey of 4155 individuals aged 16 years and older conducted in Illinois in 2003 were merged with ZIP code–level data from the 2000 Census. Using hierarchical linear models, ZIP code–level indicators were used to predict survey response propensity at the individual level. Additional models used the same ZIP code measures to predict a set of injury-risk indicators. Results: Several ZIP code measures were found to be predictive of both response propensity and the likelihood of reporting partner violence. For example, people residing in high-income areas were less likely to participate in the survey and less likely to report forced sex by partner, processes that suggest an over-estimation of this form of violence. In contrast, estimates of partner isolation may be under-estimated, as those residing in geographic areas with smaller-sized housing were less likely to participate in the survey but more likely to report partner isolation. No ZIP code–level correlates of survey response propensity, however, were found also to be associated with driving-under-the-influence (DUI) indicators. Conclusions: There is evidence of a linkage between survey response propensity and one variety of injury prevention measure (partner violence) but not another (DUI). The approach described in this paper provides an effective and inexpensive tool for evaluating nonresponse error in surveys of injury prevention and other health-related conditions. [Copyright &y& Elsevier]

Purpose: The aim is to identify the characteristics of common health survey questions that may be associated with cross-cultural variability in question comprehension. Methods: Interviews with respondents representing four cultural subgroups in the United States were analyzed through behavior coding to identify survey question characteristics that may be associated with cross-cultural variability in comprehension. Using survey responses as the unit of analysis, nested within survey respondents and survey questions, hierarchical linear modeling was used to examine the effects of four questionnaire design features on cultural variations in comprehension difficulties. Results: Respondent culture was found to moderate the effects of response format, question length, and reading levels. Conclusions: Several question design strategies that reduce overall comprehension difficulty appear to also increase cross-cultural disparities. [Copyright &y& Elsevier]

This article focuses on the future of the specialty in obstetrics and gynecology in the U. S. The decrease in the percentage of graduating American seniors choosing a career in obstetrics and gynecology and the associated decrease in residency slots filled by U.S. graduates. The marked decrease in the number of men entering the specialty is noted with concern, and the shift of students interest to emergency medicine, radiology, ophthalmology, anesthesiology and dermatology noted with envy. The concern about residency training focuses on the ever broadening scope of requirements. The author suggests for actions and execution in the clinical training and academic laboratories in gynecology and obstetrics.

Primary care physicians are in a unique position to detect patients with substance use related problems and initiate treatment at an early stage when it may be more successful. To evaluate current knowledge, attitudes, and practices of primary care physicians in the United States regarding the detection of substance use related problems, a national telephone survey of practicing primary care physicians was conducted in 1999. A total of 648 randomly selected family and general practitioners, internists, pediatricians, and OB-GYNs were interviewed regarding their perceived preparation to diagnose selected health conditions, their perceived difficulty discussing selected health conditions with patients, and their perceptions of the effectiveness of available treatments for selected health conditions. Findings suggest that primary care physicians in the United States perceive themselves as being less prepared to diagnose substance “abuse” than other chronic conditions. They additionally find it more difficult to discuss this topic with their patients, and are more skeptical about the effectiveness of available treatments. Because the social, economic, and health consequences of untreated substance misuse negatively affect the quality of life for so many patients and their families, developing new approaches to improving the attitudes and screening behaviors of primary care providers vis-à-vis substance use disorders should continue to be an important priority. [ABSTRACT FROM AUTHOR]

There is a growing number of older adults in America. Assisted-living facilities have become a more prevalent residence for this increasing population. In the study described in this article, a secondary data analysis was completed using residents of several LifeTrust America, Inc.'s assisted-living facilities across the Southeastern United States. There were 1,079 residents who completed the Healthy Generation Survey. Residents were asked whether they currently, previously, or had never had certain health conditions. They also responded to various questions about their current participation in healthy habits, such as using cigarette or tobacco products, moderate alcohol consumption, eating breakfast, eating healthy snacks, getting 7-8 hours of sleep each night, drinking the daily recommended amount of water, and participating in regular physical exercise. The research question asked if there was a relationship between current healthy habits and physical health. The study found that individuals with more current physical health conditions also reported greater participation in healthy habits. This could lead to the conclusion that after individuals acquired certain physical health conditions, they began to participate in more healthy habits. Also of significance was the finding that participation in physical exercise and recreational activity related to greater participation in all other healthy habits. [ABSTRACT FROM AUTHOR]

Relatively little is known about the substance abuse treatment need patterns and experiences of youth incarcerated in the United States juvenile justice system. To address this issue, four analytic questions concerned with understanding the predictors of treatment need and utilization patterns among adolescents entering the juvenile corrections system are examined. Data analyzed were collected as part of a face-to-face survey of 401 youth who entered the Illinois juvenile correctional system in mid-2000. Overall, need for treatment and treatment utilization each were predicted by sets of social environmental and personal characteristics, in addition to several sociodemographic variables. Less than half of youth with an identified need for treatment reported receiving treatment. Considerable variability in the effects of demographic and social environmental indicators on treatment need and utilization across race groups also was observed. These findings underscore the need for the continual development of the cultural competence of treatment providers and the expansion of onsite provision of substance abuse treatment services to incarcerated juveniles. [Copyright &y& Elsevier]

To assess the utility of biological testing in a general population survey for estimating prevalence and evaluating self-report data quality. An audio computer-assisted interview was administered to subjects from June 2001 to January 2002. Immediately following the interview, subjects were requested to participate in hair, oral fluid and urine testing. Subjects were from randomly selected households in the City of Chicago using multi-stage sampling methods. Interviews were conducted in subjects’ homes. The data represent 627 randomly selected adult participants, ages 18–40 years. Prevalance, kappa, conditioned kappa, sensitivity, specificity, under-reporting, ‘mixed model’ and logistic regression. Higher rates of marijuana use were generated from survey reports than from drug testing. Drug testing generated higher prevalence rates than survey reports for recent use of cocaine and heroin. Under-reporting of recent drug use was apparent for all three substances. Sensitivity was particularly low for cocaine and heroin. Race was related to under-reporting, with African Americans less likely to report marijuana use despite a positive test result. The utility of drug testing for surveys depends on the type of substance examined as well as on the type of test employed. Multiple tests have more utility than a single test. Drug testing is useful for identifying the levels and sources of under-reporting in a survey and provides a basis for adjusting prevalence estimates based on self-reports. [ABSTRACT FROM AUTHOR]

To better understand the prevalence, correlates, risk factors and context of club drug use among US adults in the City of Chicago. An Audio Computer-Assisted Self Interview was administered to a household probability sample of adults, aged 18–40 years, from June 2001 to January 2002. Subjects were drawn from randomly selected households using a multi-stage area probability design. The data represent 627 randomly selected adult participants. Weighted prevalence estimates with design-effect adjusted confidence intervals of life-time, past 12 month and past 30 day use of any club drug and of specific club drugs; prevalence of rave attendance, other drug use, motivation for use among club drug users; χ2 tests of significance, logistic regression and adjusted odds ratios. Overall club drug prevalence rates were nearly twice those obtained for MDMA alone. Club drug users were more likely to use multiple illicit substances and to report having been in treatment for substance use. A majority of life-time club drug users never attended a rave although rave attendees were more likely to report frequent use of MDMA. Use was associated with gender, race and sexual orientation. Prevention research should be informed by further population-based research on club drug use. Research should not focus exclusively on rave attendees, as they are only a subset of club drug users. Research is needed on neurological and behavioral sequelae across different types of club drugs, gender differences in the impact of sexual orientation on club drug risk and on the effects of personality characteristics such as sensation seeking on club drug use behavior. [ABSTRACT FROM AUTHOR]

We present an overview of the cross-cultural quality of survey reports of substance use behaviors in the United States. Empirical data from 36 published studies (1977 2003) are examined to evaluate the reliability and validity of substance use reports across cultural groups. In these studies, race/ethnicity are used as proxy indicators of respondent culture. In general, the available research suggests that, with a few exceptions, the quality of survey data on racial and ethnic disparities in substance use is often limited by differential measurement error. A conceptual paradigm is presented to consider a wide range of potential causes for these differences in measurement error that includes two dimensions: emphasis on negative vs. positive behavior patterns, and emphasis on internal vs. external causal factors. These two dimensions yield four potential models that arc useful in understanding variations in substance use measurement error: the cultural deficit model, the cultural conflict model, the mainstream conformity model, and the cultural distrust model. Future research should focus on the ability of each of these alternative models to account for cultural variability in the quality of substance use reporting. Key Words: Culture; Survey measurement error; Substance use; Risk; High risk populations; Proxy indicators; Recanting. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate whether substance abuse is a direct factor in the explanation of homelessness or one that operates indirectly through disaffiliation and human capital processes to place individuals at greater risk of the condition.METHODS: Analyses were conducted using data on substance abuse and homeless experiences from a random probability sample of 481 homeless persons and those at risk of homelessness in Cook County, Illinois. Covariance structure models were used to assess substance abuse, human capital, and disaffiliation as potential precursors of homelessness, with particular attention paid to the direct and indirect role of substance abuse in the loss of domicile.RESULTS: Analysis of several nested models of homelessness links substance abuse only indirectly to loss of domicile, primarily through its impact on social and institutional affiliations. Contrary to expectations, substance abuse did not impact homelessness indirectly by diminishing the accumulation of human capital.CONCLUSIONS: The role of disaffiliation as a proximate cause of homelessness was confirmed. This locates the phenomenon within the context of society itself, as a direct result of a breakdown in the social bonds necessary for human community. Substance abuse plays a critical role in this breakdown, negatively influencing social as well as institutional relationships. [Copyright &y& Elsevier]

Representative data from the U.S. National Health Interview Survey are used to investigate the substance use patterns of immigrants and compare them to those of the native born populations. The information examined is from the 1991 supplementary Drug and Alcohol Use Data File, which examined the self-reported substance use behaviors of approximately 21,000 adults aged 18–44. Findings indicate that immigrants to the U.S. in the late twentieth century are less likely to use alcohol and other drugs than are native born citizens. Additional findings suggest assimilation processes by which exposure to mainstream American society leads to patterns of alcohol and illicit drug use among long term immigrants that approximates that of the native born population. The patterns of substance use observed among immigrants, however, are not consistent with acculturative stress mechanisms. These findings provide an important and representative profile of the substance use patterns of one of the largest international migration streams of the past one hundred years. [ABSTRACT FROM AUTHOR]

Examines the effectiveness of the components of a smoking intervention program among female smokers with a high school education or less in Chicago, Illinois. Effects of several baseline measures and exposure to the intervention components on subsequent stage of change; Interaction between exposure to the manual and baseline stage.

Examines monthly variations in self-reports of recent alcohol consumption behavior in the United States based on telephone survey data collected by the Behavioral Risk Factor Surveillance System. Seasonal patterns of light and heavy alcohol use between male and female participants; Association of sociodemographics variables with 30-day alcohol consumption.

Changes in the number and locations of Kentucky counties with a shortage of physicians (using current federal definitions of medical underservice) were examined for the decennial years 1930 to 1980. The number of counties with a physician shortage were found to have increased from four per cent in 1930 to 20 per cent in 1970 and 1980. The per cent of population in physician shortage counties was also found to have increased between 1930 and 1970, but to have declined slightly by 1980. Differences in the average population-to-physician ratios of Appalachian and non-Appalachian counties were significant for every year except 1980. [ABSTRACT FROM AUTHOR]

The article examines HIV risk behaviors of homeless youth in an urban area in the U.S. Majority of the respondents identified HIV risk factors which include multiple sex partners, high-risk partners, inconsistent condom use, history of sexually transmitted disease, anal sex, prostitution and intravenous drug use. Therefore, researchers claimed that the group is a major risk group for acquiring and spreading AIDS. Furthermore, it was found out that increased risk-taking behaviors found among these youth may be a consequence of the severity of their homeless experience.

Despite persistent concerns about high cesarean delivery rates internationally, there has been less attention on improving perioperative outcomes for the millions of women who will experience a cesarean delivery each year. Enhanced recovery after surgery, a standardized, evidence-based, interdisciplinary protocol, has been successfully used in other surgical specialties including gynecology to improve quality of care and patient satisfaction while reducing overall health care costs through reduced length of stay. Enhanced recovery after surgery society guidelines for cesarean delivery were just released in August 2018. Obstetric patients, who face the dual challenge of being postpartum and postoperative, could benefit greatly from protocols that optimize their return to physiological function and reduce surgical morbidity. Although enhanced recovery after surgery has been widespread in other surgical specialties, uptake of this protocol in obstetrics has lagged behind. We believe enhanced recovery after surgery for cesarean delivery can effectively address 3 challenges faced by obstetrician/gynecologists. These are: (1) improving care for the high number of women undergoing cesarean deliveries; (2) using evidence-based care bundles to prevent maternal morbidity and mortality, address disparities, and reduce costs; and (3) limiting postoperative opioid prescribing in response to the opioid crisis. Enhanced recovery after surgery for cesarean delivery and other standardized care protocols have the potential to reduce the disproportionately high rates of maternal morbidity and mortality in the United States, and ensure all patients, regardless of demographics or location, receive the same level of high-quality peripartum care. [ABSTRACT FROM AUTHOR]

Disclosing one's sexual minority identity, or "coming out," has varying effects on the mental health of lesbians. Previous research indicates a negative association between disclosure and depression. However, these findings are based on research with White lesbians. To date, there is a paucity of studies that examined how the relationship between disclosure and depression may differ by race/ethnicity among lesbians. To address this gap, we examined the relationship between disclosure and depression among African American (26.5%), Latina (19.7%), and White (53.8%) self-identified lesbians (N = 351) in 2 survey-interviews (~3-years apart). Over 50% of the participants reported a history of lifetime depression at baseline and 35.9% reported depression at Time 2 (T2). Disclosure levels varied: 78.9% had disclosed to their mother, 58.4% to their father, and 83.3% to a sibling. The mean level for disclosure to nonfamily individuals was 6.29 (SD 2.64; range 0-9). Disclosure results varied by race/ethnicity showing African American lesbians (vs. White lesbians) were less likely to disclose to nonfamily individuals when controlling for covariates. Results for the relationship between disclosure and depression showed disclosure to either parent or sibling was not associated with depression for the total sample. Among Latinas only, disclosure to nonfamily individuals was associated with less depression. Additional research is needed to explore racial/ethnic differences in disclosure with certain individuals and to better understand the relation between disclosure and depression. Findings have implications for reducing overall rates of depression among lesbians living with multiple-minority identities. [ABSTRACT FROM AUTHOR]

WHAT IS KNOWN ON THE SUBJECT?: Established research from the United States and other Western countries has found that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. Suicidality among LGBT individuals is understudied in Thailand and other Asian countries, warranting additional research to better understand risk factors and to create effective treatment and suicide prevention interventions. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study examined rates and predictors of suicidality in Thai LGBT adults. Study findings suggest that general (e.g. stress and loneliness) and minority stressors (e.g. discrimination and victimization) played important roles in predicting lifetime and past-year suicidal ideation, while socio-demographic and health-related factors (e.g. living in high poverty area and having chronic diseases) were associated with suicide attempts among LGBT individuals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Changes in the nursing curriculum and continuing education resources are needed to improve knowledge and core competencies in the mental health and treatment needs of LGBT individuals in Thailand. Among LGBT serving practitioners, routine assessment of suicidality is needed to increase the early identification and treatment of individual at risk for suicidal behaviours. Standardized measures of sexual orientation and gender identity should be included in all patient intake forms. In conducting research on strategies to improve mental health outcomes among LGBT populations, standardized measures of sexual orientation/gender identity and minority-specific stressors should be used. Suicide prevention interventions aimed at reducing general and minority stress among LGBT populations should be a priority in mental health nursing., Abstract: INTRODUCTION: A large and rigorous body of research in the United States has demonstrated that lesbian, gay, bisexual and transgender (LGBT) populations are at an elevated risk for suicide. However, scant research aimed at understanding the rates and predictors for suicidality among Thai LGBT individuals exists., Aim: To examine rates and predictors of suicidality among Thai LGBT adults (N = 411)., Method: Data collection was conducted via online and in-person surveys. Guided by the Minority Stress Model, standardized measures of demographics, health-related factors, general and minority-specific stressors and suicidality were completed., Results: Thirty-nine per cent of participants reported lifetime suicidal ideation, 19.0% past 12-month suicidal ideation and 13.1% lifetime suicide attempts. Lifetime suicidal ideation was associated with higher levels of social discrimination, stress, loneliness and chronic disease (OR = 1.12, 1.16, 2.75, and 1.46, p ≤ .05, R 2 = 0.327). Past-year suicidal ideation was associated with victimization, stress, loneliness and being a former smoker (OR = 1.52, 1.20, 2.34, and 4.89, p < .05, R 2  = 0.345). Suicide attempts were associated with internalized homophobia, poverty, chronic disease, alcohol use and physical health (OR = 1.44, 1.06, 1.59, 1.45 and 0.95, p ≤ 0.05, R 2  = 0.187)., Discussion: General and minority-specific stressors negatively impacted suicidality among LGBT participants., Implication for Practice: Study findings have implications for nursing education, practice and research. Nursing education should include information about the influence of sexual orientation and gender identity on mental health outcomes. Further, systematic screening for suicidality should be conducted by LGBT serving psychiatric and mental health nurses. Finally, research is needed to determine best practices for interventions aimed at reducing suicidality risk among LGBT individuals., (© 2020 John Wiley & Sons Ltd.)

Background: Through its influence on social interactions, simpatía may have a wide-ranging influence on Latinx health. Simpatía-which does not have a direct English translation-refers to being perceived as likeable, pleasant, and easygoing. Research to investigate the influence simpatía on Latinx health is limited, likely due to a lack of options for measuring simpatía among diverse Latinx populations., Objectives: The goal of this research was to develop a bilingual, survey-based simpatía scale for use among ethnically diverse Latinx adults in health-related settings., Methods: Data were obtained through a telephone survey data of 1,296 Mexican American, Puerto Rican, and Cuban American adults living in the United States. Interviews were conducted in English and Spanish. Exploratory factor analysis, item response theory analysis, confirmatory factor analysis, and computation of estimates of internal consistency reliability were conducted to inform the development of the final simpatía scale., Results: Results indicate that the final, nine-item, simpatía scale has high internal consistency (α = .83) and measurement invariance among Mexican American, Puerto Rican, and Cuban American adults. Two dimensions were identified, as indicated by a perceptions subscale and a behavior subscale. Cuban Americans were found to have the highest simpatía scores, followed by Puerto Ricans and Mexican Americans., Discussion: Culture is often identified as a powerful potential influence on health-related behaviors, but measures are often not available to assess specific cultural traits. By developing a new tool for measuring simpatía, this research advances opportunities for understanding and promoting Latinx health.

Background: National trends show dramatic increases in the incidence of HPV-related head and neck squamous cell carcinomas (HNSCCs) among black and white males. Using cases identified through the National Cancer Data Base, we assessed factors associated with HPV 16- or 16/18 positive HNSCCs among non-Hispanic black and white males diagnosed in the U.S. between 2009 and 2013., Methods: This sample included 21,524 HNSCCs with known HPV status. Adjusted relative risks (RRs) and 95% confidence intervals (CIs) were estimated using log-binomial regression., Results: Compared to those with HPV-negative tumors, male patients diagnosed with HPV-positive HNSCCs were non-Hispanic white, younger at diagnosis, lived in zip-code areas with higher median household income and higher educational attainment, had private health insurance and no reported comorbidities at diagnosis. Although the risk of HPV-positive HNSCCs increased with measures of higher area-level socioeconomic status, the effect was stronger for non-Hispanic black males (RR Adjusted =1.76, 95% CI 1.49-2.09) than for whites (RR Adjusted =1.12, 95% CI 1.08-1.16). The peak age for diagnosis of HPV-positive HNSCCs occurred in those diagnosed at 45-49 years (RR Adjusted =1.57, 95% CI 1.42-1.73). Oropharyngeal tumors were strongly associated with HPV-positivity (RR Adjusted =4.32, 95% CI 4.03-4.63). In the analysis restricted to oropharyngeal anatomic sites, similar patterns persisted., Conclusion: In our analysis, measures of economic advantage were associated with an increased risk of HPV-positive HNSCCs. In order to develop effective interventions, greater understanding of the risk factors for HPV-positive HNSCCs is needed among both high-risk males and their healthcare providers., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Although research has documented cultural variability in respondent comprehension and interpretation of survey questions, little information is currently available on the role that acculturation might play in minimizing cross-cultural differences in the comprehension or interpretation of survey questions. To investigate this problem, we examine the potential effects of acculturation to host culture on respondent comprehension of a set of health survey questions among two distinct Latino populations on the US mainland: Mexican-Americans and Puerto Ricans. Specifically, comprehension-related respondent behaviors coded from 345 face-to-face interviews conducted with Mexican-American, Puerto Rican, African American, and non-Latino White adults living in Chicago are examined. Findings indicate that Latino respondents who were born outside of the US and who have a preference for communicating in Spanish, relative to English, were more likely to express comprehension difficulties. These findings suggest that pretest survey instruments with immigrant populations may be a useful strategy for identifying problematic questions.

Because health care providers have a central role in implementing guidelines, health care reform, and new standards of care and technologies, surveying them about their practices and perspectives is vital for health services and policy research. In November 2010, the National Cancer Institute convened a workshop to review and discuss current methodologies in designing and fielding large-scale surveys of physicians and medical groups. This report summarizes key issues and future directions for four topic areas addressed in the workshop: sample frames for surveying physicians and medical groups; points of contact and response modes; response incentives; and questionnaire design and burden. Recommendations were made for improving sample frame databases, optimizing mixed-mode surveys, and studying use of incentives with gatekeepers and in medical group settings. There is particular need for empirical assessment of factors that motivate or impede participation of physicians, other types of clinicians, and medical groups in survey research.

This paper reviews some of the potential sources of failure in surveys concerned with substance use. These failures are both conceptual and methodological in nature. Conceptual failures include nonuse and misuse of survey data, the inability of these data to detect emerging substance use trends and problems, and relevant ethical concerns. Methodological failures include sampling, coverage, nonresponse, and measurement and processing errors, which are indigenous at some level to all epidemiologic surveys. Consideration of these is necessary if survey data are to be appropriately used for their intended purposes.

The concept of time introduces important complexities in estimating intervention effects, program and evaluation design, and measurement and analysis of individual change in multilevel interventions (MLIs). Despite growing recognition that time is a critical element for assessing both individual-level outcomes and higher-level changes in organizational, community, and policy contexts, most MLI designs and evaluations have not addressed these issues. In this chapter we discuss 1) conceptualizing disease life-course and treatment theory in MLIs, 2) approaches to incorporating time in research and program design for MLIs in cancer treatment and prevention, 3) analysis of time-varying multilevel data in the context of cancer treatment and prevention, and 4) resource considerations and trade-offs of incorporating time as a dimension of MLIs and analysis. Although analytic techniques for analyzing time-related phenomena are becoming more available and powerful, there has not been corresponding progress made in the development of theory to guide the application of these techniques in program design and implementation.

Objective: This study examined the relationships between childhood and family background variables, including sexual and physical abuse, and subsequent alcohol abuse and psychological distress in adult lesbians., Methodology: Structural equation modeling was used to evaluate relationships between childhood sexual and physical abuse and parenting variables and latent measures of lifetime alcohol abuse and psychological distress in a large community-based sample of lesbians., Results: Childhood sexual abuse (CSA) directly predicted lifetime alcohol abuse, and childhood physical abuse (CPA) directly predicted lifetime psychological distress. In addition, CSA indirectly increased the risk of lifetime alcohol abuse through its negative effect on age at first heterosexual intercourse. Childhood physical abuse had only indirect effects on lifetime alcohol abuse through its strong relationship to lifetime psychological distress. Parental drinking problems and parental strictness directly predicted lifetime psychological distress; parental drinking problems indirectly predicted lifetime alcohol abuse through the mediators of age of drinking onset and lifetime psychological distress. White lesbians, younger lesbians, and those with lower levels of education were at greatest risk of psychological distress., Conclusion: While the cross-sectional design precludes causal conclusions, study findings--especially those related to CSA--are consistent with previous research on predominantly heterosexual women in the general population. Lesbians who experienced CSA were at heightened risk of lifetime alcohol abuse and those who experienced CPA were at heightened risk of lifetime psychological distress relative to lesbians without abuse histories. Given the dearth of research on childhood abuse and sexual orientation, studies are needed that examine the similarities and differences between lesbians' and heterosexual women's experiences of, and responses to, childhood abuse.

Objectives: Using data collected as part of the Multisite Women's Health Study, we examined the differences between lesbians and heterosexual women on objective breast cancer risk calculations using the Gail Model. Health risk behaviors and screening behaviors for breast cancer were also examined. It was hypothesized that lesbians would have higher objective cancer risk estimates and report more behavioral and screening risk factors for breast cancer than heterosexual women., Methods: Secondary data analyses were conducted using data from a study of women's health conducted from 1994 to 1996. Using a cross sectional design, a convenience sample of lesbian (n = 550) and heterosexual (n = 279) women was recruited from Chicago, New York City and Minneapolis-St. Paul. Data were collected using a self-administered questionnaire., Results: Estimates of 5-year and lifetime breast cancer risk were higher for lesbians compared to heterosexual women. Groups did not differ in self-perceptions of being overweight, but more lesbians reported heavier drinking and more reported abstinence from alcohol. Group differences in adherence to breast cancer screening were not significant., Conclusions: Findings suggest a small but statistically significant difference in the calculated breast cancer risk estimates of lesbian and heterosexual women, which seem to be largely accounted for by differences in reproductive risk factors.

This study examined the prevalence of alcohol- and substance-related disorders in a random sample of 627 adult probationers in Illinois. The investigation also explored the prevalence of major psychiatric disorders and their co-occurrences with alcohol and substance use disorders. To detect the presence of psychiatric disorders, researchers employed standardized assessment tools based on Diagnostic and Statistical Manual of Mental Disorders criteria. Overall, results showed that probationers had significantly higher rates of psychiatric disorders, substance use disorders, and co-occurring disorders compared with persons in the general population. In light of these findings, probation administrators are urged to invest more resources in treating drug use, mental illness, and codisorders, the latter of which is associated with a higher risk of violent behaviors.