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Introduction Sleep deficiency is associated with health risks, and time outdoors is related to health benefits. This study assessed time outdoors and its association with sleep normality. Methods As part of a health study in Louisville, Kentucky, 735 participants completed questionnaires on their health status, behaviors, neighborhoods, and demographics in 2018–2019. The measures included information on sleep, time outdoors, and mental and physical health. Participant characteristics were assessed by dichotomized sleep normality (N=728), and logistic regression (N=709) examined potential associations between time outdoors and sleep. Results As time spent outdoors increased from ≤4 hours to >4 – ≤8 hours (OR=1.04; 95% CI: 0.65–1.64) and >8 – ≤12 hours (OR=1.17; 95% CI: 0.63–2.17), odds of normal sleep increased; however, those who spent >12 – ≤16 hours (OR=0.63; 95% CI: 0.31–1.27) or >16 hours (OR=0.83; 95% CI: 0.45–1.53) outdoors had a lower likelihood of normal sleep. No associations between time outdoors and sleep were significant. There was a significant trend of less bodily pain associated with normal sleep (p

Introduction E-cigarettes are the most popular tobacco product among youth. Although harm perceptions have been linked to youth e-cigarette use, little research focuses on vulnerable populations, such as Appalachian youth. This study examines associations between e-cigarette harm perceptions and tobacco use among a sample of Appalachian youth. Methods Using data from the 2014–2016 Youth Appalachian Tobacco Study (n=1074), distributions of six e-cigarette harm perceptions by tobacco use (never, ever non-e-cigarette, ever e-cigarette) were examined, and multivariable multinomial logistic regression was used. Results Nearly one-fourth (23.4%) of the sample were ever e-cigarette users. More e-cigarette users were male (53.4%) and in high school (57.0%). Fewer e-cigarette users strongly agreed that e-cigarettes cause health problems (15.1%), breathing problems (20.3%), and oral health problems (18.7%) and that e-cigarettes are addictive (25.1%), compared to never and non-e-cigarette users. More e-cigarette users strongly agreed (32.3%) that e-cigarettes are healthier alternatives to cigarettes compared to never (24.1%) and non-e-cigarette (25.7%) users. Regression models indicate that e-cigarette users had greater odds of strongly disagreeing with e-cigarettes being harmful or addictive, compared to never users. E-cigarette users had approximately six-fold odds of strongly disagreeing with e-cigarettes causing health problems (OR=6.12; 95% CI: 3.16–11.90) and two times greater odds of disagreeing with e-cigarettes being addictive (OR=2.09; 95% CI: 1.07–4.08) compared to never users. Conclusions Appalachian youth ever e-cigarette users perceive e-cigarettes as less harmful and less addictive compared to never users. Better informing youth, especially youth tobacco users, of the harms associated with e-cigarettes is vital.

E-cigarettes are commonly used tobacco products among youth populations, including Appalachian youth. However, knowledge of the extent to which tobacco use status relates to temptation to try e-cigarettes is limited. Data from the Youth Appalachian Tobacco Study (n = 1047) were used. Temptation to try e-cigarettes was derived from a 12-item situational inventory. Tobacco use status was defined as never, ever non-e-cigarette, and ever e-cigarette use. A factorial ANOVA was used to estimate the adjusted association between tobacco use status and the e-cigarette use temptation scale. Two-way interaction terms between tobacco use status and gender, and tobacco use status and race/ethnicity, were plotted to depict effect modification. Approximately 10% of youth were ever non-e-cigarette users and 24% were ever e-cigarette users. Never and ever non-e-cigarette user middle schoolers had higher temptation to try e-cigarettes than their high school counterparts. The same relationship was found among never and ever e-cigarette users living in households with tobacco users. The ANOVA results suggest a positive, monotonic relationship between tobacco use status and temptation to try e-cigarettes, and that the adjusted group means differ by gender and race/ethnicity. The findings can inform tobacco prevention interventions for youth at higher risk for e-cigarette use, especially youth who have not yet tried e-cigarettes.

Introduction Despite decreases in the overall US smoking rate, tobacco use remains more common in some areas and by some groups. Deeper understanding of group differences is needed in order to tailor public health campaigns to the interests, perceptions and experiences of targeted audiences. Although some differences have been identified across African American and Caucasian smokers in the United States, additional insight is needed regarding factors that differentiate these groups. This study examined tobacco-related perceptions and practices, with an emphasis on identifying differences across African American and Caucasian smokers. Toward this goal, we examined key demographic variables of race and age, and tobacco use characteristics. Methods The sample consisted of 284 people from the Jackson, Mississippi area who participated in focus groups and completed surveys addressing a variety of tobacco-related topics, including knowledge and perceptions of products as well as use and health information seeking behavior. The selection criteria and recruitment approach ensured a balance across race (black, white), age (18-34, >35 years), sex, and cigarette smoking status (current, former, never). Statistical analyses were performed using SAS (v.9.4). Results Differences were observed across demographic subgroups regarding type and pattern of tobacco products used (e.g. mentholated, markers of nicotine dependence, hookah). Differences in preferred sources of health information based on age as well as perceptions of risk as a function of age, smoking status and race were also noted. Exposure to secondhand smoke and perceptions of its risks, quitting efforts and cessation methods differed by race. Conclusions Study findings suggest key differences across important subgroups. Knowledge of such differences has the potential to improve strategic public health messaging, allowing health campaigns to more effectively prevent tobacco product uptake as well as promote interest in quitting tobacco.

We examine the effects of the COVID-19 pandemic on a community-based research project. This clinical trial investigates whether increased neighborhood greenness lowers the risk of cardiovascular diseases through reduction of air pollution. Facilitating the project involves considerable community engagement, and the project relies on successful collaboration across a multidisciplinary team. As concerns surrounding SARS-CoV-2 increased, adjustments to our research were needed. When cases of COVID-19 escalated, clinical trials were halted. In this analysis, we employ a dialectical approach to examine the competing tensions evidenced in community work during the pandemic. From the vantage point of dialectical theory, competing feelings can occur simultaneously (such as concurrent experiences of dissatisfaction/satisfaction or need for progress/safety) and influence experience. This analysis considers the dialectical tensions created by the pandemic as well as the means of reconciling some tensions and wrestling with others.

Introduction Electronic nicotine delivery systems (ENDS) are a relatively new type of nicotine-containing product that has risen greatly in use within the past decade, displacing conventional tobacco products as the dominant source of nicotine exposure by many groups. Among those impacted are large sections of US youth. Though health outcomes associated with ENDS use are still being assessed, several potential harms have been noted in the extant literature. The purpose of this study is to examine which US youth subpopulations are at greatest risk for ENDS ever use and how perceptions pertaining to nicotine-containing products relate to this risk. Methods A nationwide online survey was administered to US youth ENDS users and non-users aged 13-18 years. A total weighted sample of 2501 participants was obtained. Statistical analyses included binomial logistic regression and a likelihood ratio test. Results Of these youth, 1346 (53.8%) reported having ever used an ENDS product. Those most likely to have used ENDS were White males in their late teens. Those who reported ever using a conventional tobacco product were much more likely to have reported ever using ENDS (AOR= 19.96; 95% CI: 15.30-26.05). A number of perceptions related to nicotine-containing products, including product safety and health effects, were significantly associated with an increased likelihood of ENDS use. Conclusions Certain sections of the US youth population have elevated odds of being ENDS ever users. As increasing evidence supports the need to combat ENDS use by youth, effectively targeted education and prevention campaigns will be necessary.

Introduction Prior research has shown that tobacco companies target point-of-sale (POS) marketing to low-income communities. This research assessed the association between demographic characteristics and venue type with purchasing tobacco products in response to marketing. Methods Using Population Assessment of Tobacco and Health (PATH) Study Wave 1 Adult data, this analysis compared promotion awareness and purchase influence among current smokers. Results Tobacco promotions were more likely to be noticed at convenience stores, gas stations, or tobacco stores than at other outlets. Smokers who bought their cigarettes at these outlets were more likely to purchase a brand other than their usual brand because of marketing. Smokers below the poverty level had greater odds than others to have noticed tobacco ads and to indicate purchase influence. Conclusions Point-of-sale marketing is effective in garnering the attention of low-income populations and influencing their tobacco purchases. Enforcing retailers' adherence to regulations is vital.

There is little research examining the social patterning of electronic nicotine delivery system (ENDS) use. This study investigated the association between socioeconomic status (SES) (education, income, and employment status) and current and former ENDS use. Data were collected from 2561 participants from the American Heart Association Tobacco Regulatory and Addiction Center (A-TRAC) online survey. Participants were 18–64 years old and reported demographic, SES, and ENDS use. Poisson regression was used to estimate prevalence ratios (PR 95% confidence interval-CI) of participants’ current and former (vs. never) ENDS use. Models were adjusted for age, sex, sexual orientation, race/ethnicity, marital status, and reasons for ENDS use. In the unadjusted analysis, ENDS use was primarily patterned by education and employment status. College educated persons (versus those with less than a high school diploma) had a 37% greater prevalence of current ENDS use (PR 1.37, 95% CI 1.20–1.55), and a 16% greater prevalence of former ENDS use (PR 1.16, 95% CI 1.06–1.28) in the fully-adjusted model. Persons with household incomes above $90K (versus less than $20,000) had a greater prevalence of current (PR 1.30, 95% CI 1.19–1.41) and former (PR 1.17, 95% CI 1.05–1.30) ENDS use. Those who were employed (versus not employed) had a 13% greater prevalence of current ENDS use (PR: 1.13, 95% CI 1.07–1.19) after full adjustment. Higher SES (versus lower SES) persons were more likely to use ENDS.

Research about e-cigarette use is emerging and there is no clear evidence about the effectiveness of their use in smoking cessation. The purpose of this study was to explore the knowledge and attitudes of primary care nurse practitioners (NPs) toward e-cigarettes. A nonexperimental, descriptive study was conducted with primary care NPs (N = 93). Thirty-five percent of NPs believed that e-cigarettes were healthier than traditional cigarettes; 60% endorsed using them for cessation and 19% thought they were as effective as nicotine replacement therapies. Given NPs' varying opinions regarding the use of e-cigarettes, more education regarding evidence on e-cigarette health risks and limited cessation efficacy is necessary.

Vaping is popular among adolescents. Previous research has explored sources of information and influence on youth vaping, including marketing, ads, family, peers, social media, and the internet. This research endeavors to expand understanding of peer influence. Our hypothesis is that friends’ influence on teen vapers’ first electronic nicotine delivery systems (ENDS) use varies by demographic variables and awareness of ENDS advertising. In August–October 2017, youth (n = 3174) aged 13–18 completed an online survey to quantify ENDS behaviors and attitudes and were invited to participate in follow-up online research in November-December 2017 to probe qualitative context around perceptions and motivations (n = 76). This analysis focused on the ENDS users, defined as having ever tried any ENDS product, from the survey (n = 1549) and the follow-up research (n = 39). Among survey respondents, friends were the most common source of vapers’ first ENDS product (60%). Most survey respondents tried their first ENDS product while “hanging out with friends” (54%). Among follow-up research participants, the theme of socializing was also prominent. ENDS advertising and marketing through social media had a strong association with friend networks, in fact, the odds of friends as source of the first vaping experience were 2 times higher for those who had seen ENDS ads on social media compared with other types of media. The influence of friends is particularly evident among non-Hispanic Whites, Hispanics/Latinos, those living in urban areas, those living in high-income households, those with higher self-esteem, and those who experiment with vaping. These findings support the premise that peer influence is a primary social influencer and reinforcer for vaping. Being included in a popular activity appears to be a strong driving force.

Highlights • Over one-third had tried tobacco and over one-fifth had tried two or more products. • Most participants recognized harms associated with conventional tobacco use. • E-cigarettes were perceived as less harmful than conventional tobacco products. • Smokers and polytobacco users had lower odds of indicating tobacco health risks. • E-cigarette users were less likely to perceive e-cigarettes as harmful or addictive., Appalachian youth tobacco use rates exceed the national average. Additional inquiry is needed to better understand youth product perceptions and use patterns. This study examined tobacco harm perceptions and their relationship with tobacco use among Appalachian youth. From 2014 to 2016, a survey of Appalachian middle and high school students (N = 1,136) was conducted. Tobacco harm perceptions were assessed by tobacco use status, categorized as never user, cigarette only user, smokeless only user, e-cigarette only user, or polytobacco user. Descriptive characteristics were compared by tobacco use status and harm perceptions. Adjusted multivariable logistic regression models assessed the relationship between tobacco use status and harm perceptions. Over one-third of participants were tobacco users (34.6%; 4.7% cigarette only users, 3.3% smokeless only users, 5.6% e-cigarette only users, and 21.0% polytobacco users). Approximately half agreed that e-cigarettes cause health problems (54.4%), and 64.7% agreed that e-cigarettes are addictive. Most participants (83.4–92.3%) agreed that smoking and smokeless tobacco cause health problems and are addictive. Tobacco users more often disagreed that tobacco products cause health problems than did never users. Compared to never users, e-cigarette only users were more likely to disagree that smoking (AOR: 2.99, 95% CI: 1.30–6.90) and e-cigarettes cause health problems (AOR: 2.79, 95% CI: 1.64–4.75) and that e-cigarettes cause addiction (AOR: 2.48, 95% CI: 1.48–4.16). Most youth were aware of health dangers associated with smoking, but perceptions were split on whether e-cigarettes were associated with health problems or addiction. The findings indicate the need for additional youth tobacco use prevention efforts.

Introduction As e-cigarette use increases, questions about individual and public health effects remain unanswered (e.g. cessation tool, addiction path). Despite increasing use, few studies have focused on vape shop patrons. This study examined whether vape shop patrons believe their health is affected by the use of e-cigs; more specifically, the aim was to evaluate the association between e-cig use, change in tobacco use, and perception of health. Methods A survey of e-cig users (N=78) was conducted in vape shops. Questions included e-cig and traditional tobacco use, health perceptions, and demographics. Descriptive techniques were used to characterize participants as either those who perceived e-cig use improved their health or those who perceived their health unaffected. Logistic regression assessed the association between change in tobacco use, e-cig use, and perception of health effects. Results Most reported daily e-cig (91%) and current (11.5%) or former (78.2%) combustible cigarette use. Approximately, three-fourths (76.9%) perceived better health; the remainder (23.1%) perceived unaffected health. Change in cigarette use was significantly associated with perceptions that health is better with e-cig use. Participants who decreased cigarette use by 2-3 cartons/month and more than 3 cartons/month were significantly more likely to indicate that e-cig use has improved their health compared to those who decreased tobacco use by 1.5 cartons or fewer per month (OR=4.35, 95% CI: 1.13-16.9; OR=25.67, 95% CI: 2.97-221.7, respectively). Conclusions The majority of e-cig users perceived better health. Our findings suggest that health campaign designers should carefully assess the scientific uncertainty surrounding the use of these devices and consider means to clearly convey this information. Given the lack of scientific agreement on the health effects of e-cigs and the important role that perceptions play in behavior, health campaign designers, health education practitioners, policy makers, and health care providers should err on the side of caution when advising individuals about e-cig use.

Introduction Little is known about the effectiveness of cigarette health warning labels (HWLs) among U.S. pregnant and non-pregnant women of reproductive age. Our intent was to examine HWL responses by pregnancy status and their associations with knowledge and perceived harm. Methods We conducted cross-sectional analyses of first (2013–2014) and second (2014–2015) Population Assessment of Tobacco and Health waves. The sample (N = 19,095) was representative of U.S. women of reproductive age (18–45 years). We examined three HWL responses (seeing HWLs, forgoing cigarettes because of HWLs, likely-to-quit because of HWLs), perceived harm from smoking, and knowledge of health effects to fetuses and others. Weighted logistic regression compared HWL responses by pregnancy status and their associations with perceived harm and knowledge, adjusting for demographics and tobacco use. Results were presented as marginal predicted probabilities. Results Pregnant smokers were less likely than never-pregnant smokers to report likelihood of quitting (57% vs 67%, p = 0.020). Forgoing cigarettes and likely-to-quit due to HWLs—but not seeing HWLs—were positively associated with perceived harm and knowledge. Pregnant smokers were less likely to have knowledge of fetal harm (83%) than ever-pregnant (91%, p = 0.006) and never-pregnant (92%, p = 0.003) smokers. However, pregnant smokers who reported likelihood of quitting were much more likely to have knowledge of fetal harm than those who did not (93% vs. 67%, p = 0.028). Conclusions Implementation of HWLs that elicit stronger reactions—such as pictorial HWLs—and increase knowledge of fetal risks is one action to help reduce tobacco use in pregnant and non-pregnant U.S. women of reproductive age.

Background: Using electronic nicotine delivery systems (e.g., e-cigarette) or vaping may have negative health effects from the aerosol and product constituents. Though the products are relatively new in the US, the use of e-cigarettes has rapidly increased, especially in younger adults. In this study, we examined age differences in use patterns, reasons for use, health knowledge, e-cigarette perceptions, and quit intentions among current e-cigarette users. Methods: The sample was 1,494 current e-cigarette users ages 18-64, drawn from a national adult vaping survey conducted in 2016. Intention to quit was categorized into 3 groups: very likely, moderate, and less likely. Descriptive and multivariate analyses were used. Results: The sample included participants in the following age groups: 18-24 (17%), 25-34 (38%), 35-44 (23%), and 45-64 (25%). Main reasons for e-cigarette initiation were as a cigarette alternative, perceived as healthier, and attraction to flavors. Only 4% of the participants reported using e-cigarettes on recommendation from a healthcare professional(s); 66% did not hear/see/read about the health effects of e-cigarettes in the past 3 months. Compared to older groups, the 18-24 age group was less likely to use e-cigarettes as an alternative to cigarettes (33% vs. 40-49%) or on a healthcare professional’s recommendation (2.3% vs. 6.8%), but more likely to vape for reasons such as flavors (44% vs. 20-33%) or friends’ use (18% vs. 4%). The 18-24 age group was also more likely than the oldest age group to use flavored e-liquid other than tobacco flavor (67% vs. 53%), have heard/seen/read information about vaping health effects (41.4% vs. 27%), and believe that vaping has no health benefits (26.1% vs. 16%).(All P -values for the above comparisons Conclusions: There were significant age differences in use motivation, usage patterns, receipt of health information, perceived risks, and quit intentions. Public health efforts should increase the accessibility of information on e-cigarette use risks. Different health messaging and communication strategy approaches may be required for varying age groups.

Introduction In Appalachia, youth tobacco-use rates remain higher than the U.S. national average. Past research has indicated that several factors are related to high rates of tobacco use among Appalachian youth (e.g. low socioeconomic status, rural lifestyles). Of the Appalachian states, Kentucky has one of the highest rates of youth tobacco use. The aim of this study was to explore views of tobacco among Kentucky youth living in Appalachian counties. Methods In Fall 2014 - Spring 2015, focus group interviews were conducted with middle and high school students (N=109) in Appalachian counties in Kentucky. Each focus group session included open-ended questions and was conducted by trained facilitators. Focus group transcriptions and field notes were analyzed for themes. Results Study participants described an entrenched culture of tobacco. Three themes exemplified this culture. First, adult behavior served to enable youth tobacco use (e.g. teachers ignoring dip use in class, adults smoking with youth). Second, tobacco is easily accessible to youth (e.g. restrictions on youth sales are often ignored, family members provide). Third, symbols of tobacco are prevalent (e.g. festivals celebrating tobacco heritage, tobacco barns, and tobacco marketing logos). Conclusions Youth participants described a deeply rooted tobacco culture, which they believed was unlikely to change. Additional studies and health education efforts are needed in these rural communities. Further, stricter enforcement of tobacco sales and marketing restrictions may be helpful in protecting this vulnerable population.

Introduction Tobacco use disorder is critical among people aged 16 to 25 years. College campuses are prime locations for smoking cessation interventions for young adults. The vast majority of the smoking research with college students has been epidemiological in nature. This study examined a novel motivational interviewing intervention designed for college students, and explored predictors of smoking behavior change. Methods A quasi-experimental one group pretest-posttest design with repeated measures was used to evaluate a novel text message-based brief motivational interviewing intervention. The data were collected from undergraduate students (N=33) who smoked cigarettes in Fall 2015. Results Students’ level of autonomy and relatedness needs satisfaction, autonomous motivation, and smoking cessation self-efficacy increased (p < 0.05), and their rate of daily smoking declined (p

Despite scientific uncertainty regarding the relative safety of inhaling e-cigarette aerosol and flavorings, some consumers regard the U.S. Food and Drug Administration’s “generally recognized as safe” (GRAS) designation as evidence of flavoring safety. In this study, we assessed how college students’ perceptions of e-cigarette flavoring safety are related to understanding of the GRAS designation. During spring 2017, an online questionnaire was administered to college students. Chi-square p-values and multivariable logistic regression were employed to compare perceptions among participants considering e-cigarette flavorings as safe and those considering e-cigarette flavorings to be unsafe. The total sample size was 567 participants. Only 22% knew that GRAS designation meant that a product is safe to ingest, not inhale, inject, or use topically. Of participants who considered flavorings to be GRAS, the majority recognized that the designation meant a product is safe to ingest but also considered it safe to inhale. Although scientific uncertainty on the overall safety of flavorings in e-cigarettes remains, health messaging can educate the public about the GRAS designation and its irrelevance to e-cigarette safety.

Introduction Videos promoting electronic cigarettes (e-cigarettes) can be easily accessed on YouTube. Marketing claims present in YouTube videos may help shape the public’s opinion of e-cigarettes. Thus, it is important to understand the most frequent marketing claims and video sources. Methods The objectives of this study were to 1) identify marketing claims in YouTube videos that are commonly made on e-cigarette retail websites and 2) compare the frequency of marketing claims in user-generated and professional YouTube videos. Through content analysis, this study evaluated six marketing claims and descriptive information about YouTube videos (n = 50) related to “electronic cigarettes” and “vape”. Results Overall, the most frequent marketing claim promoted e-cigarette use as better than traditional tobacco use (52%). Approximately 65% of videos appeared to be user-generated and 35% were professionally-produced. Compared to user-generated videos, significantly more professional videos made claims that e-cigarettes are cleaner (p < 0.001) and cheaper (p = 0.04) than traditional cigarettes. Additionally, more professional videos had claims promoting e-cigarettes as better than traditional cigarettes because of their convenience—the user can smoke anywhere (p < 0.0001) and the products do not produce secondhand smoke (p < 0.001). The most frequent claim in user-generated videos was related to recreation (53%). Conclusions Videos on YouTube promote e-cigarettes as safer than other tobacco products. Videos appearing to be user-generated contained different marketing claims compared to professional videos. Further research is necessary to assess how the perceived source of the video impacts the ways these marketing claims shape public perception and influence use.

Background: Cigarette smoking has been reported to be high among Lesbian, Gay, Bisexual, Transgendered and Queer (LGBTQ) populations. However, in-depth information on perception, knowledge, attitudes and behaviors, is limited. Methods: We analyzed 2016 data from the AHA-Tobacco Regulatory Addiction Center (A-TRAC) study on multi-ethnic LGBTQ groups living primarily in Chicago and New York City, ages 18-64, smokers and non-smokers. Twenty-nine focus groups and 99 individual surveys were conducted to obtain socio-demographic-economic characteristic and in-depth information on tobacco use, including cigarette smoking. Atlas.ti and SAS 9.4 were used for data analyses. Results: Of 99 participants, 58.8% of LGBTQ individuals reported smoking 100+ cigarettes during their life time; 49.5% (n=49) reported current cigarette smoking; and 17% reported frequent or occasional use of e-cigarette, e-hookah and/or other types of vaping. Age (25+) and low household income ( Conclusions: Cigarette smoking was high among the LGBTQ individuals in our sample and they seems unlikely to quit. Social stressors appear to be a strong contributing factor. Educational efforts and culturally appropriate messages to this population, are critical.

Much of the previous research on dating focused on the close relationships of younger adults, with little attention given to individuals dating in their later life. In addition, the opportunity for intergenerational relationships, such as friendships among members of different age cohorts and non‐typical romantic relationships have significantly increased. The purpose of this study was to describe the dating experiences among later‐life women. Fifteen women participated in in‐depth interviews that examined their communicative experiences, impressions, and struggles while dating later‐life men. Three themes emerged from this study: the need for independence, the need for companionship, and gender role conflict between dating partners. The results were also discussed in terms of the paradoxes that dating creates for later‐life women. Finally, these results are discussed in terms of the unique relational challenges facing later‐life women.

The essay explicates a pedagogical methodology for teaching empirical research methods, employing the principles of feminist pedagogy in the facilitation of research teams composed of a teacher and multiple graduate students. The described pedagogy is consistent with six principles of feminist pedagogy deduced from a meta‐analysis of the extant US literature on feminist pedagogy: reformation of the relationship between teacher and student, empowerment, building community, privileging voice, respecting diversity of personal experience, and challenging traditional views. The authors illuminate their pedagogy via a detailed description of one feminist research group undertaking a large sample survey. The authors contend that the feminist research group constitutes a practicum‐style educational opportunity that represents a practical alternative to the traditional classroom teaching of empirical research methods to graduate students.

This study describes illness-related talk in marriage. Both qualitative and quantitative methodologies were employed to identify and examine emergent themes of how couples talk about not feeling well. Fifty-three couples jointly participated in an open-ended interview and individually completed a series of questionnaires. Narrative analysis supports the notion that couples’ illness-related narratives are indicative of the couples’ relationship culture and identity. Five distinct couple types emerged from the illness-related scripts that the couples presented: the sympathetic couple, the independent couple, the mixed couple, the nonreciprocal couple, and the rejecting couple. Statistical analyses revealed several patterns of satisfaction and health perceptions that varied by sex.

By extending Millar and Roger's (1976) relational theory, this study examined how the physician-patient relationship was negotiated in the context of a clinical visit. Analysis of observational data obtained during the clinical visits of 1 female family practice physician revealed 5 themes central to the construction of her relationships with patients. The 5 themes included control, role negotiation, trust, health care commitment, and interrelated issues of time and money.