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Mindfulness-based interventions (MBIs) may offer a means for Latinx families to ameliorate stress, enhance emotion regulation, and foster social support. We assessed pilot data from Latinx parents in Eastside Los Angeles (n = 27) matched with their children aged 10-16 (n = 32) to determine whether participation in a community-derived MBI was associated with greater improvements in dispositional mindfulness, perceived stress, emotion regulation, and family social support compared to a control condition. Compared to the control group, parents in the MBI group showed greater reductions in perceived stress scale (PSS) scores (B =  - 2.94, 95% CI [- 5.58, - 0.39], p = 0.029), while their children reported greater increases in perceived social support from family (B = 2.32, 95% CI [0.26, 4.38], p = 0.027). Findings show a community-derived MBI may improve stress in Latinx parents and social support for their children.

BackgroundUrban trails are a useful resource to promote physical activity. This study identified features of urban trails that correlated with trail use.MethodsMultiuse urban trails were selected in Chicago, Dallas, and Los Angeles. An audit of each trail was completed using the Systematic Pedestrian and Cyclist Environmental Scan for Trails instrument, identifying built environmental features. A self-report of trail use was obtained from trailside residents (N = 331) living within 1 mile of each trail. Univariate and multivariate Poisson regressions controlled for trail time from home and motivation for physical activity.ResultsPositive associations with the past month's hours on the trail were observed for the presence of distance signs, vegetation height, vegetation maintenance, and trail crowding, and a negative association was observed for the presence of crossings on the trail. Positive associations with dichotomous trail use were observed for the presence of distance signs, vegetation height, and vegetation maintenance, and a negative association was observed for the presence of crossings on the trail.ConclusionsThese correlates should be confirmed in other studies and, if supported, should be considered in the promotion and design of urban trails.

IntroductionGiven increasing efforts to regulate e-cigarettes, it is important to understand factors associated with support for tobacco regulatory policies. We investigate such factors found in social media and hypothesize that greater online engagement with tobacco content would be associated with less support for e-cigarette regulatory policies.MethodsWe constructed social networks of Twitter users who tweet about tobacco and categorized them using a combination of social network and Twitter metrics. Twitter users were identified as representing leaders, followers or general users in online discussions of tobacco products, and invited to complete an online survey. Participants responded to questions about their engagement with tobacco-related content online, degree of support for e-cigarette regulations, exposure to tobacco marketing, e-cigarette use and other demographic information. We examined links between their reported engagement with tobacco-related content and support for e-cigarette regulatory policies using structural equation modelling.ResultsThe analytic sample consisted of 470 participants. The conceptualized structural equation model had a good fit (χ2 (32) = 24.85, p = 0.09, CFI = 0.99, RMSEA = 0.03). Findings support our hypothesis: engagement with online tobacco content was negatively associated with support for e-cigarette policies, while controlling for e-cigarette use, tobacco marketing exposure, social media use frequency and demographic factors.ConclusionsFindings suggest that our hypothesis was supported. Twitter users engaging with tobacco-related content and harboring negative attitudes toward e-cigarette regulatory policies could be an important audience segment to reach with tailored e-cigarette policy education messages.

Less than 1% of children in the United States concurrently meet guidelines for fruit/vegetable intake, physical activity, screen time, and sugar-sweetened beverages. Prior evidence suggests that parents of this 1% potentially cope with stress differently. This qualitative study used a positive deviance-based approach to locate mothers whose children avoided negative feeding outcomes despite being 'high-risk' for obesity. Semi-structured interviews were conducted in Spanish for two groups: low-income, Hispanic mothers whose children were normal weight and met recommendations for fruits/vegetables and physical activity (n = 5); and a comparison group whose children had obesity and did not meet guidelines (n = 8). Topics included weight-related parenting practices, attitudes toward health, and stress management. Interviews were transcribed, translated, and coded using NVivo for theoretically driven thematic analysis. Results suggested that mothers viewed stress differently. Mothers of healthy weight children believed stress could be prevented, such as by paying children more attention or directing one's attention away from stressors; comparison group mothers tended to report stress about managing their child's eating and about financial worries. Future research is needed to understand the underlying sources of these differences (e.g. personality traits, coping practices) and test whether stress prevention interventions can promote healthy parental feeding practices.

BackgroundPolytobacco product use is suspected to be common, dynamic across time, and increase risk for adverse behavioral outcomes. We statistically modeled characteristic types of polytobacco use trajectories during mid-adolescence and tested their prospective association with substance use and mental health problems.MethodsAdolescents (N = 3393) in Los Angeles, CA, were surveyed semiannually from 9th to 11th grade. Past 6-month combustible cigarette, e-cigarette, or hookah use (yes/no) over four assessments were analyzed using parallel growth mixture modeling to identify a parsimonious set of polytobacco use trajectories. A tobacco product use trajectory group was used to predict substance use and mental health at the fifth assessment.ResultsThree profiles were identified: (1) tobacco nonusers (N = 2291, 67.5%) with the lowest use prevalence (

IntroductionThe California Stop Tobacco Access to Kids Enforcement (STAKE) Act requires licensed tobacco retailers to post minimum age-of-sale signage at the point of sale. This study investigated STAKE Act compliance in licensed tobacco retailers across four racial/ethnic communities in Southern California.MethodsThe sample consisted of 675 licensed tobacco retailers (excluding chain store supermarkets and pharmacies) randomly selected based on zip codes from predominantly non-Hispanic White (n=196), African American (n=193), Hispanic/Latino (n=186), and Korean American (n=100) communities. A protocol for assessing signage was completed at each store by community health workers (promotoras de salud). The law changed from a minimum age of 18 to 21 years (Tobacco 21) during data collection, as of 9 June 2016. Differences in signage compliance were evaluated before and after changes in the State law.ResultsOverall, 45% of the stores were compliant with posting the required age-of-sale signage (which varied in minimum age by date of collection); 14% of stores did not have any store interior age-of-sale signs, and 41% of stores had some type of age-of-sale sign but were not compliant with the STAKE Act (e.g. 29.5% of the stores had non-compliant tobacco industry We Card signs but not STAKE Act signs). Stores observed after the 2016 implementation of Tobacco 21 had significantly lower STAKE Act signage compliance rates (38.6%) compared to stores observed before the change in the State law (70.9%) (z=6.8623, p

IntroductionThe California Stop Tobacco Access to Kids Enforcement (STAKE) Act requires licensed tobacco retailers to post minimum age-of-sale signage at the point of sale. This study investigated STAKE Act compliance in licensed tobacco retailers across four racial/ethnic communities in Southern California.MethodsThe sample consisted of 675 licensed tobacco retailers (excluding chain store supermarkets and pharmacies) randomly selected based on zip codes from predominantly non-Hispanic White (n=196), African American (n=193), Hispanic/Latino (n=186), and Korean American (n=100) communities. A protocol for assessing signage was completed at each store by community health workers (promotoras de salud). The law changed from a minimum age of 18 to 21 years (Tobacco 21) during data collection, as of 9 June 2016. Differences in signage compliance were evaluated before and after changes in the State law.ResultsOverall, 45% of the stores were compliant with posting the required age-of-sale signage (which varied in minimum age by date of collection); 14% of stores did not have any store interior age-of-sale signs, and 41% of stores had some type of age-of-sale sign but were not compliant with the STAKE Act (e.g. 29.5% of the stores had non-compliant tobacco industry We Card signs but not STAKE Act signs). Stores observed after the 2016 implementation of Tobacco 21 had significantly lower STAKE Act signage compliance rates (38.6%) compared to stores observed before the change in the State law (70.9%) (z=6.8623, p

African-American men who have sex with men and women (MSMW) are among those most heavily impacted by HIV in the United States, and those who have histories of incarceration are at further risk of infection. The Men in Life Environments (MILE) HIV prevention intervention was developed to provide culturally appropriate skills-based education and support for African-American MSMW with recent histories of incarceration. The MILE's conceptual framework was informed by three theories: Theory of Reasoned Action and Planned Behavior, Critical Thinking and Cultural Affirmation Model, and Empowerment Theory. The theory-based framework posits that improving racial pride is crucial in building self-efficacy and intentions that in turn promote health-protective behaviors. Therefore, our study aimed to assess whether baseline associations between racial pride and condom use self-efficacy, intentions, and behaviors among African-American MSMW with histories of incarceration align with our conceptual model. We report data on 212 participants recruited from Los Angeles County Sheriff's Department Men's Central Jail and the local community. Using structural equation modeling, we tested two separate models: one with female sexual partners and one with male sexual partners, while stratifying by participant's HIV status. Only among HIV-negative participants was greater racial pride associated with less condomless intercourse with men. In this group, greater self-efficacy and intentions-but not racial pride-predicted less condomless intercourse with women. Our findings suggest that racial pride is an important factor to address in HIV prevention interventions for post-incarcerated African-American MSMW.

Background and aimsAnhedonia-a transdiagnostic psychopathological trait indicative of inability to experience pleasure-could lead to and result from adolescent marijuana use, yet this notion has not been tested. This study aimed to estimate the association of: (1) anhedonia at age 14 with rate of change in marijuana use over an 18-month follow-up, and (2) marijuana use at age 14 with rate of change in anhedonia over follow-up. Secondary aims were to test whether gender, baseline marijuana use history and peer marijuana use moderated these associations.DesignObservational longitudinal cohort repeated-measures design, with baseline (age 14 years), 6-month, 12-month and 18-month follow-up assessments.SettingsTen public high schools in Los Angeles, CA, USA, 2013-15.ParticipantsStudents [n = 3394; 53.5% female, mean (standard deviation) age at baseline = 14.1 (0.42)].MeasurementsSelf-report level of anhedonia on the Snaith-Hamilton Pleasure Scale and frequency of marijuana use in the past 30 days.FindingsParallel process latent growth curve models adjusting for confounders showed that baseline anhedonia level was associated positively with the rate of increase in marijuana use frequency across follow-ups [β, 95% confidence interval (CI) = 0.115 (0.022, 0.252), P = 0.03]. Baseline marijuana use frequency was not related significantly to the rate of change in anhedonia across follow-ups [β, 95% CI = -0.015 (-0.350, 0.321), P = 0.93]. The association of baseline anhedonia with faster marijuana use escalation was amplified among adolescents with (versus without) friends who used marijuana at baseline [β, 95% CI = 0.179 (0.043, 0.334) versus 0.064 (-0.071, 0.187), interaction P = 0.04], but did not differ by gender or baseline ever marijuana use.ConclusionsIn mid-adolescence, anhedonia is associated with subsequent marijuana use escalation, but marijuana use escalation does not appear to be associated with subsequent anhedonia.

BackgroundPrevious literature suggests that trait impulsivity and engagement in non-drug-related behavioral addictions (e.g., Internet addiction, food addiction) are two risk factors for drug use. Here we further investigated the potential impact of having one or both of these risk factors on drug use in Los Angeles area adolescents.MethodHigh school students (N=1612; Mean age=14.1) completed self-report surveys measuring two potential risk factors (impulsivity, lifetime history of several behavioral addictions), and past 6-month use of tobacco, alcohol and marijuana. Participants who reported never using drugs completed questionnaires assessing their susceptibility for future use.ResultsIn general, adolescents who endorsed either impulsivity alone or at least two behavioral addictions alone were more likely to have used tobacco, alcohol, or marijuana compared to individuals who had neither risk factor (OR=2.50-4.13), and individuals who endorsed both impulsivity and three or more behavioral addictions were the most likely to have used these drugs (OR=9.40-10.13). Similarly, among those who had never tried a drug, individuals with this combined set of risk factors were the most likely to be susceptible to future drug use (OR=3.37-5.04).DiscussionThese results indicate that the combination of trait impulsivity and a history of behavioral addictions increases the risk for current and future drug use in adolescents, to a greater extent than either risk factor alone. It may be useful for drug prevention efforts to target impulsive adolescents who also actively engage in other non-drug-related addictive behaviors.

AimsThis study examined the longitudinal association between reductions in cannabis use and changes in anxiety, depression, sleep quality, and quality of life.MethodsSecondary analyses were conducted based on data from a cannabis use disorder medication trial in 302 adults (ages 18-50). Changes in symptoms of anxiety and depression, sleep quality, and quality of life were assessed in relation to changes in cannabis use during the 12-week trial of treatment.ResultsBased on the slope of individual cannabis use trajectory, the sample was classified into two groups (Cannabis Use Reduction, n=152 vs. Cannabis Use Increase, n=150) which was included as a binary covariate in subsequent modeling. Controlling for demographics (age, gender, race/ethnicity), treatment condition, and time-varying tobacco and alcohol use, separate latent growth curve models showed a significant association between the Cannabis Use Reduction group and improvement (i.e., lower values in slope) in anxiety (β=-0.09, SE=0.04; p

The social self-control scale (SSCS), which taps provocative behavior in social situations, was compared with five potentially overlapping measures (i.e., temperament-related impulsivity, psychomotor agitation-related self-control, perceived social competence, and rash action in response to negative and positive affectively charged states) as correlates of tobacco use and other drug use among a sample of 3,356 ninth-grade youth in Southern California high schools. While there was a lot of shared variance among the measures, the SSCS was incrementally associated with both categories of drug use over and above alternate constructs previously implicated in adolescent drug use. Hence, SSC may relate to adolescent drug use through an etiological pathway unique from other risk constructs. Given that youth who tend to alienate others through provocative social behavior are at risk for multiple drug use, prevention programming to modify low SSC may be warranted.

BackgroundOlder people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people.MethodsA randomised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase. Participants included 460 men and women aged 60-95 years (mean age 74.9 ± 7.7 years; 53%

Background Orthopedic patients report pain as their main symptom complaint. Subjective pain experience is correlated with self-reported psychological state, such as distress. Purpose This study tests whether scores from a measure of mindful attention are associated with subjective pain levels and whether psychological distress scores function as a mediation path. Methods During routine visits to a single orthopedic clinic in East Los Angeles, California, 525 patients were recruited to participate in the study. Participants reported on measures of pain (Universal Pain Assessment Tool [UPAT]), mindful attention (Five-Facet Mindfulness Questionnaire [FFMQ]), and psychological distress (Depression, Anxiety, Stress Scale [DASS]). We used Pearson correlations to examine relationships between FFMQ and UPAT scores and mediation analyses to test indirect effects of DASS scores as a mediation path. Results The average age of the sample was 54 years (range 18–98 years), 61% were male, and 64% were non-Hispanic White individuals. The locations of injury were the shoulder (72%), elbow (21%), and clavicle or wrist (7%). Ninety-one percent reported mild or greater pain in the prior 2 weeks (mean   =   4.2 ± 2.5, range 0–10), and 49% reported mild or more severe distress symptoms (DASS: 13.0 ± 11.5). FFMQ scores inversely predicted UPAT scores (β = –0.22, P  < .01), mediated through DASS scores. DASS subscale scores for depression (β = –0.10, P  = .02) and stress (β = –0.08, P  = .04) but not anxiety (β = –0.03, P  = .33) produced significant indirect effects. FFMQ acting-with-awareness and non-judging subscales had the largest effect on depression and stress DASS subscale scores. Conclusions We find statistical support to suggest that distress—particularly depressed mood and stress—mediates the association between mindful attention and pain intensity among orthopedic patients. A disposition of mindful attention might counter distress ailments that exacerbate subjective pain, and this has possible implications for mindfulness training interventions offered to orthopedic patients. [ABSTRACT FROM AUTHOR]

Numerous classroom-based interventions have aimed to improve sexual health outcomes for young people, yet few have shown strong, lasting effects. Ecological approaches that address multiple levels of a young person's environment offer largely untapped potential to positively change sexual behaviour. This paper presents results of a cluster-randomised trial of a multicomponent sexuality education intervention that integrated a classroom curriculum, parent education workshops and materials, peer advocate programme, and sexual health services at 10 urban high schools. An implementation evaluation, employing quantitative and qualitative instruments, was conducted to examine whether the individual components of the intervention were delivered as planned and how they were received by the target populations. Multilevel modelling was used to evaluate the effect of the multicomponent intervention on outcomes at one-year follow-up. Results showed that the intervention components were successfully implemented with and well received by target populations. Students receiving the multicomponent intervention reported greater increases in the use of sexual health services (odds ratio [OR] = 1.73, 95% CI = 1.09-2.75) and the likelihood of carrying a condom (OR = 2.71, 95% CI = 1.44-5.09) relative to those receiving a control condition. No effects were found for other behaviours, possibly due to low prevalence of sexual activity in the sample and the small number of schools randomised.

Objective: This study tested the relationships among child executive function (EF), child-perceived parent fast food intake, and child self-reported subsequent consumption of high-calorie, low-nutrient (HCLN) food. Design: One year and 6-month longitudinal observation from a larger randomized controlled trial. Setting. Southern California elementary schools. Participants: Fourth- and fifth-grade children (N = 1,005) participating in the Pathways to Health obesity prevention program. Results" Child EF problems were associated with higher concurrent HCLN intake (B = 0.29, SE = 0.10, p < 0.001) and had a significant indirect effect through higher perceived frequency of parent fast food intake ("indirect effect" = 0.17, 95% confidence interval [CI] = [0.11, 0.25], p < 0.001). Longitudinally, child EF problems did not significantly predict higher HCLN intake a year and a half later (B = 0.01, SE = 0.10, p = 0.92, n = 848) but did have a significant indirect effect through higher perceived parent fast food intake ("indirect effect" = 0.05, 95% CI = [0.02, 0.10], p < 0.001). Conclusions: Children's EF difficulties may increase their perception of parent concurrent fast food intake, contributing to their own unhealthy food intake. However, EF problems may not directly affect HCLN intake across time, except when problems are associated with child perception of more frequent parent consumption of convenience foods. Future research is needed to investigate the possibility that helping children perceive and understand role models' convenience food consumption may improve child dietary consumption patterns.

Current knowledge about the relationship of physical activity with acute affective and physical feeling states is informed largely by lab-based studies, which have limited generalizability to the natural ecology. This study used ecological momentary assessment to assess subjective affective and physical feeling states in free-living settings across 4 days from 110 non-physically active adults (Age M = 40.4, SD = 9.7). Light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured objectively by an accelerometer. Multilevel modeling was used to test the bi-directional associations between affective and physical feeling states and LPA/MVPA minutes. Higher positive affect, lower negative affect and fatigue were associated with more MVPA over the subsequent 15 min, while higher negative affect and energy were associated with more LPA over the subsequent 15 and 30 min. Additionally, more LPA and MVPA were associated with feeling more energetic over the subsequent 15 and 30 min, and more LPA was additionally associated with feeling more negative and less tired over the subsequent 15 and 30 min. Positive and negative affective states might serve as antecedents to but not consequences of MVPA in adults' daily lives. Changes in LPA may be predicted and followed by negative affective states. Physical feeling states appear to lead up to and follow changes in both LPA and MVPA., Author(s): Yue Liao [sup.1] , Chih-Ping Chou [sup.2] , Jimi Huh [sup.2] , Adam Leventhal [sup.2] , Genevieve Dunton [sup.2] Author Affiliations: (1) 0000 0001 2291 4776grid.240145.6Department of Behavioral Science, [...]

Reverse-scored items on assessment scales increase cognitive processing demands and may therefore lead to measurement problems for older adult respondents. In this study, the objective was to examine possible psychometric inadequacies of reverse-scored items on the Center for Epidemiologic Studies Depression Scale (CES-D) when used to assess ethnically diverse older adults. Using baseline data from a gerontologic clinical trial (n = 460), we tested the hypotheses that the reversed items on the CES-D (a) are less reliable than nonreversed items, (b) disproportionately lead to intraindividually atypical responses that are psychometrically problematic, and (c) evidence improved measurement properties when an imputation procedure based on the scale mean is used to replace atypical responses. In general, the results supported the hypotheses. Relative to nonreversed CES-D items, the 4 reversed items were less internally consistent, were associated with lower item-scale correlations, and were more often answered atypically at an intraindividual level. Further, the atypical responses were negatively correlated with responses to psychometrically sound nonreversed items that had similar content. The use of imputation to replace atypical responses enhanced the predictive validity of the set of reverse-scored items. Among older adult respondents, reverse-scored items are associated with measurement difficulties. It is recommended that appropriate correction procedures such as item readministration or statistical imputation be applied to reduce the difficulties. (Contains 1 table and 1 footnote.)