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Background The COVID-19 pandemic remains a public health priority, and vaccination is important for ending the pandemic. Racial and ethnic minorities are disproportionally affected by COVID-19 yet report high levels of vaccination hesitancy. Objective We conducted virtual Town Halls to address vaccine hesitancy among racial and ethnic minorities in South Florida. Methods Our approach used social influence and persuasion models. A formative phase gathered meeting preferences from our communities and developed and tested our approach. An implementation phase conducted six virtual Town Halls in partnership with minority community-based organizations. Results The Town Halls reached 383 participants (mean age 37.5 years; 63.4% female, 33.9% male, 2.7% nonbinary; 59% racial/ethnic minority), who completed pre- and post-meeting assessments. Among non-vaccinated participants, at the pre poll, 58% reported a high likelihood of seeking vaccination, rising to 63% at post-assessment. Unvaccinated “non-hesitant” and “hesitant” groups were compared on trusted information sources, and reasons and barriers for vaccination. Non-hesitant participants reported significantly greater trust in the COVID-19 Task Force (97.3% vs. 83.3%) as a source of vaccine information than did hesitant participants. Non-hesitant participants were significantly more likely to endorse family safety (82.5% vs. 63.2%), community safety (72.5% vs. 26.3%), personal safety (85% vs. 36.8%), and wanting to return to a normal life (70% vs. 31.6%), as reasons for vaccination than were hesitant participants. Hesitant participants were significantly more likely to endorse concerns about vaccine safety doubts (63.2% vs. 17.5%) and not believing the pandemic is as bad as people say it is (21.1% vs. 5%) as barriers to vaccination than were non-hesitant participants. Qualitative data revealed high consumer satisfaction with the Town Halls. Conclusion This study supports the feasibility, acceptability, and potential impact of virtual Town Halls for addressing vaccine hesitancy among racial/ethnic minorities; however, our approach was very resource intensive, required an extensive community-university collaborative infrastructure, and yielded a small effect.

Latinx youth with mental health disorders have worse outcomes when compared to their White (non-Hispanic) counterparts. Latinx youth also have less access to and lower utilization of mental health services. Emerging research supports the psychological and physical benefits of engaging in yoga and yoga may function as a complimentary treatment option for patients with mental health challenges. However, research assessing the efficacy of yoga and mindfulness is particularly sparse among Latinx youth, who may particularly benefit from mind body awareness activities given barriers to more traditional health approaches. The objective of this quasi-experimental study was to examine the effects of a 12-week Vinyasa flow-based yoga group intervention on anxiety, depression, empathy, and life satisfaction among adolescents receiving outpatient mental health treatment. Adolescents (n = 186; 12-17 years old) were recruited to an active intervention condition (Yoga); a subsequent group of participants (n = 91) were recruited in the same manner to an assessment-only comparison control condition (Comparison). The Yoga group participated in culturally and developmentally tailored group yoga classes for 12 weeks. Structural equation modelling was used to evaluate the main effect intervention response between participants in the two conditions. At the post-intervention assessment, after controlling for baseline levels of outcome variables (i.e., depression, anxiety, empathy, and life satisfaction), on average participants in the yoga condition reported: less depression symptoms (B = -1.54, p = 0.008), less anxiety symptoms (B = -0.75, p = 0.048), greater empathy (B = 1.32, p = 0.025) and greater life satisfaction (B = 0.30, p = 0.013) as compared to the Comparison condition. Yoga interventions can be an acceptable and feasible modality for promoting well-being and reducing mental health problems among Latinx youth.

This study explored barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among Hispanic/Latine individuals. Hispanic/Latine is a broad social construct that encompasses people from heterogeneous countries and cultures. In the U.S., foreign-born Hispanics/Latines tend to have better health outcomes than U.S.-born individuals. Thus, the study examined whether nativity is a significant factor in COVID-19 vaccine hesitancy. Binary logistic regression and linear regression analyses were employed and revealed that, regardless of nativity, Hispanic/Latine participants face similar barriers and find similar sources of information trustworthy. Controlling for age and race, vaccination rates or perceived likelihood of getting vaccinated did not differ between the two groups. The two groups significantly differed in specific motivators for vaccination: foreign-born Hispanic/Latine individuals were more motivated to get the vaccine to keep themselves, their families, and their community safe, and more often believed vaccination is needed for life to return to normal. Study results provide important insights into similarities and differences in barriers, motivators, and trusted sources of information regarding COVID-19 vaccination among native and foreign-born Hispanic/Latine individuals.

Alcohol and other drug (AOD) use problems among college students continue to represent a public health epidemic. In 2019, historically high rates of binge-drinking and marijuana use were reported among college-age adults, and the detrimental effects of excessive AOD use in college, such as poorer academic performance, sexual assault, injury or overdoses, and a range of other negative consequences, have been well-documented. Thus, there is a continued need for effective implementation of evidence-based, cost-effective interventions aimed at reducing risks associated with collegiate AOD use. Guided Self Change (GSC) is a brief intervention involving motivational enhancement and cognitive-behavioral strategies and has demonstrated effectiveness in reducing AOD use problems. Its brevity, client-driven style, and concrete here-and-now focus are appealing to individuals struggling with mild to moderate AOD use problems. In order to successfully intervene with collegians with AOD use problems attending minority-serving institutions, GSC requires developmental and cultural tailoring. The current report describes the developmental and cultural tailoring of GSC for emerging adult Latinx collegians, as well as our consumer-driven addition of mindfulness content. Key components of our GSC program are documented through qualitative feedback, quantitative results, and case vignettes.

Native American (NA) youth report higher rates of alcohol, marijuana, and drug use than U.S. adolescents from any other racial/ethnic group. Addressing this health disparity is a significant research priority across public health, minority health, and dissemination and implementation (D&I) sciences, underscoring the need for empirically-based interventions tailored for NA youth. Effective D&I with NA youth incorporates NA cultural values and involves tribal elders and stakeholders. SACRED Connections (NIDA R01DA02977) was a university-tribal research partnership that utilized a culturally derived Native-Reliance theoretical framework and a community-based participatory research (CBPR) approach. A significant objective of this randomized controlled trial was to close D&I gaps utilizing the RE-AIM Model and National Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Standards (HHS, 2019). Findings of this 5-year RCT revealed a statistically significant protective relationship between Native Reliance and baseline lifetime and past month alcohol and marijuana use; additionally, the likelihood of reporting marijuana use at 3 months post-intervention was significantly lower among the active condition than among the control condition. Implementation of a developmentally and NA culturally tailored brief protocol revealed: partnering with Native Americans and utilizing CBPR facilitated engagement with this hard-to-reach, underserved community; age and culture are associated with substance use severity among NA teens; a culturally adapted Motivational Interviewing (MI) brief intervention may be effective in reducing marijuana use among NA youth; the Native Reliance theory proved useful as a framework for working with this population; and RE-AIM proved helpful in conceptualizing health equity promoting D&I.

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators&rsquo, Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs&rsquo, impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation Conceptual Framework and common metrics to allow for valid inter-institutional comparisons and consortium-wide evaluations. Stakeholders could ensure evaluation metrics are used to facilitate community impacts.

OBJECTIVE: College student alcohol use remains a considerable concern. While many colleges provide universal interventions surrounding matriculation, trends indicate alcohol use increases over the college years. This study utilized a person-centered approach to examine changes in drinking across college and predictors (expectancies, attitudes, norms, and gender) of increases in risky drinking. Understanding transitions in drinking patterns and predictors of risky transitions can help identify risky students, periods of increased risk, and inform prevention efforts. METHOD: 1429 first-year students were recruited from three universities across the USA. Students were assessed in the fall of each of the four years of college using a wide variety of drinking-related measures. RESULTS: Latent transition analysis (LTA) identified five classes of students (Non-Drinkers, Weekend Light Drinkers, Weekend Heavy Drinkers, Occasional Heavy Episodic Drinkers, Heavy Drinkers). Heavy-Drinkers were not likely to move out of their status during all four years of college. All psychosocial factors were shown to predict class membership during the first year (e.g., higher positive expectancies were associated with greater likelihood of being in a higher risk class). Increased psychosocial risk factors also predicted transitioning to higher risk drinking classes, mostly for Non-Drinkers. Differences by gender were observed. CONCLUSIONS: Results indicate many students maintain or increase risky drinking practices, rather than mature out, suggesting continued need for early prevention. Targeting positive attitudes during the first year may be particularly important for later transitions. Males may benefit more from targeted intervention during the transition between third and fourth years. Keywords: College Students; Alcohol Use; Latent Transition Analyses

We examined whether discrimination experienced by Hispanic/Latino adolescents is (a) directly associated with adolescent alcohol use or (b) indirectly associated with adolescent alcohol use via mediation by ethnic identity and/or peer associations. Data were drawn from an NIAAA-funded randomized controlled trial evaluating the efficacy of a Guided-Self Change (GSC) intervention for Hispanic/Latino youth with alcohol and interpersonal violence problems (R01 AA12180; see Wagner et al., 2014). The sample for the present study included 371 Hispanic/Latino teenagers (mean age = 16.3 years [SD =1.37]; 38% female). Using structural equation modeling (SEM), results revealed that perceived discrimination was indirectly related to alcohol consumption through positive (non-drinking) peer affiliations. While perceived discrimination was related to more drinks consumed and more drinking days, we found lower levels of drinking among those who reported a greater proportion of positive peers. Additionally, ethnic identity was found to moderate the relationship between discrimination and positive peer affiliation. These findings further our understanding about how discrimination and ethnic identity interact, as well as provide directions for how the effectiveness of prevention models may be enhanced for reducing underage drinking among Hispanic/Latino adolescents.

This article was migrated. The article was marked as recommended. IntroductionThe move towards value-based care and population health has highlighted the prominent role of social and behavioral factors in determining health outcomes. Patient-centered behavioral guidance to improve patient self-management is recognized as an evidence-based intervention for a variety of chronic conditions but has yet to be adopted as a core competency or core entrustable professional activity (EPA). Motivational Interviewing (MI) is an evidence-based behavioral intervention involving an integrated set of competencies, featuring reflective listening, affirmation, evocation, and collaborative planning. An MI encounter is an observable, discrete task that can be framed as an EPA. Successful implementation of EPAs in the workplace requires institutional engagement, a thoughtful curricular approach, faculty development, and feasible, valid workplace-based assessment (WBA).MethodsWe implemented competency-based MI training and assessed competency outcomes for students and faculty. After joining the Association of American Medical Colleges Core EPA Pilot, we applied an iterative group process to develop an EPA and workplace-based assessment based on established MI competencies.ResultsDrawing upon nine years of developing MI curriculum, we present competency data for a student training study and a faculty coaching study, describe how we transitioned training from the classroom to the clinical setting employing an EPA framework, and present a one-page schematic and related WBA for an EPA based on MI.ConclusionWe propose that MI is a core EPA for future physicians practicing value-based care, and offer a roadmap for curriculum implementation.

There is growing evidence that text messaging-"short message service" (SMS)-is useful for health promotion and behavior change. SMS has become a preferred channel of communication among adolescents. Despite burgeoning interest, there remains a critical need for formative research regarding developmentally and culturally appropriate SMS-based health promotion with teenagers.The primary objective was to develop SMS message protocols and procedures effective for reducing underage drinking among Hispanic teens. Using focus groups, we sought our target population's perspectives on SMS parameters including scheduling, frequency, content, themes, and confirmation-of-receipt.We conducted, recorded, and transcribed six mixed-gender focus groups (20 adolescents, 4-5 per group) recruited from the Division of Adolescent Medicine at Miami Children's Hospital. Alcohol-related and "attention control" text messages were assembled from two sources (http://www.mobilehealth4youth.org and the existing literature); these SMSs, along with SMS procedures, were the focus of discussion. The recordings and transcription were reviewed by two researchers who employed a qualitative iterative process analytical approach.Findings revealed distinct preferences among teenagers about the scheduling, frequency, content, themes, and confirmation-of-receipt of SMSs. Moreover, teens were most enthusiastic about SMSs that addressed alcohol-related knowledge, self-efficacy, social support, or future orientation. Conclusion/Importance: Seeking our target population's perspectives on SMS parameters was essential for developing SMS message protocols and procedures with potential effectiveness for reducing underage drinking among Hispanic teens. It is strongly recommended that researchers or clinicians considering SMS-based interventions conduct a similar formative process prior to implementation.

Adolescent substance use is a pressing public health and social problem in the United States. Most (62.0%) high school seniors report past year alcohol use, 36.4% report past year marijuana use, and 40.3% report past year illicit drug use (Johnston, O’Malley, Bachman, & Schulenberg, 2013). Almost a quarter report past month binge drinking (Centers for Disease Control & Prevention, 2012), and 90.6% agree that alcohol is easy to acquire (Johnston O’Malley, Bachman, & Schulenberg, 2012). Marijuana also is quite accessible; 81.6% of 12th graders report that marijuana is easy to get (Johnston et al., 2012). Marijuana use is now at a 30-year high among high school seniors; one in fifteen high school seniors is a daily or near daily marijuana user (Johnston et al., 2013). Adolescent alcohol and other drug (AOD) use is associated with a host of immediate and long-term negative consequences. In the short-term, the greater the AOD use, the more likely an adolescent will experience injuries and emergency room visits, suicidality, interpersonal problems with family and friends, school problems and truancy, risky sex, and risky driving (Engberg & Morral, 2006; Jacobus, Bava, Cohen-Zion, Mahmood, & Tapert, 2009; Teplin et al., 2005; Windle & Windle, 2005; Zufferey et al., 2007). Moreover, recent data suggest adolescent AOD use may cause alterations in the structure and function of the developing brain (Jacobus et al., 2009; Windle & Windle, 2005). In the long-term, the greater the AOD use, the more likely an adolescent as an adult will experience alcohol dependence and other substance abuse, antisocial behavior, legal problems, vocational problems and unemployment, comorbid disorders, and interpersonal problems with family and friends (Danielsson, Wennberg, Tengstrom, & Romelsjo, 2010; Hicks, Iacono, & McGue, 2010).

Psychosocial factors may directly impact HIV health measures such as viral load (VL) whether or not patients are taking antiretroviral treatment (ART) consistently. Structural equation modeling plus Baron and Kenny's (1986) four-step approach were used to test a mediated model predicting VL among 246 HIV-infected adults who were on ART. Exogenous variables were social support, barriers to adherence, and stress. Moderators were alcohol use, marijuana use, and neurocognitive impairment. A small positive association between marijuana use and ART adherence approached significance. Only barriers to adherence predicted a decrease in adherence rates and an increase in VL. No other factors were significantly associated with either VL or adherence, and no interaction effects between exogenous variables and moderators were identified. The association between barriers to adherence and VL was partially mediated by ART adherence. Findings provide modest support for a direct link between psychosocial variables and a virologic response to ART.

Previous research on college drinking has paid little attention to Latino students. Social development models (Catalano, Hawkins, & Miller, 1992) suggest that protective influences in one domain (e.g., mothers) can offset negative influences from other domains (e.g., peers) though this possibility has not been explored with respect to Latino college student drinking. The present study had two aims: 1) to determine whether four specific maternal influences (monitoring, positive communication, permissiveness, and modeling) and peer descriptive norms were associated with college drinking and consequences among Latino students, and 2) to determine whether maternal influences moderated the effect of peer norms on college drinking and consequences. A sample of 362 first-year students (69.9% female) completed an online assessment regarding their mothers' monitoring, positive communication, permissiveness, and modeling, peer descriptive norms, and drinking and related consequences. Main effects and two-way interactions (mother×peer) were assessed using separate hierarchical regression models for three separate outcomes: peak drinking, weekly drinking, and alcohol-related consequences. Maternal permissiveness and peer descriptive norms were positively associated with drinking and consequences. Maternal communication was negatively associated with consequences. Findings indicate that previously identified maternal and peer influences are also relevant for Latino students and highlight future directions that would address the dearth of research in this area.