Mental performance and mental health services in sport: a call for interprofessional competence and collaboration.

The provision of holistic care for athletes often involves interprofessional teams with specialists to support athletic performance and overall wellness. Yet, regarding psychological support, some have advocated for a single professional to attain both a certified mental performance consultant (CMPC) credential and any type of mental health license (e.g., Licensed Psychologist [LP], Licensed Social Worker [LSW], or Licensed Professional Counselor [LPC]) to address the mental performance and mental health needs of athletes. Unfortunately, this approach may hinder interprofessional collaboration and ignore distinctions between CMPCS and other types of mental health professionals. Alternatively, CMPCs and various types of mental health professionals may work together on interprofessional psychological support teams. The purpose of this paper is to clarify the distinct historical and theoretical foundations of mental performance consulting, clinical psychology, social work, and professional counseling in sport contexts to serve as a resource for enhancing interprofessional competence within such teams. The distinct training pathways of CMPCs, LPs, LSWs, and LPCs are outlined with attention to how each can serve a valuable role on an interprofessional support team for athletes. Applications of the World Health Organization's framework for interprofessional education and collaborative practice (IPECP) to psychological support teams in sport contexts is discussed.

Risk and protective factors associated with depressive symptoms in young adults with overweight and obesity.

Objective: Approximately one-third of college students are categorized as overweight/obese and elevated weight has been associated with increased risk of depressive symptoms. Less is known about protective factors in this context. This study examined associations between depressive symptoms and health behaviors, as well as body image variables among college students with overweight/obesity, while accounting for contributions of BMI and demographics. Participants: College students (N = 175; Mage = 19.87, SD = 1.93; 70% female; 58% Non-Hispanic Black) with overweight/obesity completed in-person surveys. Methods: Depressive symptoms, exercise and diet engagement, body positivity, and body dissatisfaction were assessed. Data were examined using a hierarchical linear regression. Results: Greater exercise engagement and greater body positivity were significantly associated with lower levels of depressive symptoms. Conclusions: Established links between elevated weight and depression are complex but imperative to understand, as mutable factors that contribute to this relationship may provide novel avenues for intervening.

External Factors Associated With Community Cohesion in Women Living With HIV.

Although community cohesion has been identified as a protective factor associated with positive health outcomes, less is known about factors that increase community cohesion for women living with HIV (WLWH). We examined risk/protective factors associated with community cohesion in WLWH (N = 56) in the US Mid-South (Mage = 41.2 years, SD = 9.01). Participants completed hour-long interviews. Hierarchical linear regression modeling was used to examine factors associated with community cohesion. The final model was significant, F(5, 50) = 6.42, p < .001, adj. R = 33%; greater social support (b = .38, p < .01) and resilience (b = .27, p < .05) were significantly associated with better community cohesion. Given the protective benefits of community connectedness, findings suggest that nurses and community providers work with WLWH to harness friend- and family-support networks. In addition, strategies to enhance access to resilience resources would enable WLWH to recover from adversity.

Factors Associated with Intention of Human Papillomavirus (HPV) Vaccine Initiation Among Females With and Without a History of Childhood Cancer.

Vaccination is available to prevent human papillomavirus (HPV) types that cause cervical and other cancers. This study aimed to describe and compare vaccine intention among young females with and without a cancer history, in addition to identifying factors associated with a HPV vaccination intention. Vaccine-naïve females (aged 18-26 years, n = 120) and maternal caregivers with vaccine-naïve daughters (aged 9-17 years, n = 197) completed surveys querying HPV vaccination intention, HPV knowledge, and communication, along with sociodemographic, medical, and health belief factors. Multivariable logistic regression was utilized to calculate odds ratio (OR) and 95% confidence intervals for HPV vaccination intention. No differences in vaccine intention were identified across cancer and comparison groups. Vaccine intention and predictors of intention among vaccine-naïve females differ by age, and there is variation in the factors which influence vaccine intention by age group. These results suggest interventions should be tailored based on developmental level.

Health-enhancing physical activity during practice among student football managers at a Division I university.

Objective: Student football managers have demands on their time that may pose barriers to meeting recommended current physical activity (PA) guidelines. The study sought to assess the amount of PA obtained by student football managers at a NCAA Division I Football university. Participants: Subjects were student football managers (n = 14) with data collected in the fall 2015. Methods: Participants wore an Omron HJ-720ITFFP pedometer for seven consecutive days during football activities only, while self-reporting their overall PA on day 7. Measures were analyzed using repeated measures and mixed-design ANOVAs. Results: Managers averaged 8474 steps/day for each practice/game. All PA measures significantly varied by day and manager experience. Overall PA equated to 78 hours of walking. Conclusions: Student football managers easily met and surpassed the recommended aerobic health-enhancing PA guideline. While their manager-related PA was 140 minutes per week, other PA allowed them to easily reach significantly healthy levels of PA.

The moderating role of resilience on the relationship between perceived stress and binge eating symptoms among young adult women.

OBJECTIVE: Adolescence and young adulthood are developmental periods during the life course that are sometimes associated with heightened stress and engagement in binge eating. Binge eating has been linked to psychiatric comorbidity, poorer physical health, and lower quality of life. However, less is known about protective factors that could buffer against binge eating behaviors. The current study examined the moderating role of resilience on the relationship between perceived stress and binge eating symptoms among emerging adult female college students. METHOD: Participants were 297 young adult women aged 18-25 years (Mage = 19.22, SD = 1.51; 52% self-identifying as a racial/ethnic minority) with Body Mass Index ranging from 15 to 66 (MBMI = 25.01, SD = 6.18). Women completed this cross-sectional study while they were attending universities in the Western or Southern United States. Participants provided demographic and height/weight information, and completed the following measures: Perceived Stress Scale, Binge Eating Scale, and Brief Resilience Scale. RESULTS: Higher perceived stress was significantly associated with more severe binge eating symptoms (b = 0.31; p < .01). In addition, higher resilience was associated with lower binge eating pathology (b = -0.20; p < .01). Moderation was supported as the relationship between perceived stress and binge eating symptoms varied by resilience level (b = -0.16; p < .01). CONCLUSIONS: Women who perceived higher stress were more likely to engage in binge eating relative to women experiencing low stress; however, resilience attenuated this association. Resilience could be targeted to reduce the negative effects of perceived stress on eating behaviors in young women.

Black and White Parents' Willingness to Seek Help for Children's Internalizing and Externalizing Symptoms.

OBJECTIVE: Understanding social and environmental factors that contribute to parental help-seeking intentions is an important step in addressing service underutilization for children in need of treatment. This study examined factors that contribute to parents' intentions to seek formal and informal help for child psychopathology (anxiety and attention-deficit/hyperactivity disorder [ADHD]). METHOD: A total of 251 parents (N = 128 mothers, N = 123 fathers; 49% Black, 51% White) read 3 vignettes describing children with anxiety, ADHD, and no diagnosis. Measures of problem recognition, perceived barriers, and formal (pediatricians, psychologists, teachers) and informal (religious leaders, family/friends, self-help) help seeking were completed. Four separate hierarchical logistic regression models were used to examine parental help-seeking likelihood from formal and informal sources for internalizing and externalizing symptoms. Predictors were socioeconomic status, parent race, age, and sex, parent problem recognition (via study vignettes), and perceived barriers to mental health service utilization. RESULT: Mothers were more likely than fathers to seek help from pediatricians, psychologists, teachers, and religious leaders for child anxiety and pediatricians, religious leaders, and self-help resources for child ADHD. Black parents were more likely to seek help from religious leaders and White parents were more likely to use self-help resources. Problem recognition was associated with greater intentions to seek help from almost all formal and informal sources (except from friends/family). CONCLUSION: Understanding factors that contribute to parental help seeking for child psychopathology is critical for increasing service utilization and reducing the negative effects of mental health problems. This study highlights the importance of decreasing help-seeking barriers and increasing problem recognition to improve health equity.

Parental influences on sperm banking attempts among adolescent males newly diagnosed with cancer.

OBJECTIVE: To investigate the influence of parental sociodemographic, communication, and psychological factors on sperm collection attempts among at-risk adolescent males newly diagnosed with cancer. DESIGN: Prospective, single group, observational study design. SETTING: Pediatric oncology centers. PATIENT(S): Parents (N = 144) of 122 newly diagnosed adolescent males at increased risk for infertility secondary to cancer therapy. INTERVENTION(S): Survey-based assessment of parent factors associated with adolescent collection attempts. MAIN OUTCOME MEASURE(S): Attempt of manual collection of sperm. RESULT(S): Parental recommendation to bank sperm (odds ratio [OR] 3.72; 95% confidence interval [CI] 1.18-11.76) and perceived self-efficacy to facilitate banking (OR 1.20; 95% CI 1.02-1.41) were associated with an increased likelihood of making a collection attempt. CONCLUSION(S): Parental recommendation to bank is a critical influence for sperm banking among adolescent males newly diagnosed with cancer. These findings highlight the importance of effective communication between parents, patients, and health-care teams when discussing preservation options. Parent perceptions of their ability to facilitate sperm banking at the time of diagnosis should also be targeted in future interventions. CLINICAL TRIAL REGISTRATION NUMBER: NCT01152268.

Susceptibility to eating disorders among collegiate female student-athletes.

CONTEXT: Research has suggested that the prevalence of young women with eating disorders (EDs) is increasing, but determining the exact prevalence of EDs within the female student-athlete (FS-A) population is difficult. Looking at certain traits may help us to identify their level of susceptibility to developing an ED. OBJECTIVE: To determine the susceptibility of FS-As to EDs in relation to self-concept, including self-esteem and body image. DESIGN: Cross-sectional study. SETTING: Athletic training and health centers at National Collegiate Athletic Association Division I, II, and III institutions via e-mail questionnaire correspondence. PATIENTS OR OTHER PARTICIPANTS: A total of 439 FS-As from 17 participating institutions completed the questionnaires. The sample was primarily white (83.1%) and underclass (61.8%). MAIN OUTCOME MEASURE(S): The questionnaire consisted of 4 parts: 3 subscales of the Eating Disorder Inventory-2, the Rosenberg Self-Esteem Scale, the Body Cathexis Scale, and demographic items. RESULTS: A total of 6.8% of FS-As were susceptible to anorexia and 1.8% were susceptible to bulimia. The majority of FS-As (61%) reported normal self-esteem levels, whereas 29.4% had high self-esteem. Overall, 64.5% were satisfied and 23% were very satisfied with their body image. CONCLUSIONS: These results are generally positive in that they suggest FS-As have high levels of self-concept and are at low risk to develop EDs. However, these findings do not mean that all concerns should be dismissed. Although more than 90% of the respondents were not susceptible to an ED, there are still FS-As who may be. Athletic departments should evaluate their FS-As' levels of self-concept so that their susceptibility to EDs can be addressed. The emotional aspect of health care should be included in providing holistic care for student-athletes. Athletic trainers often are the primary health care providers for FS-As, so they should be made aware of this concern.

Gentamicin injections for Ménière disease: comparison of subjective and objective end points.

This retrospective study reports the overall efficacy and comparative results of intratympanic gentamicin injections for disabling vertigo episodes. All patients received weekly injections for diagnosed Ménière disease. In Group 1 (81 patients), treatment end points were determined by subjective complaints of imbalance, with resolution of vertigo. In Group 2 (23 patients), treatment end points were determined when 2 or more values of nystagmus were demonstrated. (Group 2 patients were assessed before initiation of therapy for head-shaking, head-thrust, and spontaneous nystagmus using infrared video goggles.) After the final injection, all patients had audiograms and balance and oculomotor retraining. Gentamicin therapy was determined to be successful based on 3-month post-therapy findings of vertigo resolution, stable hearing, normalized nystagmus, and functional balance.