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Objective Opioid overdose is a leading cause of maternal mortality, yet limited attention has been given to the consequences of opioid use disorder (OUD) in the year following delivery when most drug-related deaths occur. This article provides an overview of the literature on OUD and overdose in the first year postpartum and provides recommendations to advance maternal opioid research. Approach A rapid scoping review of peer-reviewed research (2010-2021) on OUD and overdose in the year following delivery was conducted in PubMed, PsycINFO, and Web of Science databases. This article discusses existing research, remaining knowledge gaps, and methodological considerations needed. Results Seven studies were included. Medication for OUD (MOUD) was the only identified factor associated with a reduction in overdose rates. Key literature gaps include the role of mental health disorders and co-occurring substance use, as well as interpersonal, social, and environmental contexts that may contribute to postpartum opioid problems and overdose. Conclusion There remains a limited understanding of why women in the first year postpartum are particularly vulnerable to opioid overdose. Recommendations include: (1) identifying subgroups of women with OUD at highest risk for postpartum overdose, (2) assessing opioid use, overdose, and risks throughout the first year postpartum, (3) evaluating the effect of co-occurring physical and mental health conditions and substance use disorders, (4) investigating the social and contextual determinants of opioid use and overdose after delivery, (5) increasing MOUD retention and treatment engagement postpartum, and (6) utilizing rigorous and multidisciplinary research methods to understand and prevent postpartum overdose., Author(s): Jessica Frankeberger [sup.1] [sup.2] , Marian Jarlenski [sup.3] , Elizabeth E. Krans [sup.4] [sup.5] , Robert W. S. Coulter [sup.1] [sup.2] , Christina Mair [sup.1] [sup.2] Author Affiliations: (1) [...]

Introduction: Urban emergency departments (ED) provide care to populations with multiple health-related and overlapping risk factors, many of which are associated with intimate partner violence (IPV). We examine the 12-month rate of physical IPV and its association with multiple joint risk factors in an urban ED.Methods: Research assistants surveyed patients regarding IPV exposure, associated risk factors, and other sociodemographic features. The joint occurrence of seven risk factors was measured by a variable scored 0–7 with the following risk factors: depression; adverse childhood experiences; drug use; impulsivity; post-traumatic stress disorder; at-risk drinking; and partner’s score on the Alcohol Use Disorders Identification Test. The survey (N = 1037) achieved an 87.5% participation rate.Results: About 23% of the sample reported an IPV event in the prior 12 months. Logistic regression showed that IPV risk increased in a stepwise fashion with the number of present risk factors, as follows: one risk factor (adjusted odds ratio [AOR] [3.09]; 95% confidence interval [CI], 1.47-6.50; p

Background: School assets--such as connectedness, caring relationships with adults, high behavioral expectations from adults, and meaningful participation--are associated with positive outcomes for adolescents. However, little is known about how school assets differ among adolescents with intersecting marginalized identities. Methods: We used the 2013-2014 California Healthy Kids Survey (N = 320,462 students) to examine differences in school assets with respect to sexuality, gender, race/ethnicity, and socioeconomic status using adjusted multilevel linear regression models. Results: Sexual minority, gender minority, racial/ethnic minority, and low socioeconomic status adolescents had significantly lower protective school assets. For all outcomes, the differences between sexual minority and heterosexual adolescents were more pronounced among nontransgender girls than nontransgender boys; however, these differences were not consistently present among racial/ethnic minority students. For school connectedness and meaningful participation, differences for racial/ethnic minorities versus white adolescents were more pronounced among nontransgender girls than nontransgender boys. Differences between transgender adolescents and nontransgender boys were more pronounced for white adolescents compared to some other racial/ethnic minority students. Overall, adolescents with certain multiple marginalized identities had lower school assets. Conclusions: Interventions are needed to strengthen school assets among marginalized students, thereby helping mitigate health and education inequities.

Background: Neighborhood poverty is associated with adiposity in women, though longitudinal designs, annually collected residential histories, objectively collected anthropometric measures, and geographically diverse samples of midlife women remain limited. Objective: To investigate whether longitudinal exposure to neighborhood concentrated poverty is associated with differences in body mass index (BMI) and waist circumference (WC) among 2,328 midlife women (age 42–52 years at baseline) from 6 U.S. cities enrolled in the Study of Women's Health Across the Nation (SWAN) from 1996 to 2007. Methods: Residential addresses and adiposity measures were collected at approximately annual intervals from the baseline visit through a 10-year follow-up. We used census poverty data and local spatial statistics to identify hot-spots of high concentrated poverty areas and cold-spots of low concentrated poverty located within each SWAN site region, and used linear mixed-effect models to estimate percentage differences (95% confidence interval [CI]) in average BMI and WC levels between neighborhood concentrated poverty categories. Results: After adjusting for individual-level sociodemographics, health-related factors, and residential mobility, compared to residents of moderate concentrated poverty communities, women living in site-specific hot-spots of high concentrated poverty had 1.5% higher (95% CI: 0.6, 2.3) BMI and 1.3% higher (95% CI: 0.5, 2.0) WC levels, whereas women living in cold-spots of low concentrated poverty had 0.7% lower (95% CI: −1.2, −0.1) BMI and 0.3% lower (95% CI: −0.8, 0.2) WC. Site-stratified results remained in largely similar directions to overall estimates, despite wide CIs and small sample sizes. Conclusions: Longitudinal exposure to neighborhood concentrated poverty is associated with slightly higher BMI and WC among women across midlife. [ABSTRACT FROM AUTHOR]

Background: Research on alcohol-related problems often examines individual problem types in isolation or uses scales that provide a single cumulative severity score for alcohol-related harms. This study aims to assess the patterns of seventeen distinct alcohol-related problems and how they co-occur. Methods: The East Bay Neighborhood Study surveyed a community sample of 864 adults who drank in the past year in Alameda County, California. Participants reported if they experienced each of seventeen alcohol-related problems in the last year. Latent class analysis assessed subgroups of problems. Logistic regression models examined associations between class membership, sociodemographics, and alcohol use. Results: A two-class model best fit the data. The multiple problems class (18% of respondents) was characterized by experiencing problems of all types and almost all experiences of legal, violence, and risky sex-related problems. The none/few problems class (82%) was characterized by a low prevalence of all problem types, with only a small proportion experiencing hangovers. In adjusted models, only older age (AOR = 0.90, 95% CI = 0.88–0.92) had lower odds of multiple problems class membership. Conclusions: Numerous alcohol-related problems co-occurred within a small subgroup of people who drank in the last year, while the majority experienced few problems. Results suggest that focusing on singular alcohol-related problems may overlook patterns of concurrent problems in high-risk groups. [ABSTRACT FROM AUTHOR]

Previous research suggests that the context in which drinking occurs contribute to specific alcohol-related problems. In the current study we assessed how often adolescents attended different contexts in which they could drink, how often they drank in those contexts, and whether drinking patterns and parental monitoring were related to alcohol use in those contexts. We collected survey data from 1,217 adolescents 15-18 years of age in 24 midsized California cities. Measures included past-year frequencies of attending and drinking in restaurants, bars/nightclubs, and outdoor places, typical hours spent at home (i.e., own home or someone else's home), perceptions of parental control and disclosure to parents about free time activities, and demographics. Multilevel zero-inflated negative binomial models were used to assess associations between drinking patterns, parental control, and disclosure and frequency of attending and drinking in specific contexts. There were large variations in attending contexts in which drinking could take place. More frequent drinking was related to less time spent at home, while heavier drinking was associated with more time spent at home. Parental control was related to less frequent attendance at bars/nightclubs, and disclosure to less frequent involvement in outdoor activities and spending more time at home. Among drinkers, frequencies of attendance were strongly related to frequencies of drinking in all contexts except the home. Parental control and disclosure were related to more frequent drinking at restaurants and exposure to bars/nightclubs and drinking at outdoor activities. Parental monitoring may reduce exposure to risks by shifting adolescent contexts for alcohol use.

Background: Improvements in health behaviors and academic outcomes have been associated with school-based health centers (SBHCs). However, underlying mechanisms for these associations have been largely unexamined, particularly among lower-income youth. The current study examines the relationship between SBHCs and school connectedness and whether this relationship differs by youths' socioeconomic status (SES). Methods: Student-level cross-sectional data from 503 traditional high schools in California were analyzed using multilevel regression models. California Healthy Kids Survey 2013-2014 data included information on 3 dimensions of school connectedness and demographic characteristics including SES as measured by parental education. School-level demographic data was gathered from publicly available sources. Results: Although no significant relationship between SBHCs and any of the school connectedness dimensions emerged, there were significant cross-level interactions between SBHCs and parent education. SBHCs were more positively associated with school connectedness (adult caring, adult expectations, and meaningful participation) among lower SES students compared to students with higher SES. Conclusions: SBHCs may be particularly effective in affecting school connectedness among lower income youth populations. This has wide ranging implications with regards to planning (eg, careful selection of where SBHCs can be most effective), and future research (eg, examining the effectiveness of specific SBHC strategies that support connectedness).

Sexuality health education is moving beyond the classroom, with technology expanding youth access to sexual health information. While text message services are increasingly being used to provide information, a peer education approach has yet to be incorporated. Results from this feasibility study support a sexual health textline (IOTAS), incorporating teens asking and answering questions. Our findings suggest IOTAS fills a gap for sexual health information, and the technology-based approach offers peer educators an opportunity to expand their knowledge of healthy sexual behaviors and educate an extended peer network. Further work to refine IOTAS will enable dissemination of the intervention model.

In this study, we examined how mental health inequities by gender and sexual identity changed from before the COVID-19 pandemic to during the early phase of the pandemic. Sexual and gender minority (SGM) adults and non-SGM adults were recruited through social media to complete online questionnaires. Results indicate a worsening change in depression from before the pandemic to during the early phase of the pandemic that was significantly greater for gender minorities compared to cisgender (cis) women. Anxiety and loneliness scores did not change differentially for gender minorities (vs cis women) or sexual minorities (vs heterosexuals). Overall, COVID-19 had a greater negative impact on depression for gender minorities compared with cis women. [ABSTRACT FROM AUTHOR]

This study analyzed whether discrepant (husband or wife use only) or concordant (both partners use) patterns of heavy drinking, marijuana use, and smoking are associated with increased risk for male-to-female partner violence and female-to-male partner violence among adult couples. Based on a geographic sample of married or cohabiting couples residing in 50 California cities, logistic regression analyses were conducted using dyadic data on past-year partner violence, binge drinking and frequency of intoxication, marijuana use, and smoking. When all substance use patterns were included simultaneously, wife-only heavy drinking couples were at elevated risk for male-to-female partner violence, as were concordant marijuana-using couples. Husband-only marijuana discrepant couples were at increased risk for female-to-male partner violence. Further research is needed to explore the processes by which discrepant and concordant substance use patterns may contribute to partner aggression.

This study examined drinking patterns of three different college student groups: (a) intercollegiate athletes, (b) intramural/club athletes, and (c) nonathletes. Additionally, we investigated whether a relationship exists between drinking setting and risk of increased drinking. We analyzed data on the athletic involvement, drinking behaviors, and drinking settings of 16,745 undergraduate students. The findings revealed that drinking patterns for intramural/club athletes remained relatively consistent at all quantity levels; however, intercollegiate athletes consumed alcohol in higher quantities. Further, intramural/club athletes drank in almost every drinking setting, whereas intercollegiate athletes were more limited. The drinking patterns and settings suggest a stronger social motivation for drinking among intramural/club athletes than among intercollegiate athletes and point to a need to specify competition level when studying college athletes.

Alcohol use is a robust predictor of intimate partner violence (IPV). A critical barrier to progress in preventing alcohol-related IPV is that little is known about how an individual's specific drinking contexts (where, how often, and with whom one drinks) are related to IPV, or how these contexts are affected by environmental characteristics, such as alcohol outlet density and neighborhood disadvantage. The putative mechanism is the social environment in which drinking occurs that may promote or strengthen aggressive norms. Once these contexts are known, specific prevention measures can be put in place, including policy-oriented (e.g., regulating outlet density) and individually oriented (e.g., brief interventions to reduce risk for spousal aggression) measures targeting at-risk populations. This paper reviews applicable theories and empirical research evidence that links IPV to drinking contexts and alcohol outlet density, highlights research gaps, and makes recommendations for future research.