Examining the relationship between proposed anti-LGBTQ+ legislation and LGBTQ+ college student mental health: findings from the Healthy Minds Study, 2021-2022.

Objective: This study aimed to investigate the association between proposed anti-LGBTQ+ legislation and depressive symptoms among LGBTQ+ college students. Participants: Participants (N = 72,135) included LGBTQ+ college students (N = 21,466) from over 530 colleges and universities, including technical and community institutions, across the United States who took part in the Healthy Minds Study (HMS). Methods: Data on proposed anti-LGBTQ+ legislation introduced in 2021-2022 were collected from all 50 US states, categorized, and analyzed. Individual-level data for 2021-2022 were obtained from the HMS, and a multilevel analysis was conducted to assess the association between proposed anti-LGBTQ+ legislation and depressive symptoms while considering individual factors. Results: A significant positive association between proposed anti-LGBTQ+ legislation and increased depressive symptoms among LGBTQ+ college students was found. This association remained significant after controlling for individual-level stressors and identities, including a sense of belonging, campus environment perceptions, first-generation student status, and transgender or gender non-conforming identity (TGNC). Conclusions: The findings underscore the need for mental health support and inclusive policies for LGBTQ+ college students, particularly in regions where anti-LGBTQ+ legislation is proposed or enacted, to mitigate the potential negative impact of multiple factors on their mental well-being.

Electronic Nicotine Delivery Systems (ENDS) use Among Members of a Community Engagement Program.

Electronic nicotine delivery systems (ENDS) are relatively new and ENDS use data from community engagement programs may help us understand usage patterns and facilitate targeted longitudinal studies. Community members in Florida, USA, were asked about ENDS use, tobacco use, and health history/concerns by Community Health Workers. Among 7253 members recruited during 2014 to 2021 into our HealthStreet program, 1177 had ever used ENDS; the proportion increased from 12 to 27% from 2014 to 2021 (adjusted odds ratio (aOR) 2.5; 95% CI 1.7-3.5; Ever versus never used ENDS). Ever tobacco use was strongly associated with ENDS use; 69% of ever users were current tobacco users. Demographic determinants (sex, age, race) and food insecurity were strongest predictors of ENDS use. Most who had ever used ENDS were aged 18-25 (aOR 5.9; 95% CI 4.6-7.6; vs. aged 60 + years), White (aOR 3.7; 95% CI 3.2-4.3; vs. Black/African American), male (aOR 1.5; 95% CI 1.3-1.7; vs. female), and recently food insecure (aOR 1.8; 95% CI 1.5-2.0; vs. not recently food insecure). Those with respiratory issues were more likely to have used ENDS compared to those without (aOR 2.0; 95% CI 1.6-2.6; aOR 1.3; 95% CI 1.1-1.5). Members concerned about hypertension were less likely to have used ENDS (aOR 0.7; 95% CI 0.5-0.9). In this relatively rural, micropolitan sample, tobacco use, socio-economic determinants, and certain health history/concerns were strongly associated with ENDS use. Community outreach approaches are needed to further understand these factors and implement interventions.

Gender differences in diversion among non-medical users of prescription opioids and sedatives.

BACKGROUND: Non-medical use of prescription drugs is a major public health concern in the United States. Prescription opioids and sedatives are among the most widely abused drugs and their combined use can be lethal. Increasingly rigid prescribing guidelines may contribute to the changing context of opioid use and increase drug diversion. OBJECTIVE: To examine gender differences in diversion of prescription opioids and sedatives among non-medical prescription opioid and sedative polysubstance users. We hypothesize that men will be more likely than women to engage in incoming diversion. METHODS: Data from the Prescription Drug Abuse, Misuse, and Dependence Study, a cross-sectional study focused on prescription drug users, were analyzed. Non-medical use was defined as use of a drug that was not prescribed or use in a way other than prescribed. Individuals who reported past 12-month non-medical opioid and sedative use were included; diversion was defined as incoming (obtaining drugs from a source other than a health professional) and outgoing (giving away/selling/trading prescription drugs). RESULTS: Among the 198 polysubstance users, 41.4% were female. Men were 2.85 times as likely as women to report incoming diversion (95% CI: 1.21-6.72). Women were more likely to obtain opioids from a healthcare professional; men were more likely to obtain sedatives from a roommate, coworker, or friend. Over half of men and women reported outgoing diversion opioids or sedatives. CONCLUSION: Drug diversion highlights an important point of intervention. Current prevention efforts that target prescribers should be expanded to include users and diversion activities; these interventions should be gender-specific.

Interventions for excessive energy drink use.

PURPOSE OF REVIEW: Given the increased and sometimes excessive consumption of energy drinks containing caffeine and other drugs, often sugar-sweetened, especially among young people, interventions that reduce consumption are needed. We review current findings related to interventions at the individual, outlet and regulatory levels to reduce energy drink consumption. RECENT FINDINGS: Few interventions to reduce excess energy drink consumption have been tested. Interventions to reduce consumption of sugar-sweetened beverages and caffeinated beverages are reviewed. A manual-only intervention to reduce caffeinated beverages shows promise, whereas reducing availability at outlets and in communities as a whole shows some effectiveness. SUMMARY: Although some recent studies can provide guidance on interventions to reduce energy drink consumption, no clear 'best practice' has emerged to reduce energy drink consumption. The literature reviewed points toward interventions at different levels which need further testing and could benefit from adaptation to the youth and young adult consumer.

Black-White Differences in Willingness to Participate and Perceptions About Health Research: Results from the Population-Based HealthStreet Study.

Health research participation of racial and ethnic minorities is significantly lower than their counterparts, impeding the testing and development of evidence based clinical and public health interventions for these populations. The purpose of this study was to determine African-Americans' (AAs) perceptions about health research, past participation in health research, and willingness to participate in health research studies compared to White adults from a large socio-economically disadvantaged population. Community members ages 18 years or older enrolled in HealthStreet, an innovative community engagement research program comprised the source of study population. A total of 7809 community members (58.6% females) participated in the study with 65.8% AAs and 34.2% Whites. AAs were statistically significantly less likely to have previously participated in a research study, be willing to volunteer for any type of health research study, or to trust research or researchers compared to Whites. AAs also desired significantly higher compensation amounts to participate compared with Whites adults. In logistic regression analysis, education, age, gender, visits to healthcare practitioners and facilities were statistically significant predictors for AAs participation in health research. Keeping in view the findings of our study, clinical and public health researchers and practitioners should use special recruitment and retention strategies to increase the participation of AAs in health research studies.

Correction to: Black-White Differences in Willingness to Participate and Perceptions About Health Research: Results from the Population-Based HealthStreet Study.

The original version of this article unfortunately contained a mistake in Funding section. Some of the vital information is missing in the Funding as well as the article note was not included in the published article. The complete funding information and the missed article note are presented with this erratum.

Interactions between Alcohol Consumption and Adjuvant Hormone Therapy in Relation to Breast Cancer-Free Survival.

PURPOSE: Alcohol consumption is associated with an increase in breast cancer risk, but findings on the association of alcohol with survival after breast cancer diagnosis have been inconsistent. Further, whether these associations could differ by adjuvant hormone therapy status is unknown. We examined interactions between alcohol consumption and adjuvant hormone therapy in relation to breast cancer-free survival among women with a primary breast cancer diagnosis. METHODS: Participants in this study included 1,399 women diagnosed with primary breast cancer between 2007 and 2012 at the Moffitt Cancer Center. Alcohol consumption during the year preceding diagnosis was assessed in a patient survey. Information on tumor characteristics, breast cancer treatment and outcomes was available from the Moffitt Cancer Registry. Associations were examined using Cox proportional hazards models in stratified analyses by adjuvant hormone therapy status, after adjustment for potential confounders. RESULTS: Overall, alcohol consumption was associated with significantly improved breast cancer-free survival (any vs. none: hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.65-0.92). Among women without adjuvant hormone therapy, alcohol consumption was associated with better survival in heavy drinkers (HR, 0.63; 95% CI, 0.43-0.93). Among women with adjuvant hormone therapy, survival was better in women consuming alcohol as compared to nondrinkers (moderate: HR, 0.69, 95% CI, 0.51-0.93; heavy: HR, 0.74, 95% CI, 0.57-0.96; any: HR, 0.71, 95% CI, 0.57-0.87). There was no significant interaction between alcohol and adjuvant hormone therapy (p-interaction=0.54 for alcohol modeled as none or any and p=0.34 for alcohol modeled as none, moderate, and heavy). CONCLUSION: Associations of alcohol consumption with breast cancer-free survival are similar in women with and without adjuvant hormone therapy. Future studies are warranted to elucidate potential mechanisms underlying the observed inverse associations.

Nonmedical Prescription Stimulant Use Among Girls 10-18 Years of Age: Associations With Other Risky Behavior.

PURPOSE: Little is known about the risk factors for nonmedical use (NMU) of prescription stimulants among adolescent girls. We aimed to measure the association of nonmedical prescription stimulant use with empirically linked risk factors, including weight control behavior (WCB), gambling, and depressed mood, in pre-teen and teenaged girls. METHODS: We assessed the relationship between age and race, gambling, WCB, depressive mood, and nonmedical prescription stimulant use using multivariable logistic regression. The study sample included 5,585 females, aged 10-18 years, recruited via an entertainment venue intercept method in 10 U.S. metropolitan areas as part of the National Monitoring of Adolescent Prescription Stimulants Study (2008-2011). RESULTS: NMU of prescription stimulants was reported by 6.6% (n = 370) of the sample. In multivariable logistic regression, 1-year increase in age was associated with a 21% (95% confidence interval [CI]: .15, .28) increase in risk for NMU. Whites and other race/ethnicity girls had 2.67 (CI: 1.85, 3.87) and 1.71 (1.11, 2.65) times higher odds for NMU, compared to African-Americans. Depressive mood (adjusted odds ratio: 2.69, CI: 2.04, 5.57) and gambling (adjusted odds ratio: 1.90, 1.23, 2.92) were associated with increased odds for NMU. A dose-response was identified between WCB and NMU, where girls with unhealthy and extreme WCB were over five times more likely to endorse NMU. CONCLUSIONS: We contribute to the literature linking WCB, depression, gambling, and the NMU of prescription stimulants in any population and uniquely do so among girls.

Health care disparities among out-of treatment cocaine users in St. Louis.

Cocaine users experience barriers to health care, including mental illness, drug use, and lack of insurance. Being male and a minority member increases the health care disparity. These factors were evaluated among 961 street-recruited cocaine users' baseline and three month follow-up data. Gender-related disparities in care and attitudes towards care emerged. In multivariate models controlling for baseline visits and intervention group, follow-up visits increased among depressed men and female sex traders with insurance.

Cultural and ethical issues concerning research on American Indian youth.

A study of American Indian youths illustrates competing pressures between research and ethics. A stakeholder-researcher team developed three plans to protect participants. The first allowed participants to skip potentially upsetting interview sections. The second called for participants to skip potentially upsetting interview sections. The second called for participants flagged for abuse or suicidality to receive referrals, emergency 24-hr clinical backup, or both. The third, based on the community's desire to promote service access, included giving participants a list of service resources. Interviewers gave referrals to participants flagged as having mild problems, and reported participants with serious problems to supervisors for clinical backup. Participants seldom chose to skip sections, so data integrity was not compromised. However, participants did have more problems than expected (e.g., 1 in 3 had thought about suicide, 1 in 5 had attempted suicide, and 1 in 4 reported abuse), so service agencies were not equipped to respond. Researchers must accept the competing pressures and find ethically appropriate compromises that will not undermine research integrity.

Functioning mediates between symptoms and provider assessment.

The gap between service need and service use for youth with behavioral health problems is well documented. Although provider perception of need predicts service access, studies have found low associations between youth report and provider perception. This paper posits that provider perception of functioning mediates the relationship between youth need as measured by symptoms and provider assessment of that need. Interviews concerning service need and use with 792 14-18-year olds, and surveys of 222 of their providers, were analyzed through structural equation models. Functioning mediated the path from symptoms to assessment when contextual variables were not included in the model, but did not explain additional service use. However, when both contextual factors and functioning were included, the path from functioning to assessment was not significant and less service variance was explained (46% vs. 55%) than in a model not including functioning. Functioning may explain the relationship between symptoms and assessment, but organizational and individual provider variables explain service variance.