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Background: College students are among the most vulnerable groups to problems associated with high-risk drinking consequences such as illness, injury, sexual abuse, and death. Promising mobile health (mHealth) approaches, such as smartphone (SP) apps, can be used in interventions to address or prevent excessive drinking. Method: The aim of the investigation was to examine the efficacy of a theoretically based mHealth SP app for alcohol intervention in two independent samples (N = 379): Mandated participants (Study 1) and voluntary participants (Study 2). Study 1 included a controlled trial with Mandated participants randomized into either an in-person Brief Motivational Interviewing BMI (n = 70) or BMI + SP app intervention (n = 71). Study 2 included Voluntary participants who participated in either a Control group (n = 157) or the BMI + SP app intervention (n = 81). Participants in both studies completed baseline and 6-week assessments. Results: In Study 1, peak Blood Alcohol Concentration (BAC) of participants in the in-person BMI group had increased slightly at six weeks, while it had decreased for the app-based BMI + SP group. Study 2 participants using the BMI + SP app reported significant reductions in drinking and consequences; there were no changes in the (AO) Control group. Conclusions: The BMI + SP app was effective with both Mandated and Voluntary participants. Future testing with the BMI + SP app is needed to assess whether reach, adoptability, portability, and sustainability are greater with the mHealth smartphone app for alcohol intervention than in-person approaches. [ABSTRACT FROM AUTHOR]

mHealth apps are an effective means of delivering health interventions, and the college-age population is particularly proficient at using apps. Informed by current theories of Ecological Momentary Interventions (EMI), Motivational Interviewing (MI), and the Transtheoretical Model (TTM) of Change, investigators have developed a self-monitoring app—Reductions through Ecological Momentary/Motivational Intervention/Transtheoretical (REMIT)—with the aim of reducing hazardous drinking among college students. The app was developed using the Integrate, Design, Assess, and Share (IDEAS) framework. This step-by-step process for developing digital behavior change interventions was conducted in five phases to: (1) understand the users, (2) determine target behavior, (3) base the intervention in behavioral theory; (4) create delivery strategies, and (5) develop the REMIT prototype. REMIT uses assessments (informed by EMI) and components of MI and TTM to guide administration of nine modules designed to engage users in reducing alcohol use and related problems. REMIT users self-monitor their alcohol consumption and develop strategies to change drinking behaviors using a range of easy-to-use features, such as the Virtual Coach, automated text messages, interactive gaming mechanisms (gamification), drink consumption tracking, and Blood Alcohol Concentration (BAC) calculators. mHealth interventions have been shown to reduce alcohol use among college students when they are applied in real-life, real-time contexts. REMIT is a theory-based app that incorporates user-friendly features to reduce hazardous drinking among college students. The next step is to conduct a pilot trial to test the efficacy of the app and enhance the REMIT prototype. [ABSTRACT FROM AUTHOR]

Substance abuse in young adults is a public health issue with costs to the individual and society. There is mounting evidence that the increased uses of mHealth approaches have promise as a way to facilitate reductions in substance use. This systematic review evaluated the recent body of research on mHealth-based interventions for substance use, with aims of (a) examining the functionality and effectiveness of these interventions, (b) evaluating the available research on the effectiveness of these interventions for substance use, and (c) evaluating the design, methodology, results, theoretical grounding, limitations, and implications of each study. We identified eligible studies by searching electronic databases using Boolean methods. The reviewed studies (N = 12) indicated that that a wide range of Internet-based, text messaging, and smartphone application interventions have been developed to address substance use. Interventions had an assortment of features; participants in each study highlighted the ease and convenience of the interventions; and the majority of studies provided support for the efficacy of mHealth in reducing substance use. Mobile technology is a promising tool for reducing substance use and warrants further development. Future practice including the use of mHealth interventions can be an integral part of reducing substance use. [ABSTRACT FROM AUTHOR]

This study compared personality risk factors and readiness to change drinking behavior among mandated and volunteer college students. The sample ( N = 583) completed three measures of motivation to change and personality risk factors at baseline, 3 months, and 6 months between 2011 and 2012. Linear mixed models were used to determine an association of continuous outcome variable(s) with covariates over time. Participants in the action stage had lower impulsivity scores. Gender was significant, with females showing the highest anxiety and lowest sensation seeking. The findings indicate a number of future directions to advance innovative alcohol intervention and treatment programs on college campuses. [ABSTRACT FROM AUTHOR]

Purpose Alcohol and illicit drug abuse is a serious public health issue facing college students. This study examined the impact of motivational interviewing (MI) as an intervention on the rate of blackouts among freshmen who engaged in high-risk drinking and illicit drug use. Design A sample of 188 volunteer freshmen from a university were administered the Daily Drinking Questionnaire, the Rutgers Alcohol Problem Index, and the Government Performance and Results Act at baseline and again at 6 months postintervention. MI was applied at baseline and then again at 2 weeks, 3 months, and 6 months. Methods Generalized estimated equations and logistic regression models were used to determine associations between the rate of blackouts and time, ethnicity, gender, illicit drug use, and alcohol consumption. Findings At 6 months, the rate of blackouts decreased from 40% at baseline to 16% (p < .0001). The average number, time, and days of drinking and frequency of drug use also decreased significantly (p < .0001). An association between rate of blackouts and gender was observed, but not with ethnicity. Conclusions MI had an impact on reducing alcohol consumption and the rate of blackouts among college freshmen who were engaging in high-risk drinking and illicit drug use. Clinical Relevance The findings support the importance of using MI with freshmen college students to decrease drinking and the associated negative consequences, including blackouts, which has particular relevance for advanced practice registered nurses, physicians, and community health nurses who conduct MI as an intervention with college students. [ABSTRACT FROM AUTHOR]

This longitudinal pilot study investigated the effectiveness of a Brief Alcohol Screening and Intervention for College Students (BASICS) Brief Motivational Intervention (BMI) in decreasing the quantity and frequency of high-risk drinking and associated negative consequences for freshmen. The treatment effects of the intervention (n = 110) were obtained using a quasi-experimental design. Alcohol consumption and risk behaviors were assessed for the intervention and the control group. Freshmen students who received the intervention reported a greater decrease in alcohol consumption and negative consequences than freshmen students assigned to the control group. This study supported the effectiveness of the BASICS BMI intervention for freshmen students with high-risk drinking behaviors. This pilot study has implications for the sustainability of the intervention for freshmen students and supports further research for the remaining 2-year intervention program. [ABSTRACT FROM AUTHOR]

An editorial is presented on the COVID-19's impact on the mental health of older adults. Topics include the risk factors suggest that older adults being in uncharted territory as they experience new or exacerbated psychiatric symptoms, the older adults feel overwhelmed and hopeless in the best of times, and the pandemic has heightened preexisting physical and mental health issues that have increased depression and suicide risk.

Bystander intervention—when someone intervenes to help in situations that pose a risk for harm—is a promising strategy for sexual violence prevention. In the current study, a sample of U.S. Army male soldiers (N = 10; ages 18–24) who engaged in at-risk drinking completed a 90-min individual semi-structured interview to understand the ways in which soldiers intervene to address risk for sexual violence. Two independent raters coded soldier responses using thematic analysis and identified eight main themes: (a) recognizing risk for sexual violence; (b) labeling situations as problematic and taking responsibility; (c) facilitators of intervention; (d) barriers to intervention; (e) intervention strategies; (f) reactions and consequences to intervention; (g) alcohol's influence on intervention; and (h) using bystander intervention to shift cultural norms. As soldiers reported noticing more extreme risks for violence, prevention interventions may help service members identify situations earlier in the continuum of harm. Soldiers anticipated intervening in a way that was physical and aggressive, which could facilitate physical altercation and result in collateral misconduct. Results from the present study reveal ways that bystander intervention programs for civilians can be tailored to address the unique individual, situational, and contextual factors relevant to the military. These findings also highlight the importance of teaching soldiers indirect and nonaggressive strategies for intervention. [ABSTRACT FROM AUTHOR]

Objectives To assess whether implementation of the Strengthen Opioid Misuse Prevention (STOP) Act was associated with an increase in the percentage of opioid prescriptions written for 7 days or fewer among patients with acute or postsurgical musculoskeletal conditions. Design An interrupted time-series study was conducted to determine the change in duration of opioid prescriptions associated with the STOP Act. Setting Data were extracted from the electronic health record of a large health care system in North Carolina. Subjects Patients presenting from 2016 to 2020 with an acute musculoskeletal injury and the clinicians treating them were included in an interrupted time-series study (n  = 12 839). Methods Trends were assessed over time, including the change in trend associated with implementation of the STOP Act, for the percentage of prescriptions written for ≤7 days. Results Among patients with acute musculoskeletal injury, less than 30% of prescriptions were written for ≤7 days in January of 2016; by December of 2020, almost 90% of prescriptions were written for ≤7 days. Prescriptions written for ≤7 days increased 17.7% after the STOP Act was implemented (P  < .001), after adjustment for the existing trend. Conclusions These results demonstrate significant potential for legislation to influence opioid prescribing behavior. [ABSTRACT FROM AUTHOR]

Sexual violence in the U.S. military is a serious concern. Whereas numerous studies document the prevalence of sexual violence among service members, far less research has examined etiological risk factors for sexual aggression perpetration among service members. The present study sought to evaluate the applicability of the Confluence Model of Sexual Aggression among a sample of young adult men engaged in active-duty military service within the U.S. Army. Anonymous surveys were completed by 326 male soldiers between the ages of 18 and 24 at a large military installation in the Southeastern region of the United tStates. Men's likelihood to engage in sexual aggression was operationalized as men's perceived likelihood to persist with sexual activity despite a partner's resistance. Aligning with the Confluence Model of Sexual Aggression, two composite variables reflecting hostile masculinity and tendency toward impersonal sex were created. A linear regression indicated that the main effects of hostile masculinity and impersonal sex were significantly associated with greater perceived likelihood of sexual aggression perpetration. Results also revealed that while the interaction term between hostile masculinity and impersonal sex was significant, the direction of the relationship suggests that the effect of impersonal sex is weaker at higher levels of hostile masculinity. These findings lend evidence to help identify those at elevated risk for perpetrating sexual aggression, as well as informing programmatic efforts to prevent sexual assault within the military. [ABSTRACT FROM AUTHOR]

Sexual assault is a significant problem within the United States military. Bystander intervention skills training is recognized as a promising strategy for sexual assault prevention within both civilian and military populations. Sexual assault prevention programs which include training in bystander intervention teach individuals to notice situations that may pose a risk for harm and safely act to positively influence the outcome. This study examines correlates of bystander intervention attitudes and intentions among young adult active duty male soldiers (N = 282) between the ages of 18 and 24. Positive bystander intervention attitudes and intentions were associated with lower levels of rape myth acceptance, greater discomfort with sexism, lower likelihood of continuing an unwanted sexual advance after verbal resistance from a partner, greater likelihood of gaining verbal consent from a partner, and greater perceived peer approval for bystander intervention. In a multiple regression, perceived peer approval for bystander intervention and self-reported lower likelihood of continuing a sexual advance after verbal resistance from a partner emerged as significant predictors of positive bystander intervention attitudes and intentions (R2 =.41). Given that perceptions of peer norms are modifiable, these findings highlight the importance of addressing peer norms in bystander intervention training programs for military personnel. [ABSTRACT FROM AUTHOR]

This study examines hazing among a sample of young male service members in the United States (US) military. Individual semi-structured interviews were conducted with active duty service members (N = 10) aged 18 to 24 at a large Southeastern US Army post to examine their conceptualization of hazing. Thematic analysis revealed three emergent themes: (1) the definition of hazing and hazing behaviors; (2) the ritualistic nature of hazing; and (3) the sexual nature of hazing. Most participants provided their own definition of hazing. One participant had difficulty in differentiating between hazing and bullying, the others had distinct definitions as they relate to motives. Results are consistent with prior research indicating that service members lack a full understanding of what constitutes hazing attributes and demonstrate an inability to accurately define hazing in line with current US military policy. Investigation into understanding hazing in the US military is warranted, including the intersection between sexual victimization and hazing. Thus, prevention programming is needed to reduce hazing, and ameliorate negative mental, emotional, and physical outcomes that result from these acts in the military. [ABSTRACT FROM AUTHOR]

Introduction: Hooking up is an impersonal sexual interaction, differing from sexual activity that occurs in the context of a committed relationship. Hookup behavior has been widely studied among college populations; however, this type of sexual behavior has yet to be explored in a military population.Methods: The current study conducted semi-structured interviews with 10 male soldiers with high-risk drinking habits to explore conceptualizations of hooking up. Interviews were systematically coded and analyzed via thematic analysis.Results: Five themes emerged: (1) definitions of hookups, (2) descriptions of why hookups occur, (3) how hookups occur (ie, the social context of hookups), (4) factors that facilitate hookups, and (5) differences between hookups and relationships.Conclusions: Findings suggest that perceptions of hookups among participants who were male soldiers are generally consistent with college populations, with some varying aspects. [ABSTRACT FROM AUTHOR]

The prevention of sexual assault (SA) in the U.S. military is a significant priority. This study applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to a literature search that identified research evaluating SA prevention programs conducted within military settings. Only six studies published between 2005 and 2016 met criteria for inclusion in the review. Studies demonstrated high heterogeneity in the: (1) conceptual framework of the prevention approach; (2) target population and timing of administration; (3) study recruitment methods; (4) methodological design; (5) method of delivery, program dosage and theory of change; and (6) outcome administration and efficacy. Scientific rigor according to the Oxford Center for Evidence-based Medicine was also variable. Several gaps in the research base were identified. Specifically, research evaluating SA prevention programs have only been conducted among U.S. Army and U.S. Navy samples. Most studies did not examine whether program participation was associated with reductions in rates of sexual violence. Studies also lacked utilization of a long-term follow-up period. Additionally, studies did not reflect the types of SA prevention programs currently being implemented in military settings. Taken together, further research is needed to enhance the evidence base for SA prevention in the military, and to evaluate the effectiveness of the approaches currently being conducted with service members. [ABSTRACT FROM AUTHOR]