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In the US, the growing demand for precision medicine, particularly in oncology, continues to put pressure on the availability of genetic counselors to meet that demand. This is especially true in certain geographic locations due to the uneven distribution of genetic counselors throughout the US. To assess these disparities, access to genetic counselors of all specialties is explored by geography, cancer type, and social determinants of health. Geospatial technology was used to combine and analyze genetic counselor locations and cancer incidence at the county level across the US, with a particular focus on tumors associated with BRCA mutations including ovarian, pancreatic, prostate and breast. Access distributions were quantified, and associations with region, cancer type, and socioeconomic variables were investigated using correlational tests. Nationally, in 2020, there were 4,813 genetic counselors, or 1.49 genetic counselors per 100,000 people, varying between 0.17 to 5.7 per 100,000 at the state level. Seventy-one percent of U.S. residents live within a 30-minute drive-time to a genetic counselor. Drive-times, however, are not equally distributed across the country – while 82% of people in metropolitan areas are 30 minutes from a genetic counselor, only 6% of people in nonmetro areas live within 30 minutes’ drive time. There are statistically significant differences in access across geographical regions, socioeconomics and cancer types. Access to genetic counselors for cancer patients differs across groups, including regional, socioeconomic, and cancer type. These findings highlight areas of the country that may benefit from increased genetic counseling provider supply, by increasing the number of genetic counselors in a region or by expanding the use of telegenetics a term used to describe virtual genetic counseling consults that occur via videoconference. Policy intervention to allow genetic counselors to bill for their services may be an effective route for increasing availability of genetic counselors’ services However, genetic counselors in direct patient care settings also face other challenges such as salary, job satisfaction, job recognition, overwork/burnout, and appropriate administrative/clinical support, and addressing these issues should also be considered along with policy support. These results could support targeted policy reform and alternative service models to increase access to identified pockets of unmet need, such as telemedicine. Data and analysis are available to the public through an interactive dashboard1.

Objective Research on college sexual violence perpetration suggests there are multiple groups of male perpetrators. It is important to understand the distinctions between perpetrator subgroups to determine appropriate prevention strategies, as multiple strategies may be necessary to address multiple types of perpetrators. However, previous studies on subgroups of sexually-violent college men have relied on theoretically based distinctions, and there is currently no consensus on how to best classify perpetrators based on their sexually violent behaviors. The purpose of the current study was to take a data-driven approach to identifying subgroups of sexually-violent college men to help clarify: 1) the number and size of cohesive subgroups of sexually-violent college men, and 2) the types of behaviors that characterize each group. Methods 1,982 college men across five universities in the U.S. self-reported their past sexually-violent behaviors, using the Sexual Experiences Survey (SES; Koss et al., 2007). Results Latent class analysis uncovered evidence for three groups: (1) a group unlikely to perpetrate any SV (88.6%); (2) a group likely to perpetrate SV using coercive tactics (verbal coercion or victim intoxication), but unlikely to use physical force (9.8%); and (3) a group likely to perpetrate the full range of SV (1.5%). Although the coercive tactics group was composed of men unlikely to use forceful tactics, it included the majority who attempted or completed rape based on legal definitions. Conclusions Our findings suggest that there are multiple, distinct perpetrator subgroups and signal the need for multiple prevention approaches, including approaches that address campus social norms.

This study aimed to understand the extent to which parent involvement, community involvement, and schoolwide violence-prevention initiatives reduced school violence, considering school racial/ethni...

The present cross-sectional study examined whether self-concealment was associated with general psychological distress, somatization, depression, and anxiety among Asian American, Black American, and White American college students in the U.S., and whether psychological inflexibility partially explains these associations. Participants (N = 991, 77% female, age range = 16–60 years) completed self-report measures of interest online. Results revealed the relations between self-concealment and the four distress variables in each ethnic group and suggested that these relations were explained partially through psychological inflexibility. Future research should examine this model among subpopulations of these ethnic groups, as well as the influence of various cultural variables.

This study examines self-criticism as a mechanism through which compassion meditation reduces depressive symptoms in low-income African American men and women (N = 59) who had recently attempted suicide. After completing several measures, including the Levels of Self-Criticism Scale and Beck Depression Inventory-II, participants were randomly assigned to receive either a six-session compassion meditation (CM) group (Grady Compassion and Meditation Program) or a six-session support group. As predicted, path analysis results showed that treatment condition led to changes in self-criticism from pre- to posttreatment, with those receiving CM showing greater reductions in levels of self-criticism than those randomized to the support group. Path analyses also revealed that changes in self-criticism fully mediated the link between condition and changes in depressive symptoms. These findings highlight the importance and value of targeting levels of self-criticism in compassion-based interventions to reduce the depressive symptoms of suicidal African Americans.

There is a dire need to understand behavioral health outcomes in U.S. Latina/o individuals. Following the psychological flexibility model of behavior change, the present cross-sectional study investigated the role of self-concealment in a range of distress variables in a U.S. Latina/o college sample. Participants (N = 83, 76 % female, range = 17–50 years old) completed self-report measures online. Results revealed a direct effect of self-concealment on depression and large indirect effects of self-concealment on general distress, somatization, and anxiety through psychological inflexibility. These findings suggest that maladaptive cognitive and emotion regulation processes in general, and psychological inflexibility in particular, contribute to distress in the present Latina/o sample. Future research should examine whether psychological inflexibility and self-concealment predict onset, recurrence, and/or maintenance of psychological distress among Latina/o individuals over time.

The present cross-sectional study investigated whether self-concealment and psychological inflexibility were associated with a range of psychological distress in sexual minorities and whether the associations between self-concealment and distress were established, in part, though psychological inflexibility. Participants were 100 college students (nfemale = 74) who self-identified their sexual orientations as “homosexual” or “bisexual.” Both self-concealment and psychological inflexibility were significantly and positively associated with general psychological distress, somatization, depression, and anxiety. Furthermore, results revealed that self-concealment is associated with these four distress variables at least partly through psychological inflexibility.

Caregiver–youth communication about sex protects youth against HIV/AIDS, and caregivers who believe that sex knowledge is important are more likely to talk to their youth about sex. However, caregivers who experience barriers to communication about sex may not talk to their youth about sex even if the caregiver believes that sex education is important. The Theory of Planned Behaviour predicts that an actor has perceived control is necessary for behavioural change. This study therefore hypothesised that caregivers’ perceived control moderates the relationship between caregiver attitudes about youth sex knowledge and caregiver–youth communication about sex. Results from a sample of 99 female South African caregivers of adolescent (10–14 year old) youth supported our hypothesis, indicating that caregiver attitudes about providing youth with sex knowledge positively predict communication about sex only when caregivers have perceived control. This finding illustrates the importance of perceived control in predicting caregiver–youth communication, and therefore has implications for family-based interventions aimed at improving caregiver–youth communication about sex.Keywords: HIV, family, caregivers, perceived control, parental attitudes, parent–child communicationAfrican Journal of AIDS Research 2014, 13(1): 31–36

There is evidence that individuals emotionally abused as children endorse more hopelessness, a precursor of suicidal behavior in adulthood. However, there has been little focus on this association among African-Americans or on factors that may mediate the childhood emotional abuse (CEA) - adult hopelessness link. The present study examined whether CEA is linked to hopelessness in adulthood in African-American women suicide attempters and if adult self and other attachment models mediate this association. Participants included 116 African-American women recruited from a large, urban hospital. Results revealed that CEA had no direct effect on hopelessness in adulthood, but did have an indirect effect on hopelessness through attachment models. Bootstrapping analyses showed that higher levels of CEA were related to more negative self and other attachment models, which were then linked to higher levels of hopelessness. Implications for targeting attachment in suicide intervention programs are discussed.

OBJECTIVE: To investigate the impact of answering survey questions about experiences of stressful, stigmatizing, potentially traumatic and sexually violating events on well being, defined as reactions to research, anxiety, and positive and negative affect over two weeks. METHOD: With an ethnically diverse sample of 559 higher education students, we employed a mixed experimental design (with between and within-subjects components) to evaluate changes in positive and negative affect, anxiety, traumatic stress symptoms, and reactions to research. We used multilevel regression models and planned contrasts to determine which, if any, specific characteristics of the survey questions caused changes in well being by comparing the effects of answering a randomly assigned set of survey questions about stressful, stigmatizing, potentially traumatic, or sexually violating life events across a two-week period. RESULTS: Controlling for baseline post-traumatic stress symptoms and levels of the outcome, we identified few statistically significant effects between conditions or across time. Significant effects included a small decrease in positive affect immediately after responding to questions about sexually violating events, which diminished at two weeks; these same participants perceived fewer drawbacks to research participation. Participants who responded to questions about stressful life events reported greater perceptions of benefits. CONCLUSIONS: Our data support the safety of survey research on sexual assault or other stressful, stigmatizing, or potentially traumatic events. Language: en

Objectives: Approximately 5.6 million South Africans are living with human immunodeficiency virus (HIV; UNAIDS 2010). Prevalence among Black adolescents and young adults is particularly alarming. This pilot study of an HIV preventive intervention targeting South African youth contributes to the growing body of research on culturally competent family-based interventions. Method: A total of 99 parent-child dyads were enrolled in an experimental repeated measures study using a wait-list control group. Our 6-session intervention targeted general parenting (relationship quality parental monitoring and involvement) gender roles and parent-youth communication about sex (content and quality). Parents and youth were assessed at baseline postintervention and 6-month follow-up. Eligibility included being the primary female caregiver of a 10- to 14-year-old child with whom they spent at least 4 nights a week and being able to participate in English or Xhosa. Results: Effect sizes with this small sample met or exceeded those of other family-based HIV interventions for youth in the United States and South Africa (e.g. Bell et al. 2008; Forehand et al. 2007). Parents reports at postintervention indicated larger effect sizes for general parenting than youths reports indicated. Parents reports showed medium to large effects for all sex communication outcomes at postintervention and the 6-month follow-up. Youth reports demonstrated small to medium effects for most communication variables and these effects lasted through the 6-month follow-up period. Conclusions: Intergenerational social networks (e.g. families) hold promise for HIV prevention among South African youth. A full efficacy trial with longer-term follow-up and attention to maintenance of effects is warranted.

Body image flexibility, a regulation process of openly and freely experiencing disordered eating thoughts and body dissatisfaction, has been found to be a buffering factor against disordered eating symptomatology. The present cross-sectional study investigates whether body image flexibility accounts for disordered eating behavior above and beyond disordered eating cognition, mindfulness, and psychological inflexibility in a sample of nonclinical women, and whether body image flexibility moderates the associations between these correlates and disordered eating behavior. Participants were 421 women, age 21±5.3 years old on average, who completed a web-based survey that included the self-report measures of interest. Results demonstrate the incremental effects of body image flexibility on disordered eating behavior above and beyond disordered eating cognition, mindfulness, and psychological inflexibility. Women with greater body image flexibility endorse disordered eating behavior less so than those with lower body image flexibility. Body image flexibility moderates the association between disordered eating cognition and disordered eating behavior; for women with greater body image flexibility, disordered eating cognition is not positively associated with disordered eating behavior.