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Research has consistently demonstrated the benefits of using ePortfolios in higher education and the Association of American Colleges and Universities (AAC&U) added ePortfolios to its High-Impact Practices list (Watson, Kuh, Rhodes, Light, & Chen, 2016). The majority of studies on college students' ePortfolio use have focused on implementation within a specific course or from a faculty perspective. Given the important benefit of ePortfolios for lifelong student learning, it is important to assess factors which impact intrinsic motivation from a student-centered perspective. This paper details a study of college students' motivation and confidence to use an ePortfolio system as part of a university-wide quality enhancement plan that included high-impact, experiential learning activities. This study also explored college students' personal values and their perceived advantages and disadvantages of ePortfolio use within the context of experiential learning and reflection. Data were analyzed from 339 student responses from a survey constructed based on motivational interviewing. Overall, students reported low levels of motivation and moderate levels of confidence to use ePortfolios. In addition, students who had participated in an experiential learning activity through the university's QEP reported higher confidence than those who had not. Factors identified as potentially impacting students' motivation and confidence to use ePortfolios are discussed in terms of how they can support strategies to implement ePortfolio and experiential learning programs in large, 4-year college institutions.

Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.

Background: Caregivers to intensive care unit survivors are vulnerable to caregiver burden, which has been demonstrated to have consequences to patients' and caregivers' mental and physical health. Potentially modifiable factors should be explored so that interventions may be developed. Methods: Ninety-one anticipated caregivers were prospectively assessed both at a southwestern trauma intensive care unit during their patient's admission and at home via remote interview 3 months after intensive care unit admission. Caregiver depression, posttraumatic stress symptoms, experiences, and perceived burden were assessed. Results: At follow up, there was a significant negative correlation between caregiver burden and understanding of their patient's condition (P < 0.001) and intensive care unit events (P = 0.008). Caregivers with lower understanding of their patient's injury/illness had significantly greater depressive symptoms (P = 0.04). Conclusions: Education and knowledge of intensive care unit events regarding their patient may influence perceived burden among caregivers. Interventions to orient caregivers to intensive care unit events are suggested to reduce caregiver and healthcare system burden. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has had a significant impact on mental health, and individuals with certain preexisting morbidities—such as obesity—may have disproportionately experienced pandemic-related stress. We aimed to examine whether being obese or overweight was associated with worse mood and trauma among those infected with COVID-19. Methods: Data were collected as part of a larger longitudinal survey study (n = 591) examining the psychological impact of COVID-19. Complete baseline data for those who reported testing positive from April 2020 through June 2021 were examined. Results and conclusions: Body mass index was correlated with depression (r = 0.13, P <.01) and generalized anxiety disorder (r = 0.10, P =.02), but not with posttraumatic stress disorder (r = 0.06, P =.16). Multivariable analyses revealed that body mass index was no longer a unique predictor, except for those with a body mass index >40 kg/m2, suggesting that other sociodemographic factors, not obesity, were driving mood symptoms for those infected with COVID-19. [ABSTRACT FROM AUTHOR]

Context: Before availability of COVID-19 vaccinations, rural counties with majority racial and ethnic minority populations were disproportionately impacted by COVID-19 compared to majority Non-Hispanic White (NHW) counties. Objective: Describe disparities in COVID-19 outcomes across majority NHW and minority NHW rural counties before and after the widespread availability of COVID-19 vaccinations. Study Design: Rural counties were categorized as, Presenters Anne Gaglioti, MD, FAAFP, MS, Robina Josiah Willock, PhD, MPH, Megan Douglas, JD, Lee Caplan, MD, PhD, MPH, Ashley Daniel, BS, MS, Peter Baltrus, PhD, Dominic Mack, MD, MBA, [...]

Adapt and validate the Mayo Leadership Impact Index (MLII) for settings with matrixed leadership structures. Design: A psychometric validation study utilizing classical test theory and item response theory. Setting: A tripartite hospital system in the southwestern US. Participants: Physician-respondents to a 2023 cross-sectional survey. Main Outcomes and Measures: After pilot testing, the adapted MLII was examined using a unidimensional graded response model and confirmatory factor analyses. Convergent validity was investigated via correlations with professional fulfillment, perceived autonomy support, self-valuation, and peer connectedness/respect. Divergent validity was tested via correlations with burnout. Results: Of the three candidate revisions of the MLII, the 9-item adaptation was selected for its superior validity/reliability indices. Standardized Cronbach's and Ordinal alpha coefficients were 0.958 and 0.973, respectively. CFA loadings exceeded 0.70 (p < 0.001), and coefficients of variation (R2) exceeded 0.60 for all items. GRM slope parameters indicated "high" to "very high" item discrimination. Items 2, 5, and 8 were the most informative. Positive correlations of the adapted MLII with professional fulfillment, perceived autonomy support, and peer connectedness/respect were observed, supporting convergent validity. Negative correlation with overall burnout supports divergent validity. Conclusions and Relevance: The findings provide evidence of the adapted MLII's validity, reliability, and appropriateness for implementation within matrixed leadership settings. Prior to this study, no leadership support measure had been validated for use among the growing number of healthcare systems with matrixed leadership reporting structures. Plain Language Summary: Question : What is the validity and reliability of a well-being centered leadership measure adapted for use in healthcare systems with matrixed, multiform reporting structures? Findings : Classical test theory and item response theory analyses of cross-sectional survey data from 158 physician-respondents supported the adapted measure's construct validity. All reliability coefficients were strong. Leadership ratings positively correlated with professional fulfillment, autonomy support, self-valuation, and peer connectedness/respect, and negatively correlated with burnout. Meaning : Findings support the adapted measure's validity and reliability. This study is the first to demonstrate a valid empirical measure of well-being centered leadership behaviors in settings with multiform, matrixed leadership structures. [ABSTRACT FROM AUTHOR]

To examine health-related self-efficacy for individuals following acquired brain or spinal cord injury prior to enrollment in a weight-loss intervention and associations with demographics, injury characteristics, and additional physiologic variables. Cross-sectional analysis of baseline data for community-dwelling adults following stroke (CVA), traumatic brain injury (TBI), or spinal cord injury (SCI) across three disability-adapted weight-loss interventions. Overall results suggest a significant difference between injury type and self-efficacy as measured by the Self Rated Abilities for Health Practices (SRAHP) scale. On average, individuals with SCI had the lowest overall perceived self-efficacy of the three groups (11.2-unit difference; (CI: −17.4, −5.0), followed by those with TBI (9.5-unit difference; (CI: −16.7, −2.4). There were also differences between groups in age, number of household members, time since injury, sex, race, marital status, physiological measures, and employment status. Results suggest that individuals with different disabilities following neurological injuries have different baseline perceptions in their ability to eat a healthy diet and exercise regularly. Health interventions should be tailored for these groups based on disability-specific barriers and should include components to enhance health-related self-efficacy to address weight management among these populations. Evidence suggests that health-related self-efficacy may differ following different injury types and level of disability may impact one's ability to maintain health-related behaviors Results suggest that individuals with a spinal cord injury may have different baseline perceptions of self-efficacy related to their ability to eat a healthy diet and exercise regularly compared to those with a traumatic brain injury or stroke. Health interventions should be tailored to encompass disability-specific barriers which may impact an individual's health-related self-efficacy. [ABSTRACT FROM AUTHOR]

Objective: The authors assessed changes in state insurance laws related to coverage for substance use disorder treatment across public and private insurance sectors from 2006 through 2020 in all 50 U.S. states. Methods: Structured policy surveillance methods, including a coding protocol with duplicate coding and quality controls, were used to track changes in state laws during the 2006–2020 period. The legal database Westlaw was used to identify relevant statutes within each state's commercial insurance (large group, small group, and individual), state employee health benefits, and Medicaid codes. The legal coding instrument included six questions across four themes: parity, mandated coverage, definition of substance use disorders, and enforcement and compliance. Scores were calculated to reflect the comprehensiveness of states' laws and to interpret changes in scores over time. Results: Comprehensiveness scores across all sectors (on a 0–9 scale) increased, on average, from 1.47 in 2006 to 2.84 in 2020. In 2006, mean scores ranged from 0.47 (state employee sector) to 2.80 (large-group sector) and in 2020, from 1.22 (state employee) to 4.26 (large group). Conclusions: Comprehensiveness of state insurance laws in relation to substance use disorder treatment improved across all insurance sectors in 2006–2020. The State Substance Use Disorder Insurance Laws Database created in this study will aid future legal epidemiology studies in assessing the cumulative effects of parity-related insurance laws on outcomes of substance use disorder treatments. [ABSTRACT FROM AUTHOR]

Providers frequently report pain as a barrier to weight loss yet the relationship between the pain experience and eating behavior is poorly understood. The current study examines overeating in response to physical pain (Pain Overeating). Weight-loss seeking Veterans (N = 126) completed the Yale Emotional Overeating Questionnaire, a measure used to assess the frequency of overeating in response to a range of emotions that was adapted to include a Pain Overeating item, and validated measures of pain, eating pathology, and mental health. Fifty-one participants (42.5%) engaged in at least one Pain Overeating episode in the past month, and 14.2% engaged in this behavior daily. Pain Overeating was significantly related to pain intensity and interference, and accounted for statistically significant variance in predicting BMI, eating pathology and depression. Findings suggest eating in response to physical pain is common among weight-loss seeking Veterans and may have important implications for weight management treatment., Author(s): Robin M. Masheb [sup.1] [sup.2] , Megan E. Douglas [sup.3] , Amanda M. Kutz [sup.4] , Alison G. Marsh [sup.1] , Mary Driscoll [sup.1] [sup.2] Author Affiliations: (1) grid.281208.1, [...]

Objective: The transition to college is marked by poorer eating behaviors, making emerging adulthood a particularly salient intervention point for improving lifelong health. The present study aims to better understand what psychosocial factors predict eating behaviors of college students using the Theory of Planned Behavior (TPB). Participants & Methods: Dietary recalls were analyzed the Healthy Eating Index (HEI)-2015 scoring system for 67 university students between the ages of 18 and 25 (70.1% female; 49.3% White, 20.9% Black/African American, 13.4% Asian). Results: Haye's PROCESS Model 6 was used. The full model accounted for a significant amount of variance in HEI-2015 scores (F[3, 63] = 3.09, p =.033, R2 =.12). The final model suggested a significant indirect effect of PBC on the relation between ATT and HEI-2015 (β =.859, SE =.637, 95% CI [.009, 2.482]). Conclusions: Although some college students might have favorable attitudes, only those who believe this is within their control actually ate a (somewhat) healthier diet. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic's global emergence/spread caused widespread fear. Measurement/tracking of COVID‐19 fear could facilitate remediation. Despite the Fear of COVID‐19 Scale (FCV‐19S)'s validation in multiple languages/countries, nationwide United States (U.S.) studies are scarce. Cross‐sectional classical test theory‐based validation studies predominate. Our longitudinal study sampled respondents to a 3‐wave, nationwide, online survey. We calibrated the FCV‐19S using a unidimensional graded response model. Item/scale monotonicity, discrimination, informativeness, goodness‐of‐fit, criterion validity, internal consistency, and test‐retest reliability were assessed. Items 7, 6, and 3 consistently displayed very high discrimination. Other items had moderate‐to‐high discrimination. Items 3, 6, and 7 were most (items 1 and 5 the least) informative. [Correction added on 18 May 2023, after first online publication: In the preceding sentence, the term 'items one‐fifth least' has been changed to 'items 1 and 5 the least'.] Item scalability was 0.62–0.69; full‐scale scalability 0.65–0.67. Ordinal reliability coefficient was 0.94; test‐retest intraclass correlation coefficient 0.84. Positive correlations with posttraumatic stress/anxiety/depression, and negative correlations with emotional stability/resilience supported convergent/divergent validity. The FCV‐19S validly/reliably captures temporal variation in COVID‐19 fear across the U.S. [ABSTRACT FROM AUTHOR]