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BackgroundScreen ASSIST is a cessation trial offered to current smokers at the point of lung cancer screening. Because of the unique position of promoting a prevention behavior (smoking cessation) within the context of a detection behavior (lung cancer screening), this study employed prospect theory to design and formatively evaluate a targeted recruitment video prior to trial launch. ObjectiveThe aim of this study was to identify which message frames were most effective at promoting intent to participate in a smoking cessation study. MethodsParticipants were recruited from a proprietary opt-in online panel company and randomized to a 2 (benefits of quitting vs risks of continuing to smoke at the time of lung screening; BvR) × 2 (gains of participating vs losses of not participating in a cessation study; GvL) message design experiment (N=314). The primary outcome was self-assessed intent to participate in a smoking cessation study. Message effectiveness and lung cancer risk perception measures were also collected. Analysis of variance examined the main effect of the 2 message factors and a least absolute shrinkage and selection operator (LASSO) approach identified predictors of intent to participate in a multivariable model. A mediation analysis was conducted to determine the direct and indirect effects of message factors on intent to participate in a cessation study. ResultsA total of 296 participants completed the intervention. There were no significant differences in intent to participate in a smoking cessation study between message frames (P=.12 and P=.61). In the multivariable model, quit importance (P

This study examines whether and how an individual's subjective, or self-rated, popularity is related to one's structural position in the peer network, as measured by betweenness centrality and structural hole measure. Data were drawn from the original fieldwork conducted in Laos (N = 1,490; boys = 40%; M[subscript age] = 13), a low-income country in Southeast Asia. Using friendship nominations, we constructed a global network matrix based on which sociometric variables were calculated. Findings from hierarchical linear models showed that net of sociometric and other controls, "network brokers"--those who span more structural holes or bridge across more disconnected dyads pairs--indeed perceive themselves as being "more popular." Subjective, net of objective, measure of popularity should be incorporated as a critical component in the lives of young people.

Objective: Cannabis is frequently co-used with tobacco/nicotine products, especially among young adults. Little is known about the effects of this co-use on cannabis cessation outcomes. Within a sample of young adults using cannabis frequently (current use of ≥5 days/week in the past 3 months), this study aimed to (a) document sources of exposure to tobacco/nicotine products, whether used simultaneously with cannabis or on different occasions, (b) examine if the level of cumulated exposure to tobacco/nicotine (self-reported or from biochemical testing) could predict time to cannabis lapse during a cannabis abstinence period, and (c) explore the relationship between nicotine/tobacco exposure and time to cannabis lapse according to tobacco cigarette smoking status. Method: Urine cotinine measures and self-reported data on use of different tobacco/nicotine products, collected from 32 participants (aged 19 to 23), were analyzed to predict time to lapse during a 2-week period of attempted abstinence from cannabis, controlling for cannabis dependence and sex. Results: Half of participants (56.3%) used at least one tobacco/nicotine product. Higher urine cotinine, representing higher cumulated tobacco/nicotine exposure, was related to a higher risk of lapsing (Hazard Ratio [HR] = 1.64; 95%CI [1.04, 2.58]). The risk of lapsing was even higher ([HR] = 3.46; 95%CI [1.17, 10.25]) among heavily tobacco/nicotine exposed (>600 ng/mL, urine cotinine) participants than among unexposed (

BackgroundScreening, brief intervention, and referral to treatment for adolescents (SBIRT-A) is widely recommended to promote detection and early intervention for alcohol and other drug (AOD) use in pediatric primary care. Existing SBIRT-A procedures rely almost exclusively on adolescents alone, despite the recognition of caregivers as critical protective factors in adolescent development and AOD use. Moreover, controlled SBIRT-A studies conducted in primary care have yielded inconsistent findings about implementation feasibility and effects on AOD outcomes and overall developmental functioning. There is urgent need to investigate the value of systematically incorporating caregivers in SBIRT-A procedures. ObjectiveThis randomized effectiveness trial will advance research and scope on SBIRT-A in primary care by conducting a head-to-head test of 2 conceptually grounded, evidence-informed approaches: a standard adolescent-only approach (SBIRT-A-Standard) versus a more expansive family-based approach (SBIRT-A-Family). The SBIRT-A-Family approach enhances the procedures of the SBIRT-A-Standard approach by screening for AOD risk with both adolescents and caregivers; leveraging multidomain, multireporter AOD risk and protection data to inform case identification and risk categorization; and directly involving caregivers in brief intervention and referral to treatment activities. MethodsThe study will include 2300 adolescents (aged 12-17 y) and their caregivers attending 1 of 3 hospital-affiliated pediatric settings serving diverse patient populations in major urban areas. Study recruitment, screening, randomization, and all SBIRT-A activities will occur during a single pediatric visit. SBIRT-A procedures will be delivered digitally on handheld tablets using patient-facing and provider-facing programming. Primary outcomes (AOD use, co-occurring behavior problems, and parent-adolescent communication about AOD use) and secondary outcomes (adolescent quality of life, adolescent risk factors, and therapy attendance) will be assessed at screening and initial assessment and 3-, 6-, 9-, and 12-month follow-ups. The study is well powered to conduct all planned main and moderator (age, sex, race, ethnicity, and youth AOD risk status) analyses. ResultsThis study will be conducted over a 5-year period. Provider training was initiated in year 1 (December 2023). Participant recruitment and follow-up data collection began in year 2 (March 2024). We expect the results from this study to be published in early 2027. ConclusionsSBIRT-A is widely endorsed but currently underused in pediatric primary care settings, and questions remain about optimal approaches and overall effectiveness. In particular, referral to treatment procedures in primary care remains virtually untested among youth. In addition, whereas research strongly supports involving families in interventions for adolescent AOD, SBIRT-A effectiveness trial testing approaches that actively engage family members in primary care are absent. This trial is designed to help fill these research gaps to inform the critical health decision of whether and how to include caregivers in SBIRT-A activities conducted in pediatric primary care. Trial RegistrationClinicalTrials.gov NCT05964010; https://www.clinicaltrials.gov/study/NCT05964010 International Registered Report Identifier (IRRID)PRR1-10.2196/54486

BackgroundAlcohol and other substance use disorders usually begin with substance use in adolescence. Pediatric primary care offices, where most adolescents receive health care, are a promising venue for early identification of substance use and for brief intervention to prevent associated problems and the development of substance use disorder. ObjectiveThis study tests the effects of a computer-facilitated screening and brief intervention (cSBI) system (the CRAFFT [Car, Relax, Alone, Forget, Family/Friends, Trouble] Interactive System [CRAFFT-IS]) on heavy episodic drinking, riding with a driver who is substance impaired, or driving while substance impaired among adolescents aged 14 to 17 years presenting for a well visit at pediatric primary care practices. MethodsWe are conducting a cluster randomized controlled trial of the CRAFFT-IS versus usual care and recruiting up to 40 primary care clinicians at up to 20 pediatric primary care practices within the American Academy of Pediatrics (AAP) Pediatric Research in Office Settings network. Clinicians are randomized 1:1 within each practice to implement the CRAFFT-IS or usual care with a target sample size of 1300 adolescent patients aged 14 to 17 years. At study start, intervention clinicians complete web-based modules, trainer-led live sessions, and mock sessions to establish baseline competency with intervention counseling. Adolescents receive mailed recruitment materials that invite adolescents to complete an eligibility survey. Eligible and interested adolescents provide informed assent (parental permission requirement has been waived). Before their visit, enrolled adolescents seeing intervention clinicians complete a self-administered web-based CRAFFT screening questionnaire and view brief psychoeducational content illustrating substance use–associated health risks. During the visit, intervention clinicians access a computerized summary of the patient’s screening results and a tailored counseling script to deliver a motivational interviewing–based brief intervention. All participants complete previsit, postvisit, and 12-month follow-up study assessments. Primary outcomes include past 90-day heavy episodic drinking and riding with a driver who is substance impaired at 3-, 6-, 9-, and 12-month follow-ups. Multiple logistic regression modeling with generalized estimating equations and mixed effects modeling will be used in outcomes analyses. Exploratory aims include examining other substance use outcomes (eg, cannabis and nicotine vaping), potential mediators of intervention effect (eg, self-efficacy not to drink), and effect moderation by baseline risk level and sociodemographic characteristics. ResultsThe AAP Institutional Review Board approved this study. The first practice and clinicians were enrolled in August 2022; as of July 2023, a total of 6 practices (23 clinicians) had enrolled. Recruitment is expected to continue until late 2024 or early 2025. Data collection will be completed in 2025 or 2026. ConclusionsFindings from this study will inform the promotion of high-quality screening and brief intervention efforts in pediatric primary care with the aim of reducing alcohol-related morbidity and mortality during adolescence and beyond. Trial RegistrationClinicalTrials.gov NCT04450966; https://www.clinicaltrials.gov/study/NCT04450966 International Registered Report Identifier (IRRID)DERR1-10.2196/55039

Abstract Research on attitudes toward immigrants and refugees largely focuses on intergroup conflict and related threats imposed by outgroup members. This study shifts the analytic focus to intragroup conflict: a [...]

Why do some people 'cooperate' by adhering to anti‐pandemic government guidelines and mandates, while others opt to behave in more selfish ways? This study addresses this question by focusing on the concept of 'conditional cooperation'. Data were drawn from the Global Behaviors and Perceptions in the COVID‐19 Pandemic, a large online survey (N = 98,310) consisting of respondents from 63 countries fielded during the weeks of March and April of 2020. Two‐level mixed effects models were fitted. Adjusting for controls, people's compliance behaviours were significantly related to the mechanism of conditional cooperation. More specifically, those who perceived others to be more cooperative were more likely to engage in social distancing behaviour during the COVID‐19 pandemic. In contrast, subjective assessment of the infection rate was negatively associated with it. In addition, at the macro (country) level, physical mobility index negatively predicted health‐protective or disease‐avoidant behaviour, a relationship that fluctuated partly as a function of the level of perceived infection. A major implication of this study is that cross‐nationally individual decisions to contribute to the provision of public good during a global public health crisis hinge critically on both subjective and objective measures of others' willingness to cooperate. [ABSTRACT FROM AUTHOR]

Background: This study investigates the extent to which friendship network, family relations, and school context are related to adolescent cigarette smoking. Friendship network is measured in terms of delinquent peers; family relations in terms of parental supervision; and school environment in terms of objective (eg, antismoking policy) and subjective (eg, school attachment) characteristics. Methods: Findings are based on the secondary analysis of the health behavior in school-aged children, 2009-2010. Two-level hierarchical generalized linear models are estimated using hierarchical linear modeling 7. Results: At the student level, ties to delinquent friends is significantly related to higher odds of smoking, while greater parental supervision is associated with lower odds. At the school level, antismoking policy and curriculum independently lower smoking behavior. Better within-class peer relations, greater school attachment, and higher academic performance are also negatively related to smoking. Last, the positive association between delinquent friends and smoking is "weaker" in schools with a formally enacted antismoking policy. However, this association is "stronger" in schools with better peer relations. Conclusions: Adolescent smoking behavior is embedded in a broader ecological setting. This research reveals that a proper understanding of it requires comprehensive analysis that incorporates factors measured at individual (student) and contextual (school) levels.

Using two waves of nationally representative data, the present study shows the extent to which the COVID-19 pandemic has exacerbated anti-outgroup and anti-ingroup attitudes among South Korean adults. To that end, in a quasi-experimental setting, it exploits the survey interview timing as a source of exogenous variation to investigate the causal influence of the COVID-19 pandemic. Data imbalance is initially corrected using the coarsened exact matching procedure. Then, a series of multilevel models, with data on 10,454 subjects nested in 34 wave–region units, are estimated with additional covariate adjustment to improve estimate precision. Results show that, first, those who are more relatively deprived became less inclined to support the granting of citizenship status to foreigners since the coronavirus outbreak. Second, the same trend was found among individuals who are more dissatisfied with the country's overall economic condition. Third, in the wake of the global health crisis, Korean natives became less willing to pay additional taxes to support conational others who are economically underprivileged. [ABSTRACT FROM AUTHOR]

Why are some ingroup members (i.e., natives) more tolerant of, or hostile toward, outgroup others (i.e., immigrants)? A large volume of evidence exists attempting to address this issue. The bulk of findings from observational and experimental research focuses on the dual concept of 'realistic' and 'symbolic' threat, operationalized in terms of migrant stock or percentage of foreign-born population. According to the literature, a higher stock generally indicates a higher threat, which in turn implies greater xenophobic sentiment. Against this backdrop, the present study shifts the analytic emphasis to a novel explanatory mechanism in the US context: strength of social norms at the state level. Specifically, by drawing on the concept of cultural tightness-looseness, it asks whether American citizens in a geographic region characterized by strong social norms and stringent sanctioning of deviance are, on average, more xenophobic. Results from mixed effects models provide substantial support. Based on nationally representative data collected by the Pew Research Center (2018) during the height of Trump administration, the analysis reveals that cultural tightness has a contextual effect: net of controls, residency in a state with a higher index score is associated with greater levels of anti-immigrant prejudice and stronger preference for anti-immigration policy. [ABSTRACT FROM AUTHOR]

According to critics of globalization, it has ushered in a new era of economic inequality, with some of the biggest "losers" being the majority working classes in advanced capitalist democracies. Economically aggrieved, culturally threatened, and politically excluded, they have become the bedrock of right-wing political parties in much of Europe and the United States. Integral to this phenomenon is the heightened anti-immigrant prejudice espoused by both supporters and leaders of populist movements. The present study investigates a critical issue in this context, one that has been implicitly assumed but relatively understudied: the impact of globalization on xenophobic attitudes among natives. It also examines whether and to what extent globalization moderates the effect of ethnic nationalism on their preferences for restrictive immigration and immigrant assimilation. Findings from multilevel analysis indicate that globalization, as well as the nativist backlash, plays a significant role in directly and indirectly shaping how immigration and immigrants are perceived in host societies. [ABSTRACT FROM AUTHOR]