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An increasing proportion of information technology (IT)/information system adoption research collects data using online surveys. However, a paucity of research assesses the equivalence of paper-based versus Internet-based surveys in collectivistic cultures. Furthermore, no theoretical or empirical research investigates how cultural differences between collectivistic and individualistic cultures influence the measurement equivalence (ME) of these survey modes. To explore these issues, online and paper-based surveys with comparable samples were carried out in both an individualistic (the USA) and a collectivistic culture (China). Confirmatory factor analysis was conducted to examine the ME across both survey modes in these different cultures. Results indicate that the relatively larger satisficing discrepancy between paper and online surveys causes respondents in collectivistic cultures to have an increased likelihood of providing responses that vary as compared to respondents in individualistic cultures. The disparate responses, in turn, result in increased measurement variance between the two survey modes. The findings of this study bridge a gap in the literature and address the question of how culture influences online satisficing behaviour and how that behaviour causes measurement invariance across survey modes. This study also explains the possible underlying mechanisms by which different national cultures exert their influence on survey results. The findings provide important implications for IT researchers, especially those in collectivistic cultures or those who need to collect data in collectivistic cultures using online surveys or mixed-mode surveys that include an online survey mode. [ABSTRACT FROM AUTHOR]

Introduction: Innovative interventions are needed to address the growing burden of breast cancer globally, especially among vulnerable patient populations. Given the success of Community Health Workers (CHWs) in addressing communicable diseases and non-communicable diseases, this scoping review will investigate the roles and impacts of CHWs in breast cancer screening programs. This paper also seeks to determine the effectiveness and feasibility of these programs, with particular attention paid to differences between CHW-led interventions in low- and middle-income countries (LMICs) and high-income countries (HICs).Methods: A scoping review was performed using six databases with dates ranging from 1978 to 2019. Comprehensive definitions and search terms were established for 'Community Health Workers' and 'breast cancer screening', and studies were extracted using the World Bank definition of LMIC. Screening and data extraction were protocolized using multiple independent reviewers. Chi-square test of independence was used for statistical analysis of the incidence of themes in HICs and LMICs.Results: Of the 1,551 papers screened, 33 were included based on inclusion and exclusion criteria. Study locations included the United States (n=27), Bangladesh (n=1), Peru (n=1), Malawi (n=2), Rwanda (n=1), and South Africa (n=1). Three primary roles for CHWs in breast cancer screening were identified: education (n=30), direct assistance or performance of breast cancer screening (n=7), and navigational services (n=6). In these roles, CHWs improved rates of breast cancer screening (n=23) and overall community member knowledge (n=21). Two studies performed cost-analyses of CHW-led interventions.Conclusion: This review extends our understanding of CHW effectiveness to breast cancer screening. It illustrates how CHW involvement in screening programs can have a significant impact in LMICs and HICs, and highlights the three CHW roles of education, direct performance of screening, and navigational services that emerge as useful pillars around which governments and NGOs can design effective programs in this area. [ABSTRACT FROM AUTHOR]

This paper explores racial differences in maternal risk factors associated with adverse pregnancy outcomes across urban and rural geographies using 2019 data from the Behavioral Risk Factor Surveillance System. Bivariate chi-square tests and logistic regression were performed which showed statistically significant geographical differences among Non-Hispanic (NH) Black pregnant women across income levels (p =.016) and perceived health status (p =.003). Regression analyses indicated an increased racial gap between NH White pregnant women and other racial/ethnic groups. The findings support that there are statistically significant racial differences in maternal risk factors across urban and rural geographies for NH Black and Hispanic pregnant women. [ABSTRACT FROM AUTHOR]

This paper describes a national survey of Master of Social Work (MSW) program leaders' religious and spiritual beliefs and practices across the United States. Of the 257 eligible MSW programs primary contacts, 119 (46.8%) responded to the survey, with 90 completing the items related to religion and spirituality (RS). Specifically, those RS items assessed participants' religious affiliation, intrinsic religiosity, frequency of religious service attendance and private religious activities, the degree to which the respondent is religious or spiritual, and their RS practices. Among our respondents, 80 (88.9%) held a position of leadership (e.g., dean/chair, associate dean, or program director). The results indicated that these MSW program leaders consider religion and spirituality to be important, are engaging in various RS practices, and over half reporting elements of intrinsic religiosity. Additionally, we compared this sample's responses to these items with a national sample of clinical social workers and another sample of adults across the United States. Interestingly, a number of differences emerged between MSW program leaders' RS with LCSWs and US adults. This paper addresses the implications of these findings, particularly in light of the sample being predominantly MSW program leaders, including how leaders' RS may influence the implicit and explicit curricula. [ABSTRACT FROM AUTHOR]

Individuals share a diversity of content on social media for a variety of reasons. Research has often described and explained disclosure via the application of a subjective cost–benefit analysis framed around reciprocity, suggesting that people communicate selfishly motivated by the expectation of receiving something in return. This paper investigates the moderating effects of tie strength and interpersonal trust on the relationship between expected reciprocity and intensity of communication between two social media connections. A Facebook application presented participants with a random set of their friends and asked them to rate their friendships in terms of these values. Overall, 90 participants rated 1728 friendships, while the application collected 11 activity variables depicting the actual communication that has taken place in each pair of connections. A principal component analysis was used to distinguish between text- and photograph-related communication, and two moderated multiple regressions were conducted to establish the moderating effects. The results show significant moderating effects of tie strength and trust on the communication around photographs, but not around text. This study contributes to communication research by explicating the ways that tie strength and trust affect patterns of communication on social media. Implications for social media researchers and designers are discussed. [ABSTRACT FROM AUTHOR]

This paper explores the use of withdrawal as a harm reduction approach to adolescent pregnancy prevention and its association with condom use. Data come from a baseline survey of a randomised controlled trial to test the effectiveness of FLASH, a sexual health education curriculum. Study participants completed electronic self-report surveys in health classes in their first or second year of high school (age range 14.1–17.9, mean 15.3 years). One-hundred and ninety-one students (12% of full sample) reported engaging in vaginal intercourse in the 3 months prior to the survey; of these, 66.0% reported using withdrawal as a birth control method, without significant differences by race, gender, region or birth control beliefs. Withdrawal was often used in combination with condoms (55.5%), periodic abstinence (40.0%) and birth control pills (13.4%). The effectiveness of withdrawal and its prevalence suggest an opportunity to reflect on how withdrawal is taught – moving from avoiding its use to a harm reduction approach to help sexually active youth avoid risk, reduce risk and reduce potential harm associated with sexual behaviours. Rather than focusing on withdrawal as risky, youth-serving professionals should acknowledge young people's efforts to prevent pregnancy and recognise the social and relational contexts of contraceptive choices. [ABSTRACT FROM AUTHOR]

Data services, including consultation services for data management and data visualization, have been increasingly needed among health sciences libraries over the past decade, arising from mandates from funders and a need to effectively communicate information gleaned from a proliferating amount of data. The purpose of this paper is to examine the extent to which U.S.-based health sciences libraries provide services and resources to meet data-related needs. To do so, the authors examined the webpages of American Association of Health Sciences Libraries (AAHSL) for published evidence of data-related services and resources. There were 157 library websites examined in total. [ABSTRACT FROM AUTHOR]

Sexual scripts in pornography rarely include condoms. Many teenagers in the U.S. are exposed to pornography and have unprotected sex. Despite this, only a few studies have investigated whether greater pornography exposure is associated with condomless sex among U.S. teenagers, and these were conducted using clinical, convenience samples, many years ago, with data collections at a single location. This paper reports contemporary results on U.S. teenagers' exposure to pornography, parent-adolescent sexual health communication, and condom use from the National Survey of Porn Use, Relationships, and Sexual Socialization (NSPRSS), a U.S. population-based probability study. Although the correlations were in the expected direction, neither pornography exposure nor parent-adolescent sexual health communication were related at the bivariate level to teenagers' use of condoms. However, consistent with the sexual script acquisition, activation, application model (3AM) of sexual media socialization, pornography exposure interacted with parent-adolescent sexual health communication to predict condomless sex. Pornography exposure was associated with an increased probability of condomless sex only when parents engaged in little to no sexual health communication with their children. When parent-adolescent sexual health communication was high, pornography use was unrelated to teenagers' engagement in condomless sex. These results are consistent with the public health position that pornography can be a risk factor for condomless sex, the theoretical position that the socializing impact of sexual media depends on consumers' existing sexual scripts, and the pedagogical position that parent-adolescent sexual health communication can buffer youth against detrimental effects of sexual media. [ABSTRACT FROM AUTHOR]

Purpose: Drawing on survey data (N = 7,826) collected in the United Kingdom, Australia, and the United States, this paper examines whether sexual orientation is a differentiating factor in explaining relationship quality and maintenance. Previous research suggests that sexual orientation is not significant in determining relationship satisfaction; however, these analyses have used traditional variable driven approaches, which do not provide an holistic view of the relationship by considering the unique combination of characteristics. Method: In this study, latent profile analyses were used, which is a person-centered approach that allows for identification of different types of long-term relationships. Results: Data suggested that LGB individuals had marginally higher levels of relationship quality compared to their heterosexual counterparts, and sexual orientation was also associated with differing types of long-term relationships. Discussion: These findings are interrogated in more detail, in particular, how sexual orientation is associated with types of long-term relationships and how everyday practices are associated with relationship quality. [ABSTRACT FROM AUTHOR]

This project examined the focus of environmental news frames used in seven American newspapers between 1970 and 2010. During this time newspapers were a primary source of news. Based on gatekeeping and agenda-setting theory, as well as source credibility, the content analysis of 2,123 articles examined the environmental topics within the articles, seven possible risk perception dimensions used in the story, and the primary source of information. The national newspapers typically reported an environmental issue paired with policy; local papers reported a single environmental issue. A Chi-square test found significant differences between national and local newspapers’ use of risk dimensions. [ABSTRACT FROM AUTHOR]

Background: Though college students have high rates of heavy drinking, few studies have examined the various pathways through which risks affect drinking and whether this varies by institution. We examined whether alcohol expectancy mediates the relationship between social factors (i.e., hooking up, friends drinking, Greek affiliation, entitlement) and drinking behavior comparing college students from one Midwestern and one Southeastern university.Methods: In the 2013–14 academic year, 1,482 college students (51% female) enrolled in undergraduate courses at two public universities completed a paper and pencil survey of attitudes and experiences about dating, sexuality, and substance use. Multiple group path analysis was used to compare two institutions.Results: Drinking behavior was positively associated with hooking up more often, Greek affiliation, being male, having close friends who consume more alcohol, and greater alcohol expectancies. We found unique differences in the mediating pathways for the two campuses.Conclusion: This study provides a more nuanced understanding of risk factors for heavy drinking. Moreover, it adds to the scarce body of literature concerning entitlement and drinking and the unique pathways between two college campuses. Finally, the results could lead to the development of more specific intervention strategies to reduce risky drinking among U.S. college students. [ABSTRACT FROM PUBLISHER]

Early HIV detection and treatment decreases morbidity and mortality and reduces high-risk behaviors. Many Emergency Departments (EDs) have HIV screening programs as recommended by the Centers for Disease Control and Prevention. Recent federal legislation includes incentives for electronic health record (EHR) adoption. Our objective was to analyze the impact of conversion to EHR on a mature ED-based HIV screening program. A retrospective pre- and post-EHR implementation cohort study was conducted in a large urban, academic ED. Medical records were reviewed for HIV screening rates from August 2008 through October 2013. On 1 November 2010, a comprehensive EHR system was implemented throughout the hospital. Before EHR implementation, labs were requested by providers by paper orders with HIV-1/2 automatically pre-selected on every form. This universal ordering protocol was not duplicated in the new EHR; rather it required a provider to manually enter the order. Using a chi-squared test, we compared HIV testing in the 6 months before and after EHR implementation; 55,054 patients presented before, and 50,576 after EHR implementation. Age, sex, race, acuity of presenting condition, and HIV seropositivity rates were similar pre- and post-EHR, and there were no major patient or provider changes during this period. Average HIV testing rate was 37.7% of all ED patients pre-, and 22.3% post-EHR, a 41% decline (p < 0.0001), leading to 167 missed new diagnoses after EHR. The rate of HIV screening in the ED decreased after EHR implementation, and could have been improved with more thoughtful inclusion of existing human processes in its design. [ABSTRACT FROM PUBLISHER]

Background: The correlates of alcohol misuse among female Veterans are not well understood. The present study explored associations among alcohol misuse, demographic/military-related characteristics, interpersonal violence exposure, and posttraumatic stress disorder (PTSD) and depression symptom severity. Method: Participants were 369 female Veteran patients of the VA New England Healthcare System. Participants completed a paper-and-pencil mail survey that included validated assessments of alcohol misuse, interpersonal violence, and psychological distress. Results: Younger age, adulthood physical abuse, military sexual trauma, past-year psychological aggression by an intimate partner, and PTSD and depression symptom severity showed significant univariate associations with alcohol misuse (as indicated by unsafe drinking levels, presence or incipience of an alcohol use disorder, intrapersonal alcohol-related concerns, and/or interpersonal alcohol-related concerns). A couple of these associations remained significant when examined in logistic regression models. Conclusions: Findings suggest that female Veterans who are at risk for alcohol use disorders and/or are experiencing alcohol-related problems may benefit from screening and intervention efforts that take into account interpersonal violence exposures and mental health symptoms on a case-by-case basis. Results also suggest the importance of future research examining correlates and risk factors for substance misuse among female Veterans. [ABSTRACT FROM AUTHOR]

Background: Fewer than 9% of 12–17 year olds in need (∼146,000 of 1.7 million) receive inpatient or outpatient substance abuse recovery services or other mental health services (SAMHSA, 2012). The literature on adolescent addiction is sparse, however, as most published addiction recovery efforts involve adult populations—often college students. Objectives: The present study examined social influences on escalating substance use (from tobacco, alcohol, and marijuana use to polysubstance use involving opioids) for students enrolled in recovery high schools. Methods: A sample of 31 adolescents enrolled in substance use recovery high schools were surveyed on their patterns of substance use leading to their abuse of opioids. Results: Youth who begin their substance use as young as age 8 are often pressured by peer culture to do so and come from substance-using families. Their escalation in polysubstance use to a pattern including opioids was also most often attributed to peer influence over several years. Conclusions/Importance: This paper is one of scant few that address patterns of use in high school students. Perhaps most salient from this study are the tertiary prevention implications: similar to their adult counterparts, students enrolled in recovery high school programs are likely from substance-using families and have combined complex constellations of substances including opioids by dint of their relationships with substance-using peers. [ABSTRACT FROM PUBLISHER]

Distrust and partisan identity are theorized to undermine health communications. We examined the role of these factors on the efficacy of discussion groups intended to promote vaccine uptake. We analyzed survey data from unvaccinated Facebook users (N = 371) living in the US between January and April 2022. Participants were randomly assigned to Facebook discussion groups (intervention) or referred to Facebook's COVID-19 Information Center (control). We used Analysis of Covariance to test if the intervention was more effective at changing vaccination intentions and beliefs compared to the control in subgroups based on participants' partisan identity, political views, and information trust views. We found a significant interaction between the intervention and trust in public health institutions (PHIs) for improving intentions to vaccinate (P =.04), intentions to encourage others to vaccinate (P =.03), and vaccine confidence beliefs (P =.01). Among participants who trusted PHIs, those in the intervention had higher posttest intentions to vaccinate (P =.008) and intentions to encourage others to vaccinate (P =.002) compared to the control. Among non-conservatives, participants in the intervention had higher posttest intentions to vaccinate (P =.048). The intervention was more effective at improving intentions to encourage others to vaccinate within the subgroups of Republicans (P =.03), conservatives (P =.02), and participants who distrusted government (P =.02). Facebook discussion groups were more effective for people who trusted PHIs and non-conservatives. Health communicators may need to segment health messaging and develop strategies around trust views. [ABSTRACT FROM AUTHOR]

Provoked vestibulodynia (PVD) is estimated to afflict up to 8% of women in the USA. In previous research, women with PVD report embarking on a lengthy path before obtaining a diagnosis. This paper explores how year symptoms began, and how demographic characteristics and assertiveness may affect timeliness of a diagnosis. The experience of receiving a diagnosis is described. Eighty-five participants were recruited through a Listserv and Facebook support group and answered an online survey. Dependent measures included number of appointments before receiving a diagnosis and length of time (months) after symptoms began before receiving a diagnosis. An open-ended question was analyzed. Thirty-five percent attended more than 15 appointments and 37% reported more than 36 months between first symptoms and receiving a diagnosis. The length of time to a diagnosis correlated with amount of education and year symptoms began. Four themes emerged in thematic analyses: necessary self-research, medical care frustrations, empathic health care appreciation, and a negative emotional experience along their journey. Women who began experiencing symptoms after 2005 were diagnosed in less time than those experiencing symptoms earlier, indicating an improvement in diagnostic procedures. However, women continue to have to describe having to visit many physicians before receiving a diagnosis. [ABSTRACT FROM PUBLISHER]

Obtaining employment is an important part of recovery for many people living with HIV/AIDS (PLHA). However, this population often faces barriers in their attempt to reenter the workplace. One potential barrier lies in the decision-making of employers. Little is known about what influences employers’ decision to hire PLHA. The current paper addresses this gap with findings from 156 quantitative interviews with employers across Chicago, Beijing, and Hong Kong regarding the hiring of people with HIV/AIDS. Hierarchical regression analysis showed that both fear of contagion and perceived incompetence are important factors in employers’ decision to interview even after controlling for variables related to the employers’ business size, their education level, and the provision of health benefits. These two variables accounted for 42% of the variance in employers’ decision to interview. Implications of these findings are considered for better understanding of HIV-related employment stigma and further intervention for employing PLHA. [ABSTRACT FROM PUBLISHER]

With advances in the treatment of HIV, people living with HIV (PLWH) are now expected to have a near-normal life expectancy, but challenges remain in the form of substantially poorer health-related quality of life (HRQoL) than the general population. Being overweight or obese may pose an additional burden in PLWH, but few studies have evaluated the relationship between body mass index (BMI) and HRQoL in PLWH. This study aimed to evaluate and describe the association between HRQoL and BMI among PLWH in the US. Data were obtained from the 2018 and 2019 US National Health and Wellness Survey, an online, self-reported, general population survey. Analyses included 575 PLWH who self-reported a physician diagnosis and prescription use for the treatment of HIV, as well as 1725 propensity score matched non-HIV controls. After adjusting for age, sex, race, and comorbidities, higher BMI was associated with poorer physical (β = −0.18, p = 0.005) and general (β = −0.42, p = 0.014) HRQoL among PLWH. Additionally, PLWH reported poorer mental, physical, and general HRQoL than non-HIV controls; these relationships were not moderated by BMI. The potential negative impact of higher BMI on patients' humanistic outcomes should be considered in HIV management, including selection of treatment. [ABSTRACT FROM AUTHOR]

This study used a novel survey instrument to evaluate the hypothesis that U.S. agricultural producers have significantly different stress and recovery experiences following acute-onset natural disaster compared to their non-agricultural counterparts. Participants were recruited through local organizations and targeted email and social media in communities in Arkansas and Nebraska that had experienced violent tornadoes in 2014 and/or severe flooding in 2019. The survey instrument incorporated the Brief Resilience Scale, the Revised Impact of Event Scale referencing two time points, the Posttraumatic Growth Inventory-Short Form, and original questions. Demographic, exposure, stress, and recovery measures were analyzed in SAS with Chi-square tests, t-tests, Wilcoxon tests, and multiple linear regression modeling to test for differences between agricultural and non-agricultural groups in resilience, event exposure, stress symptoms in the week after the event, stress symptoms in the month before the survey, a calculated recovery ratio, and posttraumatic growth. Analysis sample (N = 159) contained 20.8% agricultural occupation, 71.1% female, and 49.1% over age 55. No significant differences were found between agricultural and non-agricultural participants when comparing resilience, stress, or recovery ratio measures. Unadjusted posttraumatic growth score was significantly lower in the agriculture group (P =.02), and an occupation group by sex interaction was significantly associated with posttraumatic growth score (P =.02) when controlled for number of initial posttraumatic stress symptoms in the adjusted model, with agricultural women showing lower growth. Overall, there was no evidence of significant difference in disaster stress and recovery between agricultural and rural, non-agricultural groups in this study. There was some evidence that women in agriculture may have lower levels of recovery. Data indicated that rural residents continue to experience posttraumatic-type symptoms up to 8 years beyond the acute-onset natural disaster events. Communities should include strategies to support mental and emotional health in their preparedness, response, and recovery plans with intentional inclusion of agricultural populations. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine healthy collegiate athletes' perceptions of personal control and beliefs regarding the treatment efficacy related to sport-related concussion (SRC) along with identifying factors that may be associated with these perceptions. This cross-sectional study included collegiate athletes (n = 956) between the age of 18–26 years. Participants completed a 10- to 15-min survey regarding their demographics, diagnosed SRC history, SRC knowledge, and Perceptions of Concussion Inventory for Athletes (PCI-A). Chi-squared analysis and multivariable logistic regressions were conducted to identify factors associated with the PCI-A outcomes of personal control and treatment efficacy perceptions. 24.2% of respondents reported higher perceptions of personal control, while 77.3% reported higher perceptions of treatment efficacy. The multivariable logistic regression revealed males had higher odds of greater perceptions of personal control (OR = 1.50; 95% CI: 1.10–2.03), while those with a history of diagnosed SRC had lower odds of having favorable treatment efficacy beliefs (OR: 0.69; 95% CI: 0.50–0.96). This study established that collegiate athletes generally have lower perceptions of personal control and higher perceptions of treatment efficacy related to SRC recovery. Comprehensive SRC education should be expanded for individuals to understand that they have power over their own health outcomes and that SRC is a treatable injury. [ABSTRACT FROM AUTHOR]

Background: The number of Accountable Care Organizations (ACOs) in the U.S. has been rapidly increasing during the past decade. Despite the growth of Accountable Care Organizations (ACOs), little is known about the factors that are associated with hospital leadership of ACOs that contract with public and private payers. Purpose: Using a resource dependency framework, this study examines the organizational characteristics and environmental factors that are associated with hospitals who are leading an ACO. Methodology: We used the data from the American Hospital Association (AHA) Annual Survey of Hospitals for 2018, the Area Health Resources Files and the Medicare Cost Reports. A multiple logistic regression was used to test associations of the independent variables with the hospital leadership of ACOs. Results: We found that nearly one third of the hospitals studied were leading an ACO. System affiliated and not-for-profit hospitals were more likely to be the leaders. Hospitals that lead an ACO offer more clinical services and have better financial performance. Metropolitan core-based statistical areas and per capita income were significantly positively associated with leading an ACO. However, the proportion of population aged 65 and over and the percentage of Medicare advantage penetration were significantly negatively associated with leading an ACO. Conclusions: Hospitals vary in leading an ACO, which may provide critical resources for them by creating an infrastructure that enables accountable care, extends their services into population health and value-based care programs increasingly promoted by public and commercial payers. [ABSTRACT FROM AUTHOR]

Consumers increasingly search for health information online but can become frustrated in their efforts. Here, public libraries can play an important role as trusted sources. A random sample of 200 U.S. public libraries was used to identify the availability of online consumer health information (CHI) and related characteristics. We found that 110 libraries provided online CHI. The average site provided 28 sources and required two clicks to reach the information. About a third of libraries collaborated by sharing sources or linking to existing content. Collaboration may provide a way to expand the availability and quality of online CHI on public library websites. [ABSTRACT FROM AUTHOR]

Various haphazard, and often uncoordinated, efforts have been devoted to discouraging and combatting terrorism. Unfortunately, there has been a noticeable lack of quantitative studies of the problem of terrorism. Nevertheless, it can be expected that the problem of international terrorism will eventually be a focus for operations researchers. A factor fundamental to any OR study is an understanding of the underlying generating process for incidents of terrorism. Based on incidents of terrorism from 1968 to 1974, this paper notes that the Poisson is a good model for the occurrence of incidents of international terrorism in the United States. Results of both chi-square and Kolmogorov-Smirnov tests are presented. Finally, an unusual result, inconsistent with popular beliefs, is noted. [ABSTRACT FROM AUTHOR]

Immigrant populations are more likely to suffer a significant amount of distress caused by type 2 diabetes mellitus (T2DM). Mobile health applications (mHealth apps) make T2DM self-care knowledge and tools more accessible, which holds promise to improve diabetes outcomes among immigrants. The social distancing protocol and concerns about virus spread in healthcare facilities during the COVID-19 pandemic further highlights the value of mobile technology to facilitate T2DM self-care management among underserved populations. This study examined Chinese and Hispanic immigrants' acceptability for adopting a mHealth app to facilitate T2DM self-management. This study used an embedded mixed methods design. Surveys were completed by 118 participants to understand their status quo of using mobile technology. Smartphones were used by 72.88% of respondents, and among them, the frequency of use was almost every day. Half participants had not used technology for health-related purposes. Then, semi-structured interviews with sixteen Chinese and eight Hispanic participants were completed to delve into intentions, facilitators, and barriers for adopting a T2DM app for tracking self-management. Performance expectancy and effort expectancy appeared to influence participants' intention to use the app. Family to provide technical support was an essential facilitator, while poor eyesight was a major barrier. These findings showed that Chinese and Hispanic immigrants were conditionally accepting a mobile application for T2DM self-management. Developing smartphone apps meeting performance and effort expectancies and addressing the technical support and eyesight issues are critical to adoption of mHealth to reduce T2DM disparities among Chinese and Hispanic immigrants. [ABSTRACT FROM AUTHOR]

This study provides the first nationally representative estimates of parent-reported barriers to mental health services for children with mental health conditions in the United States. It identifies individual, family, and environmental characteristics associated with the most common barriers to mental health care for children with common mental health disorders reporting the need for mental health services. Cost barriers, inconvenient service times, and lack of service availability or transportation barriers were the most reported barriers to mental health services. Children with more severe conditions reported these barriers at significantly higher rates than children with less severe conditions. [ABSTRACT FROM AUTHOR]

This study investigates the impact of the perceptions of antisocial behaviour on the use of the social media platform Twitter. We extend the Unified Theory of Acceptance and Use of Technology (UTAUT) with the Perception of Antisocial Behaviour as a risk factor, and two supporting constructs: Strategic Self-Presentation and Protective Self-Presentation. We call this extended model Technology Acceptance and Use under Risk (TAUR). We investigate two groups via an online questionnaire, contrasting Anglophone countries (the UK, USA, and Canada, 200 responses), with Saudi Arabia (540 responses). In both cases the data shows that the Perception of Antisocial Behaviour impacts Twitter use, but not directly, rather it negatively impacts the influence of other factors such as Behavioural Intention – it also shows that this affects Anglophones more than Saudis. This indicates that future work should differentiate between different cultural groups, and different solutions may be needed to assuage users' fears in different parts of the world. [ABSTRACT FROM AUTHOR]

Bias pervades every aspect of healthcare including admissions, perpetuating the lack of diversity in the healthcare workforce. Admissions interviews may be a time when applicants to health profession education programs experience discrimination. Between January and June 2021 we invited US and Canadian applicants to health profession education programs to complete a survey including the Everyday Discrimination Scale, adapted to ascertain experiences of discrimination during admissions interviews. We used chi-square tests and multivariable logistic regression to determine associations between identity factors and positive responses. Of 1115 respondents, 281 (25.2%) reported discrimination in the interview process. Individuals with lower socioeconomic status (OR: 1.78, 95% CI [1.26, 2.52], p = 0.001) and non-native English speakers (OR: 1.76, 95% CI [1.08, 2.87], p = 0.02) were significantly more likely to experience discrimination. Half of those experiencing discrimination (139, or 49.6%) did nothing in response, though 44 (15.7%) reported the incident anonymously and 10 (3.6%) reported directly to the institution where it happened. Reports of discrimination are common among HPE applicants. Reforms at the interviewer- (e.g. avoiding questions about family planning) and institution-level (e.g. presenting institutional efforts to promote health equity) are needed to decrease the incidence and mitigate the impact of such events. [ABSTRACT FROM AUTHOR]

Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers' understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur. [ABSTRACT FROM AUTHOR]

Substantial out-of-pocket costs for hearing aids constitute a barrier to hearing health care accessibility for older adults among whom prevalence of hearing loss is high. This study is the first to estimate the proportion of Americans with functional hearing loss for which out-of-pocket expenditures for hearing aids would be unaffordable at current average costs and determine how affordability varies by sociodemographic factors. We utilized data from the 2016 American Community Survey to determine the proportion of adults with functional hearing loss for whom hearing aids would constitute ≥3% of annual income or have post-purchase income below a poverty standard. Chi-square tests were used to identify differences in affordability outcomes by sociodemographic characteristics. Results indicated that an average bundled cost of $2500 would constitute a catastrophic expense for 77% of Americans with functional hearing loss (N = 7,872,292) and would add an additional 4% of the population into poverty for the year (N = 423,548). Affordability outcomes varied significantly by age, race, sex, educational attainment and geographic location. Hearing aids were unaffordable for three-fourths of Americans with functional hearing loss, and their purchase would result in impoverishment for hundreds of thousands of individuals. Reductions in out-of-pocket hearing aid costs to $500 or $1000 would alleviate affordability issues for many Americans with hearing loss. Future federal and state policy should address poor rates of insurance coverage for hearing care, specifically among Medicare and Medicaid, to reduce out-of-pocket costs for hearing care particularly for older adults. An average out-of-pocket hearing care cost of $2500 was unaffordable for over three quarters of Americans with functional hearing loss. Hearing care affordability varied significantly by demographic characteristics such as age, sex, gender, educational attainment and geographic region. Affordability constitutes a significant barrier to hearing care accessibility in the United States, where most costs of hearing aids and rehabilitation are statutorily excluded from insurance coverage, including the largest insurer of Americans, Medicare. [ABSTRACT FROM AUTHOR]

The current study replicated Wang and Singer's ([2021]. A cross-cultural study of self-defining memories in Chinese and American college students. Frontiers in Psychology, 11. ) finding that Chinese college students from the People's Republic of China (PRC) recalled more self-defining memories (SDMs) focused on high school academic stress than their American counterparts. Seventy-eight American students from a private 4-year liberal arts college and 96 Chinese students from 13 different Chinese universities recalled two SDMs and rated them for affect, recall frequency, and importance. Once again, Chinese college students were more likely than American students to recall academic stress SDMs, but also expressed more redemptive themes in these memories. Overall, Chinese students rated their SDMs as more positive than the Americans, while the American sample tended to recall their negative memories more frequently. Contrasting the SDMs, American students self-reported higher levels of stress about their high school workload and less academic self-confidence. Regressions linked more negative affect in American SDMs to these work load and self-confidence concerns. Chinese students' SDM negative affect was most strongly predicted by perceived academic stress linked to parental and teachers' expectations. The discussion highlights the potential influence of Confucian values in the Chinese students' responses to past academic stress and their internalisation of academic stress memories in their narrative identity. [ABSTRACT FROM AUTHOR]

While recent meta-analyses have provided answers to a number of historically contentious debates about correlates of pornography use, several questions remain unanswered. Whether pornography is associated with sexual functioning is one such question. Informed by theorizing on sexual scripting, social comparisons, and sexual objectification, the present study examined the possibility that pornography is related to orgasm difficulty through sexual insecurity (i.e., insecurity about one's sexual performance and sexual attractiveness). Data were from the National Survey of Porn Use, Relationships, and Sexual Socialization (NSPRSS), a U.S. population-based probability study. There was an indirect effect of pornography consumption frequency on orgasm difficulty through sexual insecurity. Participants who used pornography more frequently reported higher levels of sexual insecurity, and higher levels of sexual insecurity predicted orgasm difficulty. There was also an indirect effect of partner pressure to view pornography on orgasm difficulty. Higher levels of partner pressure to view pornography were associated with higher levels of sexual insecurity, which in turn predicted orgasm difficulty. Results were indistinguishable by gender and maintained after controlling for a number of potential confounds. These findings suggest that some men and women's personal and (pressured) partnered pornography consumption have the potential to increase orgasm difficulty through bodily and performance insecurity. [ABSTRACT FROM AUTHOR]

Immigrants comprise about 14% of the existing population of the United States. The period under Trump administration and COVID-19 in particular have been challenging for immigrants. The goal of this review was to present a landscape of immigrants in the US and their experiences during the exclusionary environment under Trump administration and the pandemic. The study presents descriptive findings and chi-square results utilizing data collected from a survey. Our sample (N = 490) was collected during the early 2021. Findings indicate differences in COVID experiences, stress impact as a result of travel bans, and resiliency by race. Minority communities compared to those who were White were disproportionately impacted. By drawing on the literature, research and policy briefs and the study data, we discuss mental health implications and increased discrimination against immigrants. We propose ways in which researchers, practitioners and policy advocates can enhance support for immigrants. [ABSTRACT FROM AUTHOR]

The benefits of volunteering among youth are well documented. However, research is limited on volunteering among youth with disabilities. This study examined prevalence and associations of volunteering among youth with disabilities. We analyzed data from the 2016–2018 National Survey of Children's Health (n= 42 204). Prevalence estimates were calculated for sociodemographic and household factors, volunteering, and functional limitations. Bivariate and multivariable associations between participation in volunteering activities and variables of interest were assessed. Youth with disabilities had lower prevalence of volunteering compared to youth without disabilities (48.4% vs. 55.6%). Youth with hearing and vision impairments had the lowest prevalence of volunteering (2.1% and 2.5%, respectively). Correlates of volunteering included health status (adjusted odds ratios (aOR)=1.81; 95% confidence interval (CI) 1.13–2.91), sex, and age. Our study found low prevalence of volunteering among youth with disabilities. Since youth with disabilities face unique barriers to social inclusion, it is important to identify and reduce the barriers to participation among this group. Volunteer opportunities in the community should be designed to be both environmentally and programmatically accessible to youth with disabilities. These efforts should include accommodations and other support so that participants can fully experience all of the benefits of volunteering. Our multiyear nationally representative study found low prevalence of volunteering among youth with disabilities, particularly those with hearing and vision impairments. Since youth with disabilities face unique barriers to social inclusion, it is important to identify and reduce the barriers to participation among this group. Our findings support the need for environmentally and programmatically accessible volunteering opportunities for youth with disabilities. These efforts should include accommodations and other support so that participants can fully experience all of the benefits of volunteering. [ABSTRACT FROM AUTHOR]

Sexual minorities are at greater risk for mental health difficulties than their heterosexual peers, and bisexual and asexual individuals may be at particularly heightened risk. However, the majority of the literature has failed to examine nuanced differences within the sexual minority community. We examined depression, anxiety and happiness as indicators of mental health, and belonging and coping as general psychological processes in 2,424 female and male college students who identified as gay/lesbian, asexual, or bisexual. The findings revealed a significant main effect for sexual orientation such that bisexual individuals scored significantly higher on depression and lower on happiness than asexual and gay/lesbian individuals. Gay/lesbian and bisexual individuals scored significantly higher on anxiety and lower on coping than asexual individuals. Asexual individuals reported greater belonging than bisexual individuals, and gay/lesbian individuals scored in between those groups. The results also revealed a significant main effect for gender such that women had higher levels of depression and anxiety, and lower levels of happiness and coping than men. Finally, gender did not moderate the relationship between sexual orientation and the outcome variables. These findings highlight that the sexual minority community is not a monolithic group in terms of mental health or general psychological processes. [ABSTRACT FROM AUTHOR]

This project examined the impact of childhood maltreatment types on psychosomatic outcomes among adults with a range of self-reported disabilities. Participants (n = 643) were recruited using Amazon Mechanical Turk and Cloud Research. Single-item questions assessed sociodemographic information. The Childhood Trauma Questionnaire measured childhood maltreatment types (emotional, physical, and sexual abuse, and emotional and physical neglect) and the RAND-36 Item Health Survey evaluated physical functioning, pain, and energy/fatigue. Logistic regressions determined associations between childhood trauma and psychosomatic outcomes; stratified models compared men and women. Multivariate-adjusted models indicated physical abuse was positively associated with poor physical functioning (OR: 2.03; 95%CI: 1.35–3.06) with this relationship being stronger for men (OR: 3.25; 95%CI: 1.42–7.43) than women (OR: 1.91; 95%CI: 1.17–3.13). Adjusted models showed that physical neglect was protective against fatigue (OR: 0.58; 95% CI: 0.36–0.94), while emotional neglect increased the risk of fatigue (OR: 1.74; 95%CI: 1.02–2.95). Lastly, physical abuse was positively associated with pain (OR: 1.53; 95%CI: 1.01–2.33). This relationship was stronger in men (OR: 4.99; 95%CI: 1.91–12.99). Results improve our understanding of risk factors for poor physical health outcomes and can guide the development of trauma-sensitive rehabilitation services. Individuals with disabilities who report childhood maltreatment may experience poor psychosomatic outcomes in adulthood. Consequences of experiencing childhood maltreatment may manifest differently between men and women over the course of the lifespan. It is essential to integrate trauma-informed principles into treatment plans for individuals with poor psychosomatic health. Rehabilitation professionals should screen for abuse and refer individuals to the appropriate mental and physical health services. [ABSTRACT FROM AUTHOR]

The global pandemic caused by SARS-CoV-2 (COVID-19) poses serious health risks to humans; yet, despite recommendations by governments and health organizations, a significant number of Americans are not engaging in preventive behaviors. To understand and explain this phenomenon, we seek guidance from a theoretical model that merges the risk information seeking and processing model and the theory of planned behavior. Furthermore, given the politicized nature of the pandemic in the U.S., we pose different information seeking patterns according to media partisanship, asserting that partisanship is likely to affect cognitive structures regarding COVID-19 decision making. Our results suggest two distinct routes for information seeking to decision-making. Conservative media use is directly associated with preventive behavior avoidance, while liberal media use is indirectly associated with preventive behavior engagement. This work contributes to our collective understanding of what drives preventive behaviors in the context of health risk, particularly in the case of a highly politicized national health crisis with global implications. [ABSTRACT FROM AUTHOR]

The public's fear of COVID-19 may cause severe consequences. The current project explored what caused U.S. adults' fear of COVID-19 and how they regulated fear using a longitudinal two-wave survey on a national-representative sample (N = 315). Results showed that participants' media exposure frequency and their perceived valence of interpersonal communication predicted their fear of COVID-19 at both waves, and fear at wave 1 further motivated higher frequency of media and interpersonal communication as well as strengthened perceptions that their interpersonal conversations emphasized the danger aspect of COVID-19 at wave 2. Counterarguing was effective in down-regulating individuals' fear, which in turn further encouraged more subsequent use of such strategy. Avoidance used in wave 1 predicted counterarguing at wave 2, while counterarguing employed in wave 1 predicted the subsequent use of reappraisal. Individuals may choose to use counterarguing as a maladaptive coping strategy to control their fear, and they tend to shift from one emotion regulation strategy to another as the pandemic progresses. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare prevalence of JUUL use and JUUL risk perceptions between adolescents living in an urban area versus Appalachian areas of the U.S. Data were drawn from a prospective cohort study of adolescent males (the Buckeye Teen Health Study, or BTHS); our cross-sectional analysis used data from one timepoint, collected between January and December 2019 (N = 873). Chi-square tests and multivariable logistic regression compared JUUL use prevalence and risk perceptions between participants in an urban Ohio county and nine predominantly rural Appalachian Ohio counties. Over a quarter of the sample (29.2%) had ever used JUUL. In the unadjusted model, prevalence of JUUL use was similar between regions but Appalachian participants perceived JUUL as more harmful (p <.001) and more addictive (p =.04) than urban participants. In the adjusted model, region was not significantly related to current JUUL use (OR: 1.20, 95% CI: 0.77, 1.87) or ever JUUL use (OR: 1.15, 95% CI: 0.83, 1.60). JUUL use was similar between urban and Appalachian participants despite regional differences in risk perceptions. Interventions that only target risk perceptions may not be sufficient to prevent adolescent e-cigarette use, particularly in rural communities. [ABSTRACT FROM AUTHOR]

Introduction: Trauma is the leading cause of death for those aged 1 to 46 years with most fatalities resulting from hemorrhage prior to arrival to hospital. Hemorrhagic shock patients receiving transfusion with 15 minutes experience lower mortality. Prehospital blood transfusion has many legal, fiduciary, and logistical issues. The San Antonio Fire Department participates in a consortium designed to enhance the stewardship of prehospital whole blood. This study aimed to stratify blood usage amongst the field supervisors and special operations units that carry whole blood. Methods: This was a 12-month retrospective analysis of blood usage. Blood tracking forms (used for either blood exchange of transfusion) were cross referenced with city financial records to determine blood usage patterns in the 7th Largest City in the US. We used descriptive statistics, compared usage ratios, and chi-square to compare dichotomized data. Results: A total of 363 whole blood units were obtained and 248 (68.3%) units of whole blood were transfused. EMS field supervisors transfused 74% of whole blood vs. 44% for special operations ambulances (p= <0.001). Response vehicles located in densely populated areas had the highest usage rates. All blood units were either transfused or returned for a zero blood unit wastage for expiration. Conclusion: The information contained within this work can provide other EMS agencies with a basic framework for comparison. The data from the SAFD's whole blood transfusion rate coupled with the clinical transfusion guideline has provided some insight for prospective agencies considering adopting a whole blood program. EMS systems and municipalities with similar characteristics can project their own whole blood needs and make informed decisions regarding program feasibility and design. [ABSTRACT FROM AUTHOR]

The purpose of this cross-sectional research study was to explore the use of apps by occupational therapy practitioners in the United States to gain a more complete overview of utilisation and perceived effectiveness, and assess trends by population served, practice setting, occupation addressed, and client deficit. For this cross-sectional study, 160 self-identified occupational therapy practitioners, 126 occupational therapists and 34 occupational therapy assistants, recruited through snowball sampling on social media participated in this 26-question survey available for two weeks online. Data analysis was conducted through SurveyMonkey and SPSS version 26. The majority of respondents (71.9%) reported that they have used apps in practice, most frequently as treatment modalities (84.3%) and as recommendations (71.9%) for clients. Likewise, most respondents who reported using apps considered apps to be as effective (70.5%) or better than (27.3%) traditional practice methods. Use of apps was significantly associated with practice setting X2(9, N = 160) = 46.437, p <.001. Occupational therapists are using apps with clients of all age groups, and these apps are being used in all phases of the occupational therapy process. Apps are available that address all eight areas of occupation, and apps are perceived to be as effective or better than traditional occupational therapy interventions. The majority of occupational therapy practitioners surveyed are using apps in practice. Most therapists are being provided devices by employers that support app use in practice. Neuromusculoskeletal and movement related functions and mental functions related to cognition are the primary client impairments therapists are addressing when using apps. Lack of app knowledge and familiarity with apps were the leading barriers to app use in practice. [ABSTRACT FROM AUTHOR]

Non-binary and genderqueer (NBGQ) individuals do not identify with a binary gender identity. Some but not all NBGQ individuals identify as transgender, and it is currently unclear on which aspects of mental and sexual well-being NBGQ and binary transgender individuals may differ. To compare NBGQ, binary transgender and cisgender individuals on variables related to mental well-being, sexual well-being, and sexual self-concept discrepancies. We conducted an online questionnaire study in 125 transgender men, 72 transgender women, 78 NBGQ individuals, 98 cisgender men, and 107 cisgender women. For most variables, NBGQ individuals did not differ from binary transgender individuals. These two groups differed only on gender dysphoria and transgender specific body image worries, which were both lower in the NBGQ group. Compared to the cisgender group, NBGQ individuals scored higher on gender dysphoria, actual/ought sexual self-concept discrepancies, and actual/ideal sexual self-concept discrepancies, and lower on general life satisfaction and sexual esteem related to body perception. These results offer a first quantitative analysis of sexual well-being in NBGQ individuals, and highlight that – while both groups face unique challenges – NBGQ individuals encounter similar difficulties concerning mental and sexual well-being as binary transgender individuals. [ABSTRACT FROM AUTHOR]

Advance care planning (ACP) is atypical in the United States, especially among young adults. We designed and evaluated the effectiveness of a brief intervention about the benefits of perceived control and planning for end-of-life. Participants (N = 188) were randomized into three conditions and completed a cross-sectional questionnaire. Participants who received the intervention were less likely to worry about not getting enough care and more likely to anticipate completing verbal and written ACP within three months than were comparison group participants. Findings suggest the potential of brief interventions to raise awareness about the benefits of ACP and enhance completion among young adults. [ABSTRACT FROM AUTHOR]

Although there is a wide variety of scientific evidence that demonstrates the benefits of vaccination on a multitude of diseases, vaccination rates remain low while misperceptions about vaccines are on the rise. The primary objective of the present study is to examine the role of doctor–patient communication and vaccination. We test the impact of doctor–patient communication on trust in doctors' vaccine recommendations as a mediator, to understand the mechanisms leading to positive vaccination attitudes, and ultimately leading to actual H1N1 vaccination behavior. We use data from a nationally representative U.S. sample from one of the Multimedia Audience Research Systems (MARS) data sets collected by Kantar Media. Our results demonstrate the crucial role of doctor–patient communication in building patients' trust in doctors, which in turn positively impact vaccination attitudes and H1N1 vaccination behavior. Unlike other preventive health measures, getting vaccines after a pandemic is a critical decision because these vaccines are previously unknown. Our finding implies that verified communication from the physician's office may be one of the effective strategies during or after a pandemic. Our findings have implications for public health organizations to incorporate effective vaccination communication and could have critical implications for the COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Misinformation on social media pertaining to COVID-19 poses a great threat to public health. The active correction of misinformation by social media users and an understanding of the drivers of such behavior can help solve this ongoing issue. Drawing on the influence of presumed influence model and cognitive appraisal theory, an online experiment (N = 400) was conducted to examine how exposure to corrective messages with regard to COVID-19 misinformation induced individuals' threat appraisals of the influence of the misinformation on others and how these threat appraisals and the corresponding emotional responses motivated individuals to take corrective actions. The results suggested that people's perceptions of the severity of the influence of misinformation on others engendered anticipated guilt, which, in turn, strengthened their intentions to correct misinformation related to COVID-19. The study offers guidance on how to effectively craft a corrective message to encourage audiences to counter misinformation together. [ABSTRACT FROM AUTHOR]

Purpose: Research suggests social support may protect sexual minorities from the harmful effects of victimization that undermine mental and sexual health wellness; however, this relationship has been underexplored among a diverse youth population. We examined the association between lifetime homonegative victimization, perceived stress in the last month, and resilience factors among a diverse sample of adolescent sexual minority males. Methods: Data were collected between June 2018 and April 2020 as part of the MyPEEPS Mobile study, a multi-site randomized controlled trial evaluating the effectiveness of a mobile behavioral HIV prevention intervention for adolescents living in the U.S. We analyzed baseline survey data from 542 sexual minority males, aged 13–18 years. We used bivariate analyses to examine relationships among variables and multivariable linear regression models to determine if resilience factors attenuated the association between homonegative victimization and perceived stress. Results: Perceived stress was positively associated with younger age, internalized homophobia, experiencing verbal victimization, threats of being outed, and threats of physical violence. Relying on online friends for support and having good family relations both attenuated the relationship between verbal victimization and perceived stress. However, neither of these resilience factors significantly weakened the associations between perceived stress, threats of physical violence, and being outed. Conclusion: Resilience factors, including peer and family support, may play an attenuating role in the relationship between homonegative victimization and perceived stress among adolescent sexual minority males. ClinicalTrials.gov Identifier: NCT03167606 [ABSTRACT FROM AUTHOR]

Despite a series of high-profile media reports of sexual abuse in sport over the past few years, little research has been done to explore the scope of the problem in the United States. The current article reports on prevalence of child sexual assault in elite athletes in the United States. Using a retrospective web survey, adults answered questions on their experiences in sport. Of the 473 elite athletes surveyed, 3.8% (n = 18) reported being sexual assaulted as a minor in the sporting context. Of those reporting assault, most (61%) reported being abused by an adult authority figure (usually a coach) and 44% reported being assaulted by a peer. Abused athletes were significantly more likely to report having been diagnosed with a mental disorder (Fisher's exact test; p <.001). The findings can be utilized to improve prevention and child protection measures and other safeguarding initiatives in sport. [ABSTRACT FROM AUTHOR]

Sleep's impact on quality of life and health among the general population is well documented. Meanwhile, there is a growing number of policies across the United States that criminalize homelessness by outlawing sleeping or sheltering in public, but there is little research about sleep quality among people experiencing homelessness within the context of larger systems. Using data (N = 484) collected to explore public health implications of criminalization of homelessness, this study describes sleep among people experiencing homelessness in Denver, Colorado through an ecological systems perspective. Participants reported an average of 3.6 hours of sleep in a 24-hour period and participants, on average, slept 2.87 hours without being interrupted. Race, disability status, and military status have statistically significant correlations with interrupted sleep, suggesting the systems and structures associated with these demographics may be related to poor sleep. Furthermore, there is a statistically significant correlation between amount of sleep and uninterrupted sleep and feelings of depression, experiencing images or hallucinations, and feeling sick. In building upon previous research which shows that people experiencing homelessness typically get less than the recommended amount of sleep, this study illuminates both the systemic and self-reported health and well-being implications that poor sleep has among people experiencing homelessness. [ABSTRACT FROM AUTHOR]

Literature shows a litany of health issues disproportionately impacting Black Americans, with physical inactivity as a major risk factor. This study seeks to understand the role of smartwatches in physical activity uptake and subsequent improvement in health outcomes for students at HBCUs (Historically Black Colleges & Universities). We administered an electronic survey to undergraduate students (n = 215) about smartwatch ownership, features, competitions, fitness goals and accomplishments, exercise tracking, frequency of exercise, perceptions of weight, and student demographics. Smartwatch owners who were aware of features such as calorie counting were significantly more likely to exercise at the gym at least once per week. The majority recorded themselves running and competed with other smartwatch users in some fashion. Others were unaware of fitness tracking features. Overall, smartwatch users were not more likely to workout than non-users and were significantly more likely to see themselves as overweight. Many smartwatch users are unaware of exercise tracking features and not using the devices to become more physically active. Motivations for purchasing smartwatches must be explored, and initiatives to showcase the technology's fitness promotion potential and encourage competition between users could yield positive health impacts. [ABSTRACT FROM AUTHOR]

There has been a dramatic increase in the rate of truancy cases throughout the United States, and despite truancy reduction efforts, truancy rates remained constant. Truancy is frequently associated with youth's high-risk behaviors and negative academic and life outcomes. Given the negative impact of truancy, conducting research on school attendance is critical to the success of youth over the life course. The current study examined a sample of 23,459 students referred to the Truancy Assessment and Service Centers (TASC) program to understand the characteristics of elementary school children at risk for truancy by exploring gender differences in the service needs reported by truant children and their families. Results indicate the leading risk factors for truancy include child behavioral problems, educational issues, and parental practices. Also, there were no significant differences between boys and girls related to truancy risk factors nor the types of services children in the TASC program needed. [ABSTRACT FROM AUTHOR]

Objectives: Emerging adulthood—spanning 18–29 years of age—is associated with the highest risk for onset of certain behavioral health disorders (e.g. major depression, bipolar disorder, psychosis, substance use disorders) and high prevalence of many behavioral health disorders. Yet, rates of mental health service use remain low in this age range. Racial/ethnic minorities are particularly impacted by individual, cultural/linguistic, and community-level barriers to mental health care. This study examined community-level factors associated with mental health service use and investigated whether these associations varied by race/ethnicity. Design: This study analyzed individual- and county-level data for emerging adults in the United States (N=3,294) from the nationally representative Collaborative Psychiatric Epidemiological Surveys (CPES). Using the Andersen Model of Health Care Utilization, analyses examined predisposing, enabling, and need factors utilized in prior studies with adult samples as well as novel community characteristics hypothesized to impact service use among emerging adults of diverse racial/ethnic backgrounds. Past-year use of both specialty and any mental health services were assessed, controlling for individual- and community-level variables, and adjusting for presence of past-year mental health disorder, overall health status, and functional impairment. Differences between racial/ethnic minority groups and Non-Latino Whites were tested through a multilevel model incorporating random intercepts logistic regression, with analysis focusing on the interaction between race/ethnicity and community-level supply variables. Results: For past-year use of specialty mental health services, density of hospitals with child wellness programs was linked to service use among Black emerging adults, whereas density of hospitals with linguistic/translation services was linked to service use among Latino emerging adults. Conclusions: This study expands on previous research in behavioral health disparities to examine ways to improve behavioral health services for an emerging adult population with unmet service needs and identifies specific community-level factors that can improve mental health for racial/ethnic minority emerging adults. [ABSTRACT FROM AUTHOR]