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Background: Following the spread of COVID-19, the Rhode Island Department of Health delivered its first virtual World Diabetes Day (RIWDD) event. Evaluations exploring advantages and disadvantages of delivering public health events virtually are generally lacking. Purpose: The aims of the present paper were to evaluate the reach, feasibility, and effectiveness of delivering RIWDD virtually. Methods: Quantitative methods were used to: (1) estimate and compare the target population to RIWDD's event reach; and (2) evaluate whether diabetes knowledge increased amongst attendees. Qualitative methods assessed event facilitators' perceptions of the strengths, limitations, and challenges of using a virtual format to inform planning and implementation of future RIWDD events. Results: Results revealed segments of RI's population disproportionately affected by diabetes, including men, persons of color, and older adults were underrepresented at the event. The event was not associated with increases in diabetes knowledge; however, attendees possessed high diabetes knowledge overall. Facilitators identified several important factors associated with virtual delivery in the context of COVID-19. Discussion: Considerations for delivering virtual events are discussed. Translation to Health Education Practice: A key takeaway of this evaluation is the critical need for cultural competency as a guiding framework for professional practice when delivering events virtually.

The article focuses on disparities in tobacco use among individuals with mental distress in Rhode Island. Topics include the prevalence of tobacco use, sociodemographic characteristics, commercial tobacco, not sacred and ceremonial tobacco used by many American Indian communities, and strategies to address tobacco-related health disparities among this population.

Sexual assault and harassment are significant problems that begin early in the lifespan. The current study sought to understand the contextual factors that influence the implementation of school‐wide sexual assault prevention programs in middle schools that focus on fostering community norms change. The Consolidated Framework for Implementation Research (CFIR) is a menu of constructs arranged across 5 domains that assists stakeholders in assessing and identifying site‐specific determinants of successful intervention implementation. In the present study, researchers conducted a series of 10 interviews with middle school stakeholders (i.e., principals, guidance counselors, teachers) to document characteristics inside and outside of the school environment (i.e., cultural norms, relative priority, prior interventions, implementation climate) relevant to the implementation of prevention programming, using the CFIR as a guiding framework for analysis. Whereas schools recognized the importance of implementing violence prevention programming, stakeholders reported several other competing demands (i.e., time, resources) that make it difficult to implement rigorous programming without support from an outside agency/team. Community agencies and research teams hoping to implement violence prevention in middle schools can benefit from using stakeholder interviews grounded in the CFIR model to gain a better awareness of the school‐ and community‐specific factors that are likely to influence successful implementation of violence prevention programs in middle schools. [ABSTRACT FROM AUTHOR]

Examined effects of social support dimensions on risk institutionalization. Specific aspects of social support (having spouse or adult child caregiver) or having caregiving relationship of at least three years' duration moderated impact of one type of stress on risk of entering nursing home. Networks that included paid provider modestly offset impact of multiple impairments on nursing home admission. (Author/NB)

Research demonstrates that both peer socialization and underage drinking play a significant role in teen dating violence. However, less is known about the lasting effects of these risk factors on boys' ability to form healthy romantic relationships as they get older. The present study examined whether boys who perceived their peers would respect them more for having sex and those who engaged in past year heavy alcohol use would be more likely to perpetrate sexual intimate partner violence (IPV) in young adulthood compared to boys who did not endorse perceived peer approval for sex or report past year heavy drinking. Analyses were conducted using a sample of boys (n = 1,189) from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health (Add Health). A logistic regression was conducted to assess the relationship between perceived peer approval to have sex and heavy alcohol use at Wave I and sexual IPV at Wave III, after adjusting for demographic factors and other correlates of sexual IPV at Wave I, including age, race/ethnicity, sexual initiation in adolescence, parental attachment, annual family income, and neighborhood poverty. Boys who believed they would gain peer respect by having sex and boys who reported getting drunk in the last 12 months, regardless of how often, were significantly more likely to report sexual IPV in young adulthood compared to boys who did not endorse either of these factors. Targeting boys' perceived peer norms regarding sexual activity and heavy alcohol use may therefore be especially important for preventing sexual IPV later in life. [ABSTRACT FROM AUTHOR]

Violence against women is now widely recognized as a major public health issue worldwide, (1-3) but surveillance systems to track incidence, prevalence, and trends are just beginning to be established. […]

The Confluence Model of Sexual Aggression is a well-established framework for understanding factors that contribute to men's perpetration of sexual aggression against women, highlighting the roles of hostile masculinity, impersonal sex orientation, and exposure to pornography. To date, only one study has applied aspects of the Confluence Model to examine predictors of sexual aggression in adolescent males, and the study did not include pornography exposure as a predictor. The current study evaluates the Confluence Model as a framework for understanding the perpetration of both contact and noncontact sexual aggression in a sample of 935 heterosexual 10th-grade adolescent boys. Composite scores for hostile masculinity and impersonal sex orientation were generated. Nearly all the variables included in the hostile masculinity and impersonal sex constructs were associated with perpetration. Zero-inflated Poisson regression models revealed distinct combinations of salient predictors when the dependent variable was identified as boys' frequency of perpetration, compared with when the dependent variable was defined as any perpetration of sexual aggression. Impersonal sex orientation and violent pornography exposure were associated with perpetrating noncontact sexual aggression in the last 6 months, while violent pornography exposure and the interaction of hostile masculinity and impersonal sex orientation increased the frequency of recent contact sexual aggression. Results suggest that hostile masculinity, impersonal sex orientation, and violent pornography exposure are important factors to address within sexual assault prevention approaches for adolescent boys. [ABSTRACT FROM AUTHOR]

This study documents disparities in the mental health burden of young adults in Rhode Island during the COVID-19 pandemic as it pertains to essential worker status, sexual orientation, gender identity, and childhood trauma. A cross-sectional web-based survey of young adults aged 18 to 25 years conducted between May and October of 2020 assessed anxiety symptoms, depressive symptoms, and thoughts of suicide. In fully adjusted regression models, (n =528 young adults) being an essential worker, a sexual minority, having lower relative SES, and having more adverse childhood experiences were significantly associated with negative mental health outcomes. In models adjusted for individual ACEs, exposure to mental illness in the household, physical violence between adults in the household, emotional abuse, and sexual abuse were independently associated with all three outcomes. Young adults most vulnerable and stigmatized in the community are also those who are most severely affected in terms of mental health. [ABSTRACT FROM AUTHOR]

Abstract Background Inpatient HIV/AIDS charges decreased from 1996–2000. This decrease was mainly attributable to treatment of HIV/AIDS patients with Highly Active Antiretroviral Therapy (HAART). This study aims to evaluate the trend in inpatient charges from 2000–2004. Methods Rhode Island Hospital Discharge Data (HDD) from 2000 to 2004 was used. International Classification of Disease (ICD-9) diagnosis code 042–044 was used to identify HIV/AIDS admissions. The final study population included 1927 HIV/AIDS discharges. We used a multivariable linear regression model to examine the factors associated with inflation adjusted inpatient charges. Results We found a significant increase in inpatient charges from 2000–2004 after adjusting for length of stay (LOS), gender, age, race and point of entry for hospitalization. In addition to calendar year, LOS, gender and race were also associated with inpatient charges. Conclusion HIV/AIDS inpatient charges increased after adjusting for inflation despite earlier studies that showed a decline. Our results have implications for uninsured, as well as insured HIV/AIDS patients who do not have a medical plan that covers their charges sufficiently. Future research should investigate what factors are contributing to rising inpatient charges among HIV/AIDS patients.

The article reports that the substantial decline in cigarette smoking among adolescents is a notable public health achievement. It notes that point of sale (POS) refers to any location where tobacco products are displayed, advertised, and purchased. It adds that the decrease in the availability of tobacco products that did not explicitly identify a flavor can be attributed, in part, to the results from the RI-STARS surveys from Providence and Central Falls.

Objective: To investigate if duration of supplemental breastfeeding is associated with a lower asthma risk and whether adverse childhood experiences (ACEs) early in life influence this relationship in children ages 3 to 5 years. Methods: Data were from the 2011-2012 National Survey of Children's Health, a nationally representative cross-sectional survey. Modified Poisson regression models were used to estimate incident risk ratios (IRR) for lifetime and current asthma in young children aged 3 to 5 years (n = 15,642). We tested for effect measure modification using stratified analyses. Results: Exclusive breastfeeding for at least 6 months or supplemental breastfeeding for children ≥12 months significantly reduced the risk of lifetime asthma prevalence compared to never breastfed children (IRR 0.64; 95% CI: 0.46-0.88, p = 0.007; and IRR 0.68; 95% CI: 0.47-0.99, p = 0.044, respectively), adjusted for covariates. In stratified analyses, breastfeeding reduced the risk of lifetime asthma for children who experienced 1 ACE but not for children who experienced 2 or more ACEs. Conclusion: Exclusive breastfeeding for at least 6 months, with and without supplementation, appears to prevent asthma or delay its onset. The protective effect of breastfeeding was attenuated among children who experienced more than 2 ACEs. The known harmful effects that ACEs have on children's health may outweigh the benefits of breastfeeding in reducing the risk of a child developing asthma. Understanding how specific time periods in a child's life may be most affected by exposure to early life adversities, along with the protective effect of breastfeeding against asthma, are important areas of further study. [ABSTRACT FROM AUTHOR]

Introduction. This study examines the association between recent screening for breast and cervical cancers, knowledge of cancer risk factors, and perceptions of surviving cancer. Methods. Data were from the Cancer Control Supplement to the 1992 National Health Interview Survey (NHIS-CCS). The dependent variable combined breast and cervical cancer screening practices into a single composite index. Two independent variables combined women's knowledge about breast and cervical cancers into single indicators-one representing risk factor knowledge, the other representing perceived likelihood of surviving breast and cervical cancers following early detection. Results. Multivariate analysis showed that recency of screening for both breast and cervical cancers was associated with knowledge of cancer risk factors and perceptions of surviving cancer. Education, household income, and smoking status also were correlates of comprehensive screening. Significant interactions between income and perceived survivability, and between education and perceived survivability suggested that the effects of income and education on comprehensive screening varied with perceptions about surviving cancer. Conclusion. The study suggests that knowledge and attitudinal questions can be combined for two diseases to enhance understanding of who is most likely to be screened comprehensively for breast and cervical cancers. Although national trends show that large percentages of women over age 50 are having mammograms and Pap tests, this progress is not likely to be sustained unless existing barriers are eliminated. Limited knowledge about breast and cervical cancer risk factors and misperceptions about survival from cancer represent two of these barriers. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com]

This study uses a feminist theoretical framework to extend the literature on the relationship between sexual history, bullying victimization, and poor mental health outcomes. First, we examined whether an association between the sexual double standard and bullying victimization would apply to sexual minority youth the same way it applies to heterosexual youth. A second aim was to assess whether sexual minority boys, typically stereotyped as effeminate, would report the highest odds of bullying victimization. A third and final aim of our study was to look at the joint effect of sex and sexual intercourse on depression and suicidal ideation. Our analytic sample (N = 9,300) was from the 2009, 2011, and 2013 Rhode Island Youth Risk Behavior Surveys. Findings demonstrated that heterosexual girls who engaged in sexual intercourse had significantly higher adjusted odds of bullying victimization than heterosexual boys who engaged in the same behavior. Similar results were not found for sexual minority adolescents, suggesting the sexual double standard may not apply to sexual minority adolescents in the same way it applies to heterosexual adolescents. Consistent with our second hypothesis, sexual minority boys reported the highest odds of being recently bullied compared with heterosexual boys. Among students who were recently bullied, sexual minority girls displayed the highest adjusted odds of recent depression and suicidal ideation. Our study demonstrated that using a feminist theoretical framework broadens our understanding of why girls and sexual minority boys are particularly vulnerable to bullying victimization and the sequel of depression and suicidal ideation. [ABSTRACT FROM AUTHOR]

The article discusses the Youth Risk Behavior Survey (YRBS) which reveals the self-reported health risk behaviors and violence-related behavior of state residents in Rhode Islands as of December 2016. The survey reveals the performance of self-reported suicide attempts among middle school and high school students in the state. The survey also notes on the challenges of limitations for medical records and treatment for patients with suicidal behavior.

The article discusses findings from first three years of implemention of Rhode Island Suicide Prevention Initiative. This inititative is coordinated youth suicide prevention referral system which connects public elementary, middle and high schools with mental health services. It diverts at risk students from Emergency Department visits by connecting the students to local mental health system.