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There are substantial disparities in clinical trial participation, which is problematic in diseases such as lupus that disproportionately affect racial/ethnic minority populations. We examined the effectiveness of an online educational course aiming to train medical providers to refer Black and Latino patients to lupus clinical trials (LCTs).The American College of Rheumatology's Materials to Increase Minority Involvement in Clinical Trials (MIMICT) study uses an online, randomized, two-group, pretest/posttest design with medical and nursing providers of multiple specialties. We exposed intervention group participants to an education course, while the control group participants received no intervention. Controlling for the effects of participant characteristics, including specialty, and professional experience with lupus, we modeled relationships among exposure to the education course and changes in knowledge, attitudes, self-efficacy, and intentions to refer Black and Latino patients to LCTs. We also examined education course satisfaction.Compared to the control group, the intervention group had significantly higher posttest scores for knowledge, self-efficacy, and intentions to refer Black and Latino patients to LCTs. Both medical and nursing trained intervention group participants had significantly higher mean posttest scores for knowledge and intentions to refer compared to the medical and nursing trained control group participants. Attitude was insignificant in analysis. The online education course, which received a favorable summary score, indicated that satisfaction and intentions to refer were strongly and positively correlated.The MIMICT education course is an effective method to educate medical providers about LCTs and improve their intentions to refer Black and Latino patients.

Sleep deprivation may be a contributing factor to adolescents' willingness to experiment with substance use, including electronic nicotine devices (ENDS). While it is generally accepted that nicotine has a negative overall effect on sleep, no studies have yet explored whether sleep deprivation may contribute to adolescents' initiation of ENDS use. The purpose of this study is to explore whether sleep deprivation is associated with adolescents' self-reported susceptibility to initiating ENDS use in the next month. Respondents were 1,100 adolescents aged 13-17 across the United States who participated in the Vaping Attitudes Youth Perspectives Survey (VAYPS). We used logistic regression to examine cross-sectional associations between self-reported average sleep duration and self-reported likelihood of trying ENDS in the future. Results of the three logistic regression models show that adolescents who reported getting less than six hours of sleep per night were associated with greater odds of reporting any likelihood to try a vape in the next 30 days even when controlling for demographics and potential confounders (6hrs sleep: OR = 2.63, 95% CI 1.30-5.31). Future research on the association between sleep deprivation and ENDS use among adolescents will benefit from using longitudinal approaches to better understand causality.

In the United States, the reported prevalence of lupus is 100,000 to 500,000 patients. Lupus disproportionately affects minority populations, including African Americans and Latinos, and the associated health disparities are substantial. Women are at a higher risk of lupus than men and lupus prevalence is the highest in African Americans and Latinos compared to non-Hispanic whites. African Americans and Latinos also have increased disease symptom severity, experience more lupus-related complications, and have a two- to three-fold mortality rate compared to non-Hispanic Whites. Lupus clinical trials offer opportunities for quality care and can result in new treatment options, but African Americans and Latinos are underrepresented in clinical trials because of substantial patient- and provider-side barriers. In conjunction with the limited knowledge of clinical trials that potential participants may have, the healthcare staff approaching participants have limited time to adequately educate and explain the aspects of clinical trials. Indeed, ninety percent of clinical trials fail to meet their recruitment goals on time, so a multi-faceted approach is necessary to address the issue of low minority participation in clinical trials.

BackgroundYouth e-cigarette use is a major public health concern. Large-scale tobacco prevention campaigns are a proven strategy to prevent tobacco use. There is a gap in understanding what types of e-cigarette prevention messages might be most effective. This study addresses this gap by reporting youth reactions to health messages aimed at preventing e-cigarette use.MethodsIn 2018, twenty-four focus groups, with 159 teens (12–17) at risk for or experimenting with e-cigarettes were conducted in four cities across the USA. During focus groups, youth responded to creative concepts dealing with (1) the addictive nature of e-cigarettes, (2) the fact that e-cigarettes come in flavours, which may encourage youth initiation, and nicotine which may lead to addiction, or (3) that youth who use e-cigarettes are more likely to use cigarettes. Youth also gave feedback to specific facts about harmful and potentially harmful chemicals in e-cigarettes. Transcripts were analysed using thematic analysis.ResultsMessages focusing on addiction alone did not resonate with participants. While youth found the idea that e-cigarettes may contain nicotine and can be addictive believable, with many describing personal experiences of addiction, they questioned how bad this really was, comparing addiction to e-cigarettes to things like being addicted to food. Participants wanted more information about negative consequences of vaping. Concepts paired with strong health effects messages resonated with participants.ConclusionThese focus groups clarified which e-cigarette prevention messages might be most persuasive to teens. Youth in this study responded favourably to messages stating specific health consequences of e-cigarette use.

To examine gender differences in commentary about self and others in same- and mixed-gender contexts, the authors analyzed dyadic conversations involving 78 children in 5 preschool facilities. Compared to girls talking to girls, boy talking to boys made more statements with negative connotations for others and less often pointed out self–other similarities. No gender differences were observed in mixed-gender contexts. Compared to boys talking with boys, boys talking with girls spoke more frequently of similarities and abilities. Compared to girls with girls, girls with boys less often spoke descriptively or talked of activities and possessions and more often spoke of conduct, possibly in an effort to manage boys’ behavior. Overall, the findings support a social-constructivist or contextual rather than a biological perspective on early gender differences.

Promotores are community lay health workers, who provide outreach and services to Latinos. Little research on the promotores programs exists and the focus of this article is to identify the challenges faced by community-based nonprofits when implementing promotores programs. To explore this type of program telephone interviews were conducted with ten promotores academic experts and nonprofit executives. The results suggest that implementation challenges fall into three major categories: the lack of standardized information on promotores programs, labor issues, and organizational costs. Future recommendations are made which highlight promotores recruitment and retention strategies, and the development of a clearinghouse of programmatic implementation information for community-based nonprofits.

This study evaluated the efficacy of Above the Influence (ATI), a national media-based health persuasion campaign to deter youth drug use. The campaign uses public service anti-drug prevention messages and targets youth between the ages of 14 and 16, a period of heightened susceptibility to peer influences. The evaluation utilized mall intercepts from geographically dispersed regions of the country. Theoretical impetus for the campaign combines elements of the theory of reasoned action (TRA), persuasion theory, and the health belief model. A series of structural equation models were tested with four randomly drawn cross-validation samples ( N = 3,000). Findings suggest that awareness of ATI is associated with greater anti-drug beliefs, fewer drug use intentions, and less marijuana use. Congruent with the TRA, changes in beliefs and intentions are intermediate steps linking campaign awareness with behavior. This study provides further evidence of positive campaign effects and may strengthen reliance on mass media health persuasion campaigns as a useful adjunct to other programs targeting youth.

This paper reports on data from a population of caregivers of people with Autism Spectrum Disorders (ASD) to examine the extent and motivations for their use of the Internet to obtain information on caregiving. The study found not only considerable interest for web-based information but also a strong bifurcation among respondents on the preferential type of information. The majority of respondents indicated that websites that provide factual information about caregiving are most important. Other respondents saw the Internet as a vehicle for social exchanges about ASD. Regardless of their preferred method to consume web-based information, all respondents reported using websites to obtain caregiving information.

This study examines the impact of a video-based intervention to increase children’s knowledge and positive attitudes toward a peer with Tourette Syndrome (TS). TS, a neurological disorder characterized by verbal and motor tics, is a confusing and potentially stigmatizing disorder. Although symptoms wax and wane over the life span, TS typically begins in childhood and peaks at puberty. The available literature suggests that individuals with TS are at risk for social rejection; because TS is primarily a childhood disorder, many of the social adjustment problems experienced by individuals with the disorder have their roots in negative childhood experiences in the classroom. An intervention was developed and evaluated using a pretest, posttest control group study. Children exposed to the intervention video showed greater changes in knowledge, positive attitudes, and behavioral intentions than a control group. Such interventions may have potential to improve social outcomes for children with differences.

The purpose of the current study was to examine differences in responses of older adults (age 55 and above) and younger adults (ages 18 to 54) to the Drug Abuse Problem Assessment for Primary Care (DAPA-PC), a computerized drug and alcohol abuse screening instrument developed for primary care settings. Data were collected from a diverse population of 327 adults presenting for care at The George Washington University Medical Faculty Associates clinic in downtown Washington, DC. Results indicated that rates of drug and alcohol abuse were similar in both groups. However, older adults were less likely than younger adults to perceive their drug use as problematic. This finding has serious implications for older adults, who tend to be underrepresented in treatment programs. There is a need for screening seniors and identifying those who may be at risk for substance abuse problems. Differences in responses to alcohol and drug assessments by age should be taken into consideration when designing screening instruments. The results of this study suggest that the DAPA-PC would provide a useful instrument for screening older adults in a primary care setting.

Differences in responses by ethnic group to The Drug Abuse Problem Assessment for Primary Care (DAPA-PC) were examined. The DAPA-PC is a self-administered (via computer), internet-based screening instrument with automatic scoring, patient profile for medical reference, and unique motivational messages. Results indicate differences between blacks and whites on responses to several items in these instruments. Differences in drug use were also found between the two ethnic groups in hair/urine results. The screening criteria for the DAPA-PC instrument appear to work for both the groups in this study. Differences in responses to alcohol and drug screening instruments by ethnic group should be taken into consideration when designing screening instruments for alcohol and/or other drug use and these instruments should be adapted for different ethnic groups, when necessary. The results of this study suggest that the DAPA-PC instrument is a useful alcohol and drug abuse screening instrument for both the blacks and whites in a primary care population.

Objective: To evaluate a multicomponent pain management intervention, including cognitive behavioral strategies, for children with human immunodeficiency virus (HIV) infection undergoing routine venipuncture. Methods: Following a baseline venipuncture, children were exposed to an intervention including preparation, relaxation, distraction, reinforcement, parent involvement, and EMLA (eutectic mixture of local anesthetics) cream, and followed for three additional venipuncture procedures. After each procedure, child distress was rated on the Procedure Behavior Checklist (PBCL), child self-report of pain was obtained using the FACES scale, and parent anxiety was reported on the State Trait Anxiety Inventory—State Scale (STAI). Results: Significant reductions in child distress and pain were found by the second postintervention procedure and maintained at the third. Parent anxiety was significantly reduced by the second postintervention procedure, but many parents chose not to participate in the third postintervention procedure. Conclusions: With repeated exposure, a multicomponent pain management intervention, including cognitive behavioral strategies and EMLA, appears effective at reducing pain, distress, and parent anxiety for children with HIV.

The Drug and Alcohol Problem Assessment for Primary Care (DAPA-PC), developed under a contract from the National Institute on Drug Abuse, is a comprehensive screening system developed for quickly identifying and addressing substance abuse and related problems in a primary care setting. The DAPA-PC system includes a two-level screening instrument, resources for scoring and reporting results, motivational messages, treatment referrals, and informative links, which together address the multifaceted needs of patients dealing with addiction problems and their providers. The need for such a system, preliminary reactions to the instrument, and future course of research are discussed.

The misuse of prescription drugs by teens in the United States is a growing public health problem. This article provides a systematic synthesis of multiple strands of literature to recommend effective prevention methods. Using a social-ecological framework, we review the scope of the problem of prescription drug use among teens. Then, we analyze the multiple factors that may influence teen knowledge and attitudes toward prescription drugs and discuss the important challenges related to the construction of effective prevention programs. Finally, we provide recommendations for practice that attempt to overcome these challenges.