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Background: Interventionists commonly identify promising messages for health communication efforts based on audience members' ratings of perceived message effectiveness (PME).Purpose: We sought to validate a new PME measure that improved on existing scales by focusing on the behavior and respondent, being brief, and having strong psychometric properties.Methods: Participants were a national convenience sample of 999 adults and national probability samples of 1,692 adults and 869 adolescents recruited in 2015. Smokers and nonsmokers rated up to six brief messages about the chemicals in cigarette smoke on two PME scales. The first was the new three-item University of North Carolina (UNC) PME Scale that assessed effects perceptions. The second was an established six-item PME scale that assessed message perceptions. We examined the UNC PME Scale's psychometric properties and compared both scales using item factor analysis.Results: The UNC PME Scale measured the same construct across multiple chemical messages (all factor loadings ≥ 0.86). It exhibited high reliability (>0.85) over very low to moderate levels of PME (z = -2.5 to 0.2), a range that is useful for identifying more promising messages. Samples of adults and adolescents showed a similar pattern of results. As expected, the UNC PME Scale was strongly positively correlated with message perceptions (r = .84). It also exhibited strong psychometric properties among participants regardless of education, reactance, sex, and smoking status.Discussion: The UNC PME Scale reliably and validly measured PME among adults and adolescents from diverse groups. This brief scale may be used to efficiently evaluate candidate antismoking messages and may be suitable for adaptation to other health risk behaviors. [ABSTRACT FROM AUTHOR]

Background: Many people receiving treatment for addiction gain an excessive amount of weight during early recovery. We outline two hypothesized mechanisms that might explain weight gain: The Addiction Transfer Hypothesis, which suggests that some individuals respond to cravings with non-nutritive eating behavior, and the Propensity for Behavioral Addiction Hypothesis, which suggests that some people are at higher risk for addiction, and that excess weight gain results from a rebound of appetitive processes that were temporarily suppressed during active addiction. Method: We evaluate the extent of support for these alternative hypotheses using repeated measures of cravings and eating behavior collected in real time using a combination of ecological momentary assessment methodology and interviewer-based 24-hour dietary recall. Participants included N = 111 individuals receiving treatment for substance use disorder who were currently abstaining from use, but who had used their primary treatment substance within the past 12 months. Results: Using linear mixed models to test the temporal effects of cravings on subsequent eating behaviors hypothesized by the Addiction Transfer Hypothesis and generalized linear models to evaluate the effect of a common propensity for behavioral addiction factor on eating behaviors (a test of the Propensity for Behavioral Addiction Hypothesis), we find no evidence to support the Addiction Transfer Hypothesis, but we find modest support for the Propensity for Behavioral Addiction Hypothesis. Findings do not account for appetitive effects of psychotropic medications. Conclusions: General nutrition education and encouragement of health eating behaviors may be useful for reducing excessive weight gain among people recovering from substance dependence. [ABSTRACT FROM AUTHOR]

Purpose "Lock‐in" programs (LIPs) are used by health insurers to address potential substance (eg, opioid) misuse among beneficiaries. We sought to (1) examine heterogeneity in trajectories of dispensed opioids (in average daily morphine milligram equivalents (MMEs)) over time: prior to, during, and following release from a LIP, and (2) assess associations between trajectory patterns and beneficiary characteristics. Methods: Medicaid claims were linked to Prescription Drug Monitoring Program records for a cohort of beneficiaries enrolled in the North Carolina Medicaid LIP (n = 2701). Using latent class growth analyses, we estimated trajectories of average daily MMEs of opioids dispensed to beneficiaries across specific time periods of interest. Results: Five trajectory patterns appeared to sufficiently describe underlying heterogeneity. Starting values and slopes varied across the 5 trajectory groups, which followed these overall patterns: (1) start at a high level of MMEs, end at a high level of MMEs (13.1% of cohort); (2) start medium, end medium (13.2%); (3) start medium, end low (21.5%); (4) start low, end medium (22.6%); and (5) start low, end low (29.6%). We observed strong associations between patterns and beneficiaries' demographics, substance use‐related characteristics, comorbid conditions, and healthcare utilization. Conclusions: In its current form, the Medicaid LIP appeared to have limited impact on beneficiaries' opioid trajectories. However, strong associations between trajectory patterns and beneficiary characteristics provide insight into potential LIP design modifications that might improve program impact (eg, LIP integration of substance use disorder assessment and referral to treatment, assessment and support for alternate pain therapies). [ABSTRACT FROM AUTHOR]

This study tested the prospective association between observational indicators of temperament, which were obtained across multiple assessments when children were 6–36 months of age, and parent and teacher reports of children's attention-deficit/hyperactivity disorder (ADHD) behaviors, when children were in first grade. Data were drawn from the Family Life Project and included 1,074 children for whom temperament and either parent- or teacher-reported ADHD behavioral data were available. The results of variable-centered regression models indicated that individual differences in temperament regulation, but not temperamental reactivity, was uniquely predictive of parent- and teacher-reported ADHD behaviors. Latent profile analyses were used to characterize configurations of temperamental reactivity and regulation. Person-centered regression models were subsequently estimated in which temperamental profile membership replaced continuous indicators of temperamental reactivity and regulation as predictors. The results of person-centered regression models indicated that temperamental reactivity and regulation both contributed (both alone and in combination) to the prediction of subsequent ADHD behaviors. In general, the predictive associations from early temperament to later ADHD were of modest magnitude (R2 = .10–.17). Results are discussed with respect to interest in the early identification of children who are at elevated risk for later ADHD. [ABSTRACT FROM AUTHOR]

This study had two objectives: first, to determine the degree to which experiences of victimization by peers during adolescence led to a subsequent rise in depressive symptoms, and second, to identify genetic markers that predict depressive reactivity to victimization. We used a cohort sequential design to obtain a longitudinal sample of 1,475 adolescents (3,263 observations) in Grades 8 to 12 (56% female; 47% Black, 46% White). Multilevel growth curve models were used to assess whether victimization predicted depressive symptoms 6 months later, beyond baseline trajectories for depressive symptoms. We modeled the interactive effects of peer victimization with three genetic polymorphisms (on 5-HTTLPR, DRD2 TaqIA, and BDNF Val66Met) on depressive symptoms. Although victimization predicted subsequent depressive symptoms, there was substantial heterogeneity in the magnitude of the effect of victimization. Val alleles, associated with higher brain-derived neurotrophic factor (BDNF) functioning, predicted more sensitivity to victimization. Neither DRD2 TaqIA, a marker associated with dopaminergic functioning, nor 5-HTTLPR, a marker associated with serotonin activity, was associated with sensitivity to victimization. The social stress of peer victimization triggers depressive symptoms most strongly in individuals who are homozygous for the Val allele on the BDNF Val/Met polymorphism. This polymorphism has been linked with sensitivity to social defeat in animal models. Future research should explore behavioral, cognitive, and emotional explanations of the effects of BDNF Val/Met on responsivity to victimization. [ABSTRACT FROM PUBLISHER]

When missingness is suspected to be not at random (MNAR) in longitudinal studies, researchers sometimes compare the fit of a target model that assumes missingness at random (here termed a MAR model) and a model that accommodates a hypothesized MNAR missingness mechanism (here termed a MNAR model). It is well known that such comparisons are only interpretable conditional on the validity of the chosen MNAR model’s assumptions about the missingness mechanism. For that reason, researchers often perform a sensitivity analysis comparing the MAR model to not one, but several, plausible alternative MNAR models. In the social sciences, it is not widely known that such model comparisons can be particularly sensitive to case influence, such that conclusions drawn could depend on a single case. This article describes two convenient diagnostics suited for detecting case influence on MAR–MNAR model comparisons. Both diagnostics require much less computational burden than global influence diagnostics that have been used in other disciplines for MNAR sensitivity analyses. We illustrate the interpretation and implementation of these diagnostics with simulated and empirical latent growth modeling examples. It is hoped that this article increases awareness of the potential for case influence on MAR–MNAR model comparisons and how it could be detected in longitudinal social science applications. [ABSTRACT FROM AUTHOR]

Background. The Inventory of Callous-Unemotional Traits is a self- and other report questionnaire of callous-unemotional behaviors that is increasingly widely used in research and clinical settings. Nonetheless, questions about the factor structure and validity of scales remain. Method. This study provided the first large-scale (N = 1,078) investigation of the parent report version of the Inventory of Callous-Unemotional Traits in a community sample of school-age (first-grade) children. Results. Confirmatory factor analysis indicated that a two-factor model that distinguished empathic-prosocial (EP) from callous-unemotional (CU) behaviors provided the best fit to the data. EP and CU were moderately to strongly correlated with each other (ϕ = −.67, p < .001) and with oppositional defiant disorder and conduct disorder (ODD/CD) behaviors (ϕODD/CD, EP = −.55; ϕODD/CD, CU = .71, ps < .001). Individual differences in EP and CU behaviors explained unique variation, beyond that attributable to ODD/CD behaviors, in peer-, teacher-, and parent relationship quality. Moreover, whereas EP moderated the effects of ODD/CD in the prediction of student–teacher relationship quality, CU moderated the effects of ODD/CD in the prediction of peer and parent relationship quality. Conclusions. Results are discussed with respect to the use of the ICU with school-age children. [ABSTRACT FROM PUBLISHER]

• For opioid use disorder patients, tobacco use was associated with increased craving. • Tobacco use frequency was also associated with small increases in negative affect. • Tobacco use frequency did not significantly affect patients' stress levels. • Tobacco use does not provide affect regulatory benefits for these patients. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) effects over a third of Latin American women and results in significant health, economic and social consequences. While theory suggests that increasing the status of women, in their homes and neighborhoods, should prevent IPV, little empirical work has tested this in South America, in particular examining neighborhood-level indicators. We conduct multilevel analysis to identify predictors of recent emotional and physical and/or sexual IPV within a longitudinal sample of 1312 low-income women living in northern Ecuador, near the Colombian border. Status indicators, measured at the household and neighborhood-level, included women's asset ownership, intra-household decision making, labor force participation, and education, age, and salary relative to male partner. Females' increasing participation in household decision-making (between time 1 and time 2) was associated with decreased risk of physical and/or sexual (AOR: 0.41, 95% CI: 0.21, 0.78) and emotional IPV (AOR: 0.57, 95% CI: 0.30, 1.06), although the latter was marginally significant. Increases in neighborhood-level decision-making was protective against emotional IPV (AOR: 0.78, 95% CI: 0.61, 0.99). Women with lower education than their partners were significantly more likely to experience IPV than women with the same or more education as their partner. Indicators of economic status of women were not associated with IPV outcomes in the expected directions. Findings support policies and interventions seeking to raise the status of women as a mechanism to reduce IPV. Future research can explore economic empowerment and IPV, as well as the interaction between household and neighborhood-level factors. [ABSTRACT FROM AUTHOR]

Contact with child protective services (CPS) functions as an independent marker of child vulnerability. Alaska children are an important population for understanding patterns of CPS contact given high rates of contact overall and among specific demographic groups. We aimed to identify longitudinal trajectory classes of CPS contact among Alaska Native/American Indian (AN/AI) and non-Native children and examine preconception and prenatal risk factors associated with identified classes. We used data from the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project, a linkage of 2009–2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) births with administrative data including CPS records. We conducted growth mixture modeling to identify trajectory classes of CPS contact from birth to age five years. We used Vermunt's three-step approach to examine associations with preconception and prenatal risk factors. Among AN/AI children, we identified three classes: 1) no/low CPS contact (75.4%); 2) continuous CPS contact (19.6%), and 3) early, decreasing CPS contact (5.0%). Among non-Native children, we identified four classes: 1) no CPS contact (81.3%); 2) low, increasing CPS contact (9.5%); 3) early, rapid decline CPS contact (5.8%); and 4) high, decreasing CPS contact (3.3%). Maternal substance use had the largest impact on probabilities of class membership, increasing the probability of membership in classes characterized by CPS contact, among both AN/AI and non-Native children. Results reveal heterogeneity in longitudinal patterns CPS contact across early childhood among Alaska children and identify maternal substance use as an important target for primary prevention. [ABSTRACT FROM AUTHOR]

To select promising health messages, formative research has often relied on perceived message effectiveness (PME) scales assessing either of two related constructs, message perceptions (persuasive potential) and effects perceptions (potential for behavioral impact). We sought to examine their incremental criterion validity within a comparative framework. Participants were 703 U.S. adult smokers (ages ≥ 21) who received anti-smoking or comparable control (littering) messages on their cigarette packs for 3 weeks. Structural equation models examined both PME constructs as simultaneous correlates of outcomes from the UNC Tobacco Warnings Model. Message perceptions demonstrated incremental criterion validity with attention, an early behavioral antecedent (β = 0.82, p <.001). Effects perceptions demonstrated incremental criterion validity with later behavioral antecedents (range β = 0.74–0.87, all p <.01) and quitting behaviors (β = 0.36–0.66, all p <.001). Formative research on anti-smoking messages may benefit from focusing on effects perceptions to characterize potential for behavior change. [ABSTRACT FROM AUTHOR]

• DAGs are a tool to reduce bias, improve transparency, and increase precision. • An example from addiction research illustrates the benefits of a DAG approach. • DAGs allow researchers to communicate assumptions regarding causal concepts. [ABSTRACT FROM AUTHOR]

Objective: The relationship between smoking and adolescents' peer relationships is complex, with studies showing increased risk of smoking for adolescents of both very high and very low social position. A key question is whether the impact of social position on smoking depends on an adolescent's level of coping motives (i.e., their desire to use smoking to mitigate negative affect). Method: We assessed how social position predicts nicotine dependence in a longitudinal sample (N = 3,717; 44.8% male; mean age = 13.41 years) of adolescent lifetime smokers measured between 6th and 12th grades. Using both social network analysis and multilevel modeling, we assessed this question at the between-person and within-person level, hypothesizing that within-person decreases in social position would lead to increased risk of nicotine dependence among those with high levels of coping motives. Results: In contrast to our hypotheses, only interactions with the between-person measures of social position were found, with a slight negative relationship at low levels of coping motives. In addition, the main effect of coping motives was considerably stronger than that of social position at the between-person level, and social position had no significant within-person main effect on nicotine dependence risk. Conclusions: These results suggest that adolescents with higher overall levels of social position among their peers may have slightly decreased risk for nicotine dependence, but only when coping motives are low. Counter to expectations, higher levels of nicotine dependence risk were not linked to fluctuations in social position. [ABSTRACT FROM AUTHOR]

An understanding of factors contributing to variation in child welfare outcomes in cases of prenatal substance exposure (PSE) can help identify gaps in research and practice and guide state and agency policy. To summarize the evidence base and identify critical gaps in the literature, we conducted a scoping review regarding individual- and institutional-level factors associated with child welfare decision-marking across the service continuum and caregivers' perceptions of child welfare involvement in cases of PSE. The sample included peer-reviewed studies based in the United States. We conducted a comprehensive search of four databases for studies investigating 1) sociodemographic, behavioral, policy, or other factors contributing to variation in child welfare outcomes and 2) maternal, family, or provider perceptions of the child welfare process in cases of PSE. We followed an established methodological framework for conducting scoping reviews. Of the 23 articles included in the review, 20 explored variation in decision-making across the child welfare services continuum and three examined caregivers' perceptions of child welfare involvement. At the institutional level, provider characteristics, such as agency capacity, were linked to specific child welfare outcomes including reports and removals. At the individual level, factors such as socioeconomic status, race, and substance type were also associated with outcomes across the service continuum. Child welfare agencies use an unsystematic approach in addressing PSE, contributing to a variation in child welfare outcomes and potentially allowing for bias. This review highlights a need for increased resources and guidance for caseworkers. • Variation in prenatal substance exposure policies may allow for systemic bias. • Variation in decisions is associated with child welfare outcomes. • Caseworkers need additional resources in prenatal substance exposure cases. [ABSTRACT FROM AUTHOR]

Background: Physical activity can improve osteoarthritis-related symptoms; however, many people with osteoarthritis (PWOA) are insufficiently active. Social support for physical activity from an intimate partner can help PWOA increase activity, but managing multiple, chronic physical or mental health conditions (i.e., multimorbidity) may influence provision and receipt of that support. Method: Data from a 1-year longitudinal observational study was used to examine associations between multimorbidity and three dimensions of partner support for physical activity—companionship partner support (doing activity together), enacted partner support, and social support effectiveness—in 169 insufficiently active PWOA and their partners. Results: Multivariable-adjusted multi-level models indicated baseline differences in support by multimorbidity status: when partners had multimorbidity, PWOA reported receiving less companionship support and less effective support from partners; when PWOA had multimorbidity, partners reported providing less enacted support and both partners and PWOA reported less effective partner support. Broad trends (p <.05) indicate initial increases and subsequent decreases in companionship and enacted partner support when PWOA had multimorbidity, and among partners with and without multimorbidity. When PWOA had multimorbidity, an initial increase in support effectiveness was followed by no significant change; a similar trend was seen among partners with and without multimorbidity. Conclusion: Multimorbidity may generally contribute to less partner support for physical activity or less effective support, although influences on support over time are less clear. Physical activity interventions for couples experiencing multimorbidity would likely benefit from attention to the impact of multiple chronic health conditions on physical activity and physical activity–related partner support. [ABSTRACT FROM AUTHOR]

We apply a spatial perspective to measure the extent to which the 2018 U.S. racial, ethnic, and socioeconomic composition of census tracts were each associated with tobacco retailer density within a tract and in its neighboring tracts (n = 71,409). A 10-percentage point increase in the Black population was associated with 0.07 (p < 0.05) more retailers per square mile within a focal tract and 0.35 (p < 0.001) more retailers per square mile in its neighbors on average. A greater percent of Hispanic/Latino residents was associated with more retailers per square mile, both within a focal tract (b = 0.95, p < 0.001) and in its neighbors 0.39 (p < 0.001). Inverse associations were observed for percent white. We also observed inequities by socioeconomic status. The overall magnitude of inequities may be underestimated if the spatial dependence between focal tracts and their neighbors are not taken into consideration. Policymakers should prioritize interconnected geographic areas experiencing high racialized and socioeconomic segregation when designing and implementing policies to reduce retail tobacco product availability. [ABSTRACT FROM AUTHOR]

There are associations between tobacco retailer density and smoking behaviors, but little is known about whether places with more tobacco retailers have more smoking-related health problems. Using cross-sectional data from 2014, we investigated the relationships between tobacco retailer density and chronic obstructive pulmonary disease (COPD) related outcomes in a sample of 1510 counties across the United States. Higher retailer density was associated with a 19% (IRR, 1.19; 95% CI, 1.12-1.27) higher COPD-related hospital discharge rate and 30% (IRR, 1.30; 95% CI 1.21-1.39) higher total COPD-related hospital costs per population. The tobacco retailer environment may be an important target for reducing smoking-related health burdens and costs. [ABSTRACT FROM AUTHOR]

The current study examined whether social status and social integration, two related but distinct indicators of an adolescent's standing within a peer network, mediate the association between risky symptoms (depressive symptoms and deviant behavior) and substance use across adolescence. The sample of 6,776 adolescents participated in up to seven waves of data collection spanning 6th to 12th grades. Scores indexing social status and integration were derived from a social network analysis of six schools and subsequent psychometric modeling. Results of latent growth models showed that social integration and status mediated the relation between risky symptoms and substance use and that risky symptoms mediated the relation between social standing and substance use during the high school transition. Before this transition, pathways involving deviant behavior led to high social integration and status and in turn to substance use. After this transition, both deviant behavior and depressive symptoms led to low social integration and status and in turn greater substance use. These findings suggest that the high school transition is a risky time for substance use related to the interplay of increases in depressive symptoms and deviant behavior on the one hand and decreases in social status and integration on the other. [ABSTRACT FROM AUTHOR]

In the study of adolescent health, it is useful to derive indices of social dynamics from sociometric data, and to use these indices as predictors of health risk behaviors. In this manuscript, we introduce a flexible latent variable model as a novel way of obtaining estimates of social integration and social status from school‐based sociometric data. Such scores provide the flexibility of a regression‐based approach while accounting for measurement error in sociometric indicators. We demonstrate the utility of these factor scores in testing complex hypotheses through a combination of structural equation modeling and survival models, showing that deviance mediates the relationship between social status and smoking onset hazard at the transition to high school. [ABSTRACT FROM AUTHOR]

Objective: The current study examined whether an adolescent's standing within a school-bounded social network moderated the association between depressive symptoms and substance use across adolescence as a function of developmental and demographic factors (gender, parental education, and race/ethnicity). Method: The sample of 6,776 adolescents participated in up to seven waves of data collection spanning 6th to 12th grade. Results: Results of latent growth models showed that lower integration into the social network exacerbates risk for depression-related substance use in youth, particularly around the high school transition, but social status acted as both a risk factor and a protective factor at different points in development for different youth. Findings also varied as a function of youth gender and parental education status. Conclusions: Together these findings suggest that lower integration into the social network exacerbates risk for depression-related substance use in youth, particularly around the high school transition in general as well as just before the high school transition in those with lower parental education or just after the high school transition in males. Thus, the risky impact of social isolation appears more consistent across this period. Social status, however, showed a more varied pattern and further study is needed to understand the sometimes risky and sometimes protective effects of social status on depression-related substance use. [ABSTRACT FROM AUTHOR]

• Breastfeeding is associated with higher mean oxytocin levels than bottle-feeding. • Oxytocin may be lower during infant feeding in women taking antidepressants. • We found no difference in oxytocin during breastfeeding by depression or anxiety status. This study aimed to quantify the relationship between postpartum depression and anxiety, oxytocin, and breastfeeding. We conducted a longitudinal prospective study of mother-infant dyads from the third trimester of pregnancy to 12 months postpartum. A sample of 222 women were recruited to complete the Beck Depression Inventory II and Spielberger State-Trait Anxiety Inventory-state subscale, participate in observed infant feeding sessions at 2 and 6 months postpartum, and provide venous blood samples during feeding. Maternal venous oxytocin levels in EDTA-treated plasma and saliva were determined by enzyme immunoassay with extraction and a composite measure of area under the curve (AUC) was used to define oxytocin across a breastfeeding session. Linear regression was used to estimate associations between postpartum depression and anxiety as predictors and oxytocin AUC during breastfeeding as the outcome at both 2 and 6 months postpartum. Mixed models accounting for correlations between repeated oxytocin measures were used to quantify the association between current depression and/or anxiety symptoms and oxytocin profiles during breastfeeding. We found no significant differences in oxytocin AUC across a feed between depressed or anxious women and asymptomatic women at either 2 or 6 months postpartum. Repeated measures analyses demonstrated no differences in oxytocin trajectories during breastfeeding by symptom group but possible differences by antidepressant use. Our study suggests that external factors may influence the relationship between oxytocin, maternal mood symptoms, and infant feeding. [ABSTRACT FROM AUTHOR]

Few studies have documented the pathways through which individual level variables mediate the effects of neighborhoods on health. This study used structural equation modeling to examine if neighborhood characteristics are associated with depressive symptoms, and if so, what factors mediated these relationships. Cross-sectional data came from a sample of mostly rural, older adults in North Carolina (n = 1,558). Mediation analysis indicated that associations among neighborhood characteristics and depressive symptoms were mediated by loneliness (standardized indirect effect = -0.19, p < 0.001), physical activity (standardized indirect effect = -0.01, p = 0.003), and perceived individual control (standardized indirect effect = -0.07, p = 0.02) with loneliness emerging as the strongest mediator. Monitoring such individual mediators in formative and process evaluations may increase the precision of neighborhood-based interventions and policies. [ABSTRACT FROM AUTHOR]

Combining datasets in an integrative data analysis (IDA) requires researchers to make a number of decisions about how best to harmonize item responses across datasets. This entails two sets of steps: logical harmonization, which involves combining items which appear similar across datasets, and analytic harmonization, which involves using psychometric models to find and account for cross-study differences in measurement. Embedded in logical and analytic harmonization are many decisions, from deciding whether items can be combined prima facie to how best to find covariate effects on specific items. Researchers may not have specific hypotheses about these decisions, and each individual choice may seem arbitrary, but the cumulative effects of these decisions are unknown. In the current study, we conducted an IDA of the relationship between alcohol use and delinquency using three datasets (total N = 2245). For analytic harmonization, we used moderated nonlinear factor analysis (MNLFA) to generate factor scores for delinquency. We conducted both logical and analytic harmonization 72 times, each time making a different set of decisions. We assessed the cumulative influence of these decisions on MNLFA parameter estimates, factor scores, and estimates of the relationship between delinquency and alcohol use. There were differences across paths in MNLFA parameter estimates, but fewer differences in estimates of factor scores and regression parameters linking delinquency to alcohol use. These results suggest that factor scores may be relatively robust to subtly different decisions in data harmonization, and measurement model parameters are less so., (© 2022. Society for Prevention Research.)

Objective: Adverse childhood experiences (ACEs) are associated with increased risk of sustaining a traumatic brain injury (TBI). Alcohol use may play an important role in this relationship. This study examines whether binge drinking mediates the relationship between four ACEs and TBIs sustained in adulthood., Methods: Using the National Longitudinal Survey of Youth, 1979 cohort, we conducted longitudinal mediation analyses (n=6317). Interviews occurred annually from 1979 to 1994 and biennially until 2016. We evaluated the direct and indirect effects of individual ACEs (ie, experiencing physical violence, low parental warmth, familial alcoholism and familial mental illness; reported retrospectively) and a cumulative ACEs score on mean level of binge drinking (calculated across waves) and having a TBI in adulthood. To establish temporality, we included binge drinking that was measured at age 18 or older and before any reported TBI., Results: Cumulative ACEs, familial alcoholism and physical abuse exposure were significantly associated with having a TBI through binge drinking, although this only explained a small part of the association between ACEs and TBI. Other ACEs were not significantly associated with binge drinking or TBI., Conclusion: The results indicate that while ACEs and adult TBI risk were significantly associated, lifetime binge drinking explains only a small part of the association. Future research could examine alternative social, biological and behavioural mechanisms along the pathway between ACEs and TBI. Determining this mechanism will allow public health practitioners to design and implement effective TBI prevention programmes for those at higher risk of injury due to ACE exposure., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Studies document inequitable tobacco retailer density by neighborhood sociodemographics, but these findings may not be robust to different density measures. Policies to reduce density may be less equitable depending on how the presence of store types differs by neighborhood characteristics. We built a 2018 list of probable tobacco retailers in the United States and calculated four measures of density for all census tracts ( N = 71,495), including total count, and number of retailers per 1,000 people, square mile, and kilometers of roadway. We fit multivariable regression models testing associations between each density measure and tract-level sociodemographics. We fit logistic regression models testing associations between sociodemographics and the presence of a tobacco-selling pharmacy or tobacco shop. Across all measures, tracts with a greater percentage of residents living below 150% of the federal poverty level (FPL) had higher density. A higher percentage of Black residents, Hispanic or Latino residents, and vacant housing was inconsistently associated with density across measures. Neighborhoods with a greater percentage of Black residents had a lower odds of having a pharmacy (adjusted odds ratio [a OR ] = 0.96, 95% confidence interval [CI; 0.95, 0.97]) and tobacco shop (a OR = 0.87, CI [0.86, 0.89]), while those with a greater percentage of residents living below 150% FPL had greater odds of having a tobacco shop (a OR = 1.18, CI [1.16, 1.20]). Researchers and policymakers should consider how various measures of retailer density may capture different aspects of the environment. Furthermore, there may be an inequitable impact of retailer-specific policies on tobacco availability.

The goal of this manuscript is to advance HIV risk behavior prevention efforts for South African adolescent girls by identifying distinct trajectory patterns across multiple behavioral domains for adolescent and young adults. We draw from a sample of N = 1070 adolescent girls from South Africa who were between the ages of 13-15 at baseline. Participants were followed across 6 waves of data collection between 2011 and 2019. We focus on predicting trajectories between ages 15 and 21. All participants were HIV negative and had not experienced sexual debut at baseline. We examine group-based multi-variable trajectories across several known HIV risk behaviors: earlier age of sexual debut, engaging in unprotected sex, engaging in transactional sex, earlier age at first pregnancy, and exposure to physical IPV. We characterized three prototypical joint trajectories: abstainers (54%), early unprotected sex (36%), and high-risk sexually active (11%). We then predicted membership based on the following baseline risk and protective factors: household expenditures, bonding to school, parental monitoring, number of close friends, and community engagement. We found that school bonding and parental monitoring were the strongest predictor of sexual risk, and that, among those in both the early unprotected sex and high-risk groups, risky behaviors like unprotected and transactional sex most frequently occurred early in adolescence. These findings suggest that interventions should target girls early in adolescence, and that interventions focused at improving school bonding and promoting parental involvement may be most effective at preventing risky sexual behavior., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Greater availability of tobacco product retailers in an area may be associated with smoking behaviors, and the majority of people who smoke purchase their cigarettes at gas stations and convenience stores. This cross-sectional study investigates the associations of overall tobacco retailer density and gas/convenience density with adult smoking behaviors., Methods: This study built a list of tobacco retailers in 2014 and calculated the county-level number of retailers per 1,000 people. Individual-level smoking behavior data were drawn from the 2014-2015 Tobacco Use Supplement for a sample of adults (n=88,850) residing in metropolitan counties across the U.S. General estimating equation models were fit to investigate the associations between retailer density and cigarette smoking behaviors (smoking status, quit attempt, quit length). Analyses were conducted in 2020., Results: A greater number of tobacco retailers (AOR=1.63, 95% CI=1.35, 1.96) and gas stations and convenience stores (AOR=3.29, 95% CI=2.39, 4.52) per 1,000 people were each associated with a higher odds of a respondent smoking every day than the odds of a respondent not smoking. In addition, both measures were associated with a higher odds of a respondent being an every-day than being a some-day smoker. Associations for gas/convenience density were similar in models that additionally controlled for other tobacco retailers (excluding gas/convenience). Study results did not support associations between retailer density and cessation., Conclusions: Tobacco retailer density, especially gas/convenience density, is correlated with daily smoking, the most harmful tobacco use behavior. Calculating tobacco retailer density using gas/convenience stores may be a feasible proxy for overall tobacco retailer density., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Researchers commonly use message perceptions (persuasive potential) or effects perceptions (perceived behavioral impact) in formative research to select tobacco risk messages. We sought to identify whether message perceptions or effects perceptions are more useful as proxies for the behavioral impact of tobacco risk messages. In a three-week trial, 703 U.S. adult smokers (ages ≥ 21) were randomly assigned to receive brief messages on their cigarette packs about toxic chemicals in cigarette smoke (chemical messages) or control messages about properly disposing of cigarette litter. The final follow-up survey assessed message perceptions, effects perceptions, quit intentions, and six behavioral outcomes. We conducted multiple mediation analysis in a structural equation modeling framework to test the indirect effects of messages by way of message perceptions and effects perceptions. Message perceptions did not independently mediate the impact of chemical messages on any of the outcomes (7 p -values ≥ 0.01). In contrast, effects perceptions mediated the impact of chemical messages on avoiding the messages, seeking chemical information, intentions to quit smoking, butting out a cigarette, forgoing a cigarette, and making a quit attempt (6 p -values ≤ 0.001). No mediation was present for social interactions about the message ( p -value = 0.72). The effect sizes for these mediated effects were small to medium. Thus, effects perceptions, but not message perceptions, were a proxy for risk messages' impact on quit intentions and six quitting and related behaviors. These findings point to the diagnostic value of effects perceptions in formative research on tobacco risk messages.