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This paper explores how Indigenous-led research reframes the impacts and response to environmental disasters in the context of acid mine spills in rural communities of the Southwest United States. The collaborative research project addressing the Gold King Mine Spill (GKMS) designed qualitative methodologies that center Indigenous worldviews and contribute to broader understandings of environmental justice. The research team, led by Diné scholars and community leaders, gathered qualitative responses from 123 adult participants in twelve focus groups from three rural communities on the Navajo Nation. The project incorporated fluent Diné speakers and cultural consultants to lead focus groups in a manner consistent with cultural worldviews. The analysis of the focus group data resulted in original findings that reframe previous understandings of environmental harm by broadening the boundaries to include: 1) social relations across time; 2) social relations across space; 3) spiritual relations; and 4) restoring balance. The findings allow for greater insight into the colonial context of disaster on rural and Indigenous lands and confronts colonial-rooted disasters through Indigenous-informed political action., Competing Interests: There are not conflicts of interest between co-authors and/or funding sources

Introduction: Many adolescents living with HIV in sub-Saharan Africa (SSA) experience poverty and have access to limited resources, which can impact HIV and mental health outcomes. Few studies have analyzed the impact of economic empowerment interventions on the psychosocial wellbeing of adolescents living with HIV in low resource communities, and this study aims to examine the mediating mechanism(s) that may explain the relationship between a family economic empowerment intervention (Suubi + Adherence) and mental health outcomes for adolescents (ages 10-16 at enrollment) living with HIV in Uganda., Method: We utilized data from Suubi + Adherence, a large-scale six-year (2012-2018) longitudinal randomized controlled trial (N = 702). Generalized structural equation models (GSEMs) were conducted to examine 6 potential mediators (HIV viral suppression, food security, family assets, and employment, HIV stigma, HIV status disclosure comfort level, and family cohesion) to determine those that may have driven the effects of the Suubi + Adherence intervention on adolescents' mental health., Results: Family assets and employment were the only statistically significant mediators during follow-up (β from -0.03 to -0.06), indicating that the intervention improved family assets and employment which, in turn, was associated with improved mental health. The proportion of the total effect mediated by family assets and employment was from 42.26% to 71.94%., Conclusions: Given that mental health services provision is inadequate in SSA, effective interventions incorporating components related to family assets, employment, and financial stability are crucial to supporting the mental health needs of adolescents living with HIV in under-resourced countries like Uganda. Future research should work to develop the sustainability of such interventions to improve long-term mental health outcomes among this at-risk group., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: This study examines the extent to which three mental health measures (hopelessness, depression, and poor self-concept) are improved through a family-based economic intervention implemented among adolescents living with HIV in Uganda., Methods: We used repeated measures from Suubi + Adherence, a large-scale 6-year (2012-2018) longitudinal randomized controlled trial. Bivariate analyses were conducted to test for observable group differences between the intervention and control conditions. Multilevel piecewise repeated measure mixed models were then conducted to assess hypothesized time × intervention interaction in changes in hopelessness, depression, and self-concept using participant-specific follow-up intervals., Results: At 24-month postintervention initiation, adolescents in the intervention condition reported a statistically significant lower hopelessness score than adolescents in the control condition (4.79 vs. 5.56; p = .018; N = 358). At 36-month follow-up, the intervention condition reported a statistically significant lower score on depression in the depression subgroup (N = 344) than the control condition (4.94 vs. 5.81; p = .029)., Conclusions: The results indicate that family-based economic interventions such as Suubi + Adherence can effectively improve the mental health of adolescents living with HIV who evidenced mental health challenges at baseline. Given the promising positive effects of these interventions, at least in the short term, future studies should investigate strategies to promote the sustainability of these mental health benefits., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: The purpose of this study is to understand the self-reported advantages and disadvantages of socially networking about body image/eating disorders (EDs) and to examine the openness of these participants to online outreach and support for ED symptoms., Method: A cross-sectional online survey was conducted with a sample of N = 598. Eligible participants were ≥15 years old, English-speaking, and U.S. residents who endorsed posting or following thin-ideal/body-image content on social media. Quantitative measures were used to assess online peer support and online interaction preferences, and to identify ED symptoms. Deductive and inductive qualitative approaches were used to analyze open-ended items about the advantages and disadvantages of social networking about thin-ideal content on social media platforms (SMPs)., Results: Among those who posted about the thin-ideal on social media, 70% felt that the peer responses were positive and supportive. Participants generally favored online interaction, and a third stated that they would accept support from someone they did not know online (38%). The most common advantages noted for posting/following thin-ideal content on SMPs were motivation/encouragement to engage in a certain behavior, socializing, and information giving/seeking. The most common disadvantages mentioned for posting/following thin-ideal content on SMPs were that the content elicits negative/bad feelings, having to deal with the negative consequences/reactions of others when socially networking about this topic, and that it triggers a desire to engage in ED behaviors., Discussion: With these findings, researchers, health practitioners, and social media administrators can devise ways to reduce harmful consequences of posting/following body-image/ED content on social media., (© 2020 Wiley Periodicals, Inc.)

Introduction: Opioid misuse has evolved into an American health crisis over the past decade, becoming a public health epidemic. Measures need to be taken to prevent overdoses by opioid misuse as well as prevent the transition into injection drug use, a high risk factor for contracting HIV/HCV. This study utilized social media to survey individuals currently misusing opioids to identify groups of individuals with different risk and use patterns., Methods: We recruited participants for our online survey from Reddit. Five risk behaviors were used to characterize overdose and HIV/HCV risk groups. Gender, age, and socioeconomic status were also included in the analyses, as well as items outlining social media use surrounding opioids., Results: Two groups of participants were characterized by high likelihoods of different combinations of risky behaviors: (1) Overdose Risk Group and (2) Sexual Risk Group. Those in the Overdose Risk Group were more likely to be younger in age and female, and this group was more likely to desire or be ready for treatment relative to the lowest risk group. Those in the Sexual Risk Group were more likely to be of a minority race/ethnicity, to desire or be ready for treatment, and to post more often on Reddit about opioid use., Discussion: The results of this study illustrate patterns of opioid use and risk behaviors to inform tailored outreach and treatment efforts for groups of opioid misusers and suggests the potential for utilizing social media as a tool to engage these individuals into treatment and recovery activities., (Copyright © 2019 Elsevier B.V. All rights reserved.)