LGBTQIA+ Individuals' Experiences With Intimate Partner Violence and Perceptions of Victim Services.

This study explored lived experiences of LGBTQIA+ survivors of intimate partner violence (IPV). Seven participants completed a one-on-one, in-depth interview to share their experiences of IPV and any internal or external factors that influenced whether they sought support services or reported victimization. Thematic analysis revealed four overarching themes: (a) health complications, (b) coping mechanisms, (c) barriers to seeking professional help, and (d) suggestions for professionals. Results contribute insight into internal and external barriers LGBTQIA+ IPV survivors face when accessing support services and outline practical approaches for professionals providing support to LGBTQIA+ IPV survivors.

Impact of COVID-19 stress on food insecurity and fruit and vegetable consumption among college students.

Objective: This cross-sectional study utilized structural equation modeling to examine effects of COVID-19 stress on food insecurity and fruit and vegetable consumption mediated through personal agency and behavioral intention. Participants: Students (n = 749) enrolled at one federally designated Hispanic-serving public university during the fall 2020 semester. Methods: A 34-item survey was developed and administered. Results: COVID-19 stress had a statistically significant impact on food insecurity (B = .341; p < .001) and an inverse impact on personal agency to consume fruit and vegetables (B = -.283; p < .001). Personal agency (B = .389; p < .001) and behavioral intention to consume fruit and vegetables were directly associated while food insecurity inversely impacted behavioral intention (B = -.076; p = .034). Conclusions: Pandemic-related stress impacts nutrition behaviors among the student population already at risk of poor fruit and vegetable intake. During periods of high pandemic-related stress, college students need adequate access to fruits and vegetables and health promotion programs emphasizing stress management and healthy dietary behaviors.

Analysis of respiratory kinematics: a method to characterize breaths from motion signals.

Objective.Breathing motion (respiratory kinematics) can be characterized by the interval and depth of each breath, and by magnitude-synchrony relationships between locations. Such characteristics and their breath-by-breath variability might be useful indicators of respiratory health. To enable breath-by-breath characterization of respiratory kinematics, we developed a method to detect breaths using motion sensors.Approach.In 34 volunteers who underwent maximal exercise testing, we used 8 motion sensors to record upper rib, lower rib and abdominal kinematics at 3 exercise stages (rest, lactate threshold and exhaustion). We recorded volumetric air flow signals using clinical exercise laboratory equipment and synchronized them with kinematic signals. Using instantaneous phase landmarks from the analytic representation of kinematic and flow signals, we identified individual breaths and derived respiratory rate (RR) signals at 1 Hz. To evaluate the fidelity of kinematics-derived RR, we calculated bias, limits of agreement, and cross-correlation coefficients (CCC) relative to flow-derived RR. To identify coupling between kinematics and flow, we calculated the Shannon entropy of the relative frequency with which flow landmarks were distributed over the phase of the kinematic cycle.Main Results.We found good agreement in the kinematics-derived and flow-derived RR signals [bias (95% limit of agreement) = 0.1 (± 7) breaths/minute; CCC median (IQR) = 0.80 (0.48-0.91)]. In individual signals, kinematics and flow were well-coupled (entropy 0.9-1.4 across sensors), but the relationship varied within (by exercise stage) and between individuals. The final result was that the flow landmarks did not consistently localize to any particular phase of the kinematic signals (entropy 2.2-3.0 across sensors).Significance.The Analysis of Respiratory Kinematics method can yield highly resolved respiratory rate signals by separating individual breaths. This method will facilitate characterization of clinically significant breathing motion patterns on a breath-by-breath basis. The relationship between respiratory kinematics and flow is much more complex than expected, varying between and within individuals.

Increased Likelihood of Forced Sexual Intercourse, Sexual Violence, and Sexual Dating Violence Victimization Among Sexual Minority Youth.

Sexual violence victimization among adolescents, specifically sexual minority youth, is a significant public health concern. The purpose of this study was to compare sexual violence victimization rates among sexual minority and heterosexual youth using nationally representative data from the 2019 Youth Risk Behavioral Surveillance System. Results indicated that lesbian, gay, bisexual, and questioning youth were significantly more likely than heterosexual youth (p < .05) to experience sexual violence (22.3% vs. 9.1%), sexual dating violence (16.3% vs. 6.4%), and forced sexual intercourse (17.6% vs. 5.9%). Among sexual minority youth, female participants were more likely than male participants (p < .05) to experience sexual violence (23.5% vs. 18.0%), sexual dating violence (17.2% vs. 11.6%), and forced sexual intercourse (19.0% vs. 13.1%). This study identified varying rates of sexual violence victimization among a national sample of youth while examining the differences between heterosexual and sexual minority communities. The additional behavioral risks experienced by sexual minority youth should be further researched to determine impact on overall quality of life and to help guide health education intervention development.

The Role of Chiropractic Care in Providing Health Promotion and Clinical Preventive Services for Adult Patients with Musculoskeletal Pain: A Clinical Practice Guideline.

Objective: To develop evidence-based recommendations on best practices for delivery of clinical preventive services by chiropractors and to offer practical resources to empower provider applications in practice. Design: Clinical practice guideline based on evidence-based recommendations of a panel of practitioners and experts on clinical preventive services. Methods: Synthesizing the results of a literature search for relevant clinical practice guidelines and systematic reviews, a multidisciplinary steering committee with training and experience in health promotion, clinical prevention, and/or evidence-based chiropractic practice drafted a set of recommendations. A Delphi panel of experienced practitioners and faculty, primarily but not exclusively chiropractors, rated the recommendations by using the formal consensus methodology established by the RAND Corporation/University of California. Results: The Delphi consensus process was conducted during January-February 2021. The 65-member Delphi panel reached a high level of consensus on appropriate application of clinical preventive services for screening and health promotion counseling within the chiropractic scope of practice. Interprofessional collaboration for the successful delivery of clinical preventive services was emphasized. Recommendations were made on primary, secondary, tertiary, and quaternary prevention of musculoskeletal pain. Conclusions: Application of this guideline in chiropractic practice may facilitate consistent and appropriate use of screening and preventive services and foster interprofessional collaboration to promote clinical preventive services and contribute to improved public health.

The Association of Social Support and Leisure Time Physical Activity With Mental Health Among Individuals With Cancer.

PURPOSE: This study examined the relationship among social support, leisure time physical activity (LTPA), and mental health among people with cancer. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Using the 2017 Health Information National Trends Survey, we extracted data of 504 respondents who had been diagnosed with any of the 22 types of cancer listed in the survey questionnaire. MEASURES: As independent variables, we assessed 3 different types of support: emotional, informational, and tangible support. As mediating and outcome variables, we measured LTPA and mental health, respectively. ANALYSIS: Using AMOS version 22, a path analysis was conducted to measure model fit. A mediation test was then conducted using bootstrapping procedures. RESULTS: The hypothesized model provided an acceptable fit to the data. Specifically, emotional support (b = .15, p = .005), informational support (b = .13, p = .008), tangible support (b = .12, p = .010), and LTPA (b = .14, p = .001) were significantly associated with mental health. We revealed a significant mediating effect of LPTA on the relationship between emotional support and mental health (Estimate = .037, 95% CI = .001-.098, p < .05). CONCLUSION: Social support and LTPA played a significant role in promoting mental health among people with cancer. In particular, the results confirmed that individuals with cancer who reported receiving emotional support tended to engage in LTPA and thus reported better mental health.

Sexual Dating Violence, School-Based Violence, and Risky Behaviors Among U.S. High School Students.

Sexual dating violence is associated with several risky health behaviors among adolescents. This study explored the associations between school-based violence, risky health behaviors, and sexual dating violence victimization among U.S. high school students using the 2017 Youth Behavior Risk Survey data. Results indicate a statistically significant correlation (p < .05) between sexual dating violence, sex, sexual identity, and various risky behaviors including bullying, electronic bullying, alcohol use, and physical fighting. These additional behavioral risks experienced by sexual dating violence victims should be further researched to determine impact on overall quality of life and to help guide health education intervention development.

If We Build It, Will They Come? Challenges of Adapting and Implementing a Smoking Cessation Program for the LGBTQ Community in Southcentral Texas.

Studies indicate that tobacco use among lesbian, gay, bisexual, transgender, or queer (LGBTQ) community members is consistently higher than the general population. The Last Drag is a tobacco cessation program developed and implemented in 1991 in San Francisco, California, that has shown promise in assisting LGBTQ members with tobacco cessation. This article describes the practical challenges of adapting The Last Drag to be implemented in a southcentral Texas community. Primary challenges included short time line to expected implementation, issues with culturally insensitive language, and barriers to participant recruitment. Acknowledging and overcoming these challenges can assist public health educators who are addressing tobacco cessation in LGBTQ populations.

Hooking-Up, Religiosity, and Sexting Among College Students.

The purpose of this study was to evaluate the mediation effect of sexting, and taking sexually suggestive photos on religiosity and hooking-up with three separate sexual outcomes. A web-based survey examined the relationship between religiosity and the three hooking-up outcomes among students reporting sexting or taking a sexually suggestive photo in the last 30 days (n = 231). Sexting, as well as taking sexually suggestive photos mediated the relationship between religiosity and hooking-up among females. Sexting may be initiated by females as a way to engage in a nonphysical sexual interaction, which ultimately predisposes them to a physical sexual outcome.

The FLASHE Study: Racial and Sex Disparities in Adolescent and Parent Modifiable Cancer Risk Behavior.

Objectives: Understanding modifiable risk factors related to cancer among adolescents and their parents may help identify at-risk populations and intervention aims for reducing cancer risk among families. Methods: Participants were 1336 adolescent-parent dyads who participated in the 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) conducted by the National Cancer Institute. Using independent samples t-test and one-way ANOVA, we assessed differences in mean behavioral scores by sex and race/ethnicity, respectively. Results: For this nationwide sample, non-Hispanic black adolescents and parents were significantly (p < .05) more likely to participate in multiple dietary and sedentary behaviors than their Hispanic and non-black counterparts. Male adolescents reported significantly higher consumption of sugar-sweetened beverages and processed and red meats than their female peers (p < .02 for all). We also found a strong positive association between adolescents' and their parents' dietary and sedentary behaviors (p < .001 for all). Conclusions: Sex and racial differences in cancer-related health behaviors among adolescents and their parents suggest current guidelines for cancer may benefit from inclusion of younger populations and families. Effective health interventions targeting adolescent-parent dyads may help reduce cancer risk among multiple populations simultaneously.

Energy Drink and Nutritional Supplement Beliefs Among Naval Aviation Candidates.

INTRODUCTION: The National Academy of Medicine called for increased research on nutritional supplement use among military members. Current research has suggested potential health risks posed by energy drink consumption. The purpose of this study was to examine the relationship of energy drink consumption and beliefs about nutritional supplements in a U.S. military population. METHODS: Data were collected by means of an anonymous 44-item survey that was administered to and completed by 302 naval aviation candidates (100% response rate) enrolled in aviation preflight indoctrination (API) at Naval Air Station Pensacola, FL. RESULTS: Bivariate correlations indicated a statistically significant relationship between beliefs regarding the safety of energy drinks, energy drink consumption frequency, and personal beliefs regarding supplements [r(202) = -0.23]. The negative correlational coefficient indicated an inverse relationship between favorable perceptions on supplements and energy drink consumption. DISCUSSION: This study assessed beliefs about the safety of nutritional supplements among API candidates and to examine if a relationship between nutritional supplement beliefs and energy drink consumption exists. Results indicated a significant inverse relationship between API candidates' beliefs regarding consumption frequency and safety of energy drinks as well as beliefs regarding supplement use. Results also suggested that the more positively an API candidate perceived nutritional supplements, the less frequently energy drinks were consumed. The findings of this study indicated a weak inverse relationship between the beliefs/use of energy drinks and beliefs regarding the effectiveness of nutritional supplement use among naval aviation candidates.Sather TE, Woolsey CL, Delorey DR, Williams RD Jr. Energy drink and nutritional supplement beliefs among naval aviation candidates. Aerosp Med Hum Perform. 2018; 89(8):731-736.

Intrapersonal Factors of Male and Female Adolescent Fruit and Vegetable Intake.

OBJECTIVES: In this study, we examined the role of socio-demographic (race/ethnicity, sex, grade, nativity, literacy, body mass index) and individual-level (normative beliefs, knowledge, perceived barriers, food preference, self-efficacy) factors on US adolescent fruit and vegetable consumption. METHODS: We conducted hierarchical multiple regression analysis to determine the influence of factors on adolescent fruit and vegetable consumption in a nationally represen- tative sample of 795 adolescents from the National Cancer Institute's 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study. RESULTS: Socio-demographic variables explained little variance (1.7%) whereas individual-level factors explained approximately 29% of the variance in adolescent fruit and vegetable consumption. Statistically significant (p < .001) predictors of adolescent fruit and vegetable consumption were food preference (ß = .253), self-efficacy (ß = .184), perceived barriers (ß = -.139), and normative beliefs (ß = .134). After controlling for sex, food preference and normative beliefs were stronger predictors of male, and perceived barriers was a stronger predictor of female, adolescent fruit and vegetable consumption. CONCLUSIONS: Understanding the predictive strength and sex-specific differences of intrapersonal variables on male and female adolescent fruit and vegetable consumption informs health promotion efforts to increase intake to recommended amounts.

Adolescent Nonmedical Use of Opioids and Alcohol Mixed with Energy Drinks.

Objective In this study, we examined the relationship between alcohol mixed with energy drink use (AmED) and nonmedical prescription opioid use among 12th graders, using data from the 2015 Monitoring the Future Study. Methods Wilcoxon-Mann-Whitney and logistic regression analyses were used to determine differences in nonmedical prescription opioid use by students who used alcohol-only (AO) versus AmED and to identify covariates of nonmedical prescription opioid use. Results Greater frequency of AmED use was associated with greater frequency of nonmedical Oxycontin (r = 0.391, p < .001) and Vicodin (r = 0.379, p < .001) use with moderate effect sizes. Results revealed statistically significant differences in frequency of nonmedical Oxycontin (p < .001, Cohen's d = 0.29) and Vicodin (p < .001, Cohen's d = 0.30) use between AO and AmED use. Likelihood of nonmedical prescription opioid use increased by a factor of 2 for each time AmED was consumed in the past 12 months. Conclusion Our results highlight the need to improve understanding of the relationship between nonmedical prescription opioid, energy drink and AmED use. AmED use appears to be associated with increased nonmedical prescription opioid use.

Urban and Rural Adolescents' Points-of-Access for Alcohol and Tobacco.

The purpose of this study was to examine alcohol and tobacco access points among a sample of rural and urban youth. Through collaboration with four regional school districts, a local drug prevention coalition administered a survey to a sample of 445 youth representing 30 different communities in a central U.S. region. The survey items included demographics, 30-day use measures, and questions about points-of-access for alcohol and tobacco. Results showed no differences among points-of-access between urban and rural youth. Ability to obtain alcohol from family, peers, other non-peer youth, and other non-family adults (P < 0.05) were each statistically significant predictors of 30-day alcohol use. Ability to obtain tobacco from family, peers, other non-peer youth, other non-family adults, and self-purchase (P < 0.05) were statistically significant predictors of 30-day tobacco use. Access through peers was the strongest predictor for both 30-day alcohol and tobacco use. Determining the primary social points-of-access youth use to obtain alcohol and tobacco can assist in the development of appropriate community-level prevention strategies and policies.

High-Risk Driving Behaviors Among 12th Grade Students: Differences Between Alcohol-Only and Alcohol Mixed With Energy Drink Users.

BACKGROUND: About 30% of high school students use energy drinks. Alcohol mixed with energy drinks (AmED) has been associated with higher rates of risky driving among college students. OBJECTIVES: The purpose of this study was to: (a) examine AmED-use in a sample of high school students and (b) to specifically investigate differences in risky driving behaviors between 12th grade students who engaged in AmED-use and those who consumed alcohol only. METHODS: Differences in risky driving behaviors were investigated by utilizing secondary data analyses of nationally representative data from the Monitoring the Future Study (N = 1305). RESULTS: 12th grade AmED users were significantly more likely to be in a motor vehicle accident (p <.001) and receive a ticket for a traffic violation (p <.05). Additionally, 12th grade AmED users were significantly less likely to wear a seatbelt as a driver or passenger (p <.001). Conclusions/Importance: Although this study does not link risky driving behaviors to specific drinking events, it does indicate a relationship between AmED-use and high-risk driving. Because traffic accidents are the highest cause of mortality among U.S. teenagers, drug education efforts to reduce high-risk driving behaviors should include information on the decision-making and synergistic effects of energy drinks when mixed with alcohol.

Adolescent Energy Drink Use Related to Intake of Fried and High-sugar Foods.

OBJECTIVE: We assessed the relationship between energy drinks, fried food, and high-sugar food consumption. METHODS: Secondary analyses including Mann-Whitney U, Cohen's d and effect sizes were used to examine 7-day intakes of energy drinks, fried foods, and high-sugar foods among teenagers (N = 1570) who participated in the 2014 FLASHE Study. RESULTS: Energy drink consumption during the past 7 days was reported by 14.4% (N = 226) of participants. Those who reported consumption of energy drinks in the past 7 days were more likely to eat various fried and high-sugar foods than those who did not report past 7-day energy drink consumption. These foods include candy (p < .001), cake (p = .011), desserts (p < .001), sugary cereal (p < .001), fried potatoes (p < .001), fried chicken (p < .001), and chips (p < .001). CONCLUSIONS: Energy drink consumption among adolescents may be linked to other high-risk nutrition intake behaviors, specifically increased consumption of fried and high-sugar foods. This study adds to the growing number of recent studies highlighting the multiple behavioral risks associated with early energy drink use. Health promotion and nutrition education efforts should focus on delaying early consumption of energy drinks among adolescents.

Caffeine Consumption Among Naval Aviation Candidates.

INTRODUCTION: Education frequently dictates students need to study for prolonged periods of time to adequately prepare for examinations. This is especially true with aviation preflight indoctrination (API) candidates who have to assimilate large volumes of information in a limited amount of time during API training. The purpose of this study was to assess caffeine consumption patterns (frequency, type, and volume) among naval aviation candidates attending API to determine the most frequently consumed caffeinated beverage and to examine if the consumption of a nonenergy drink caffeinated beverage was related to energy drink consumption. METHODS: Data were collected by means of an anonymous 44-item survey administered and completed by 302 students enrolled in API at Naval Air Station Pensacola, FL. RESULTS: Results indicated the most frequently consumed caffeinated beverage consumed by API students was coffee (86.4%), with daily coffee consumption being approximately 28% and the most frequent pattern of consumption being 2 cups per day (85%). The least frequently consumed caffeinated beverages reported were energy drinks (52%) and energy shots (29.1%). The present study also found that the consumption patterns (weekly and daily) of caffeinated beverages (coffee and cola) were positively correlated to energy drink consumption patterns. DISCUSSION: Naval aviation candidates' consumption of caffeinated beverages is comparable to other college and high school cohorts. This study found that coffee and colas were the beverages of choice, with energy drinks and energy shots being the least frequently reported caffeinated beverages used. Additionally, a relationship between the consumption of caffeinated beverages and energy drinks was identified.Sather TE, Williams RD, Delorey DR, Woolsey CL. Caffeine consumption among naval aviation candidates. Aerosp Med Hum Perform. 2017; 88(4):399-405.

Energy Drink Use Linked to High-sugar Beverage Intake and BMI among Teens.

OBJECTIVE: We assessed the relationship of energy drink, high-sugar, and low-sugar beverage consumption. METHODS: Mann-Whitney U, Cohen's d and effect sizes were used to examine data from 1737 adolescents in the United States who participated in the 2014 FLASHE Study. Secondary analysis examined consumption of energy drinks, high- and low-sugar beverages, and adolescents' BMIs. RESULTS: Among adolescents, 13.7% (N = 239) reported past 7-day energy drink consumption. Participants who did not consume energy drinks in the past 7 days were more likely to consume low-sugar beverages of water (p < .001) and milk (p = .046). Consumption of energy drinks was positively related to sweetened fruit drinks (p < .001), pure fruit juice (p = .008), soda (p < .001), and sports drinks (p < .001). Energy drink consumers also reported higher mean BMI (p = .004). CONCLUSIONS: Adolescents who consume energy drinks during the past 7 days are more likely to also consume other high-sugar beverages. Whereas those who report no past 7-day use of energy drinks consume higher rates of low- or no-sugar beverages. Health education and prevention efforts to reduce adolescent energy drink consumption may lead to reductions in other high-sugar beverage intake and have a positive impact on obesity rates among adolescents.

Impact of alcohol and alcohol mixed with energy drinks on non-medical prescription stimulant use in a nationally representative sample of 12th-grade students.

BACKGROUND AND OBJECTIVES: Approximately 30% of high school students use energy drinks. Alcohol use and alcohol mixed with energy drink use (AmED) is associated with risky behavior, including non-medical prescription stimulant use. We assessed alcohol-only, AmED and non-medical prescription stimulant use among 12th grade students in the U.S. using a nationally representative secondary data from the 2012 Monitoring the Future Study. METHODS: Wilcoxon-Mann-Whitney tests and logistic regression analyses were used to determine differences in non-medical prescription stimulant use by students who used alcohol-only versus AmED and to identify covariates of non-medical prescription stimulant use. Pearson-product moment coefficients were used to determine strength of variable relationships. RESULTS: Significant differences were found in frequency of Ritalin (p < .001, Cohen's d = .23) and Adderall (p < .001, Cohen's d = .32) use between alcohol-only students and AmED students. Greater frequency of AmED use was also associated with greater frequency of Ritalin use (r = .293, p < .001) and Adderall use (r = .353, p < .001). Males (b = .138, OR = 1.148) were more likely to use prescription stimulants non-medically than females. DISCUSSION AND CONCLUSIONS: This study highlights the need to better understand influences on non-medical prescription stimulant, energy drink and AmED use, as the combined effects of stimulants contained in energy drinks and the depressant effects of alcohol appear to be associated with increased non-medical prescription stimulant use. SCIENTIFIC SIGNIFICANCE: Research on the influential factors related to energy drinks, alcohol, and non-medical prescription stimulants will help practitioners to more appropriately design prevention and intervention strategies addressing these high-risk behaviors. (Am J Addict 2016;25:378-384).

Age of first use of energy beverages predicts future maximal consumption among naval pilot and flight officer candidates.

BACKGROUND: Energy drinks are popular beverages that can have adverse long-term health effects when consumed by children and adolescents. This study sought to determine if the age of first energy drink use in a U.S. military population is predictive of the maximum number of energy drinks consumed during a single day and/or single occasion (operationally defined as a couple of hours; e.g., a night out, during studying or sport session). METHOD: Student U.S. naval aviator and naval flight officers who reported past-year use of energy drinks (N = 239) were surveyed to determine various measures of energy drink consumption. RESULTS: Age of first consumption was predictive of the maximum number of energy drinks consumed during a single occasion within the past year. Within this sample, the age range between 13 and 16 years appeared to be a critical period with results indicating that people who began consuming energy drinks during this period were 4.88 times more likely to consume high quantities (four or more) of energy drinks during a single occasion when compared to those who started consuming energy drinks between the ages of 20-23. Likewise, persons who began to consume energy drinks between the ages of 13-16 are 2.48 times more likely to consume high quantities of energy drinks during a single occasion than those who started between the ages of 17-19. There was no difference between 17 and 19 year olds and 20-23 year olds. Age of first use was not correlated to daily average intake or daily maximal intake of energy drinks. CONCLUSIONS: A lower age of first energy drink use suggests higher risk of single-occasion heavy episodic consumption in this military population. Researchers should further explore the relationship of early onset energy drink consumption and potential future health risks.