Community Support for Harm Reduction and Treatment of Opioid Use Disorder.

As the opioid epidemic continues, availability of evidence-based strategies for harm reduction and treatment in communities is critical to reduce overdose and other consequences of opioid use disorder. Community members' support of harm reduction and treatment services is needed for new programs and to maintain existent programs. This study sought to understand beliefs and attitudes associated with support for three community-based strategies to address opioid misuse and addiction: naloxone, needle exchange, and medication-assisted treatment. We conducted a cross-sectional online survey with 545 adults. Results of the survey showed that participants supported all three strategies, with the strongest support for medication-assisted treatment. Multiple regression showed that stigma and perceived stigma were significant predictors for all three strategies, with inverse relationships. Stigmatizing beliefs predicted less support while perceiving stigma among others was associated with greater support for the strategies. Normative beliefs also significantly predicted support for all three strategies, such that stronger belief that others were supportive of each strategy was associated with greater support for that strategy. Other predictors varied across the three strategies. Support for harm reduction and treatment programs in communities affected by the opioid epidemic may be bolstered by reducing stigma and increasing normative beliefs. Stronger support for medication-assisted treatment may be leveraged and extended to harm reduction strategies. Results of our study contribute insights for bolstering community support for harm reduction and treatment, which is vital for adoption and maintenance of these important programs.

Preventing opioid overdose with peer-administered naloxone: findings from a rural state.

BACKGROUND: In response to the opioid epidemic, naloxone distribution programs aim to prevent overdose death by making naloxone available and training people to use it. Peers of individuals at risk of opioid overdose are well-positioned to administer naloxone and prevent overdose death. METHODS: We conducted key informant interviews with 18 individuals with past or current opioid and heroin drug use who had administered naloxone to a peer during an overdose emergency. Interviews explored individuals' experiences with administration and their recommendations for program and policy improvement. Data were systematically coded and analyzed for themes. RESULTS: Participants sought naloxone rescue kits because they perceived high risk of overdose. They described high satisfaction with training and felt prepared to administer naloxone during overdose incidents. Overwhelmingly, participants perceived naloxone to be effective and emphasized the need to make it widely available. Findings suggest that engagement in overdose prevention strategies other than naloxone differs by gender, with females more likely than males to use multiple different strategies. Participants described that overdose experiences do not have a lasting impact on drug use behaviors. CONCLUSIONS: Findings support the feasibility of naloxone distribution to peer opioid and heroin users and provide recommendations for policy improvement, including effective and well-advertised Good Samaritan laws and links to treatment for opioid use disorder.

An Environmental Scan of the Role of Nurses in Preventing Fetal Alcohol Spectrum Disorders.

Nurses are in an ideal position to talk to their patients of reproductive age about alcohol use and encourage the prevention of alcohol-exposed pregnancies. Effective conversations can be efficiently included in the clinical encounter to identify alcohol misuse and offer appropriate follow-up. This report presents results of an environmental scan of resources relevant to nursing professionals and nurses' role in addressing alcohol misuse. Gaps in nursing education and practice guidelines with regard to defining the nursing role in preventing alcohol-exposed pregnancies were revealed. Findings identified a need to promote adoption among nurses of evidence-based preventive practices to prevent alcohol misuse.

Perceived control as a longitudinal moderator of late-life stressors on depressive symptoms.

OBJECTIVES: This study examined perceived control as a moderator of the relationship between late-life stressors and depressive symptoms among a sample of older New Zealanders. METHOD: Data were drawn from a longitudinal study with two data collection periods, one year apart. The Time 1 sample consisted of 1489 participants ranging in age from 65 to 94 years and 72% percent participated at Time 2. Correlational and multiple regression procedures were used to examine study hypotheses. RESULTS: Results showed that Time 1 perceived control beliefs were a unique predictor of depressive symptoms at Time 2 after controlling for Time 1 depressives symptoms and other relevant variables. Further, perceived control beliefs at Time 1 moderated the relationship between late-life stressors and depressive symptoms at Time 2. Those with low perceived control demonstrated a stronger relationship between late-life stressors and depressive symptoms than those with high perceived control. CONCLUSION: This study provides evidence that perceived control influences levels of depressive symptoms over time among older adults. Results also support the hypothesis that control beliefs moderate the relationship between late-life stressors and depressive symptoms among older adults. Implications include attributional retraining to promote perceived control and subsequent well-being in older adults.

Role of Trusted Sources and Behavioral Beliefs in Promoting Mitigation Behaviors During the COVID-19 Pandemic: Survey Study.

BACKGROUND: During the ongoing COVID-19 pandemic and in preparation for future public health crises, it is important to understand the relationship between individuals' health beliefs, including their trust in various sources of health information, and their engagement in mitigation behaviors. OBJECTIVE: We sought to identify relationships between trust in various sources of health information and the behavioral beliefs related to vaccination and mask wearing as well as to understand how behavioral beliefs related to vaccination differ by willingness to be vaccinated. METHODS: We conducted an online survey of 1034 adults in the United States and assessed their trust in federal, local, and media sources of health information; their beliefs about vaccination; and their masking intention and vaccination willingness. RESULTS: Using regression, masking intention was predicted by trust in the World Health Organization (P<.05) and participants' state public health offices (P<.05), while vaccine willingness was predicted by trust in participants' own health care providers (P<.05) and pharmaceutical companies (P<.001). Compared to individuals with low willingness to be vaccinated, individuals with high willingness indicated greater endorsement of beliefs that vaccines would support a return to normalcy, are safe, and are a social responsibility (P<.001 for all). CONCLUSIONS: Results can be used to inform ongoing public health messaging campaigns to manage the COVID-19 pandemic and increase readiness for the next pandemic. Additionally, results support the need to bolster the public's trust in health care agencies as well as to enhance trust and respect in health care providers to increase people's adoption of mitigation behaviors.

Seasonal affective disorder and engagement in physical activities among adults in Alaska.

Seasonal affective disorder (SAD) is a type of depression in which symptoms occur during a particular season. While physical activity has been shown to improve symptoms for depression in general populations, the relationships between physical activity and experiences of seasonality and SAD remain underexplored. We conducted a survey with adult members of a recreational gym in Fairbanks, Alaska. The survey collected self-report data on sociodemographics, health behaviours, and elements of the Seasonal Pattern Assessment Questionnaire (SPAQ). Results indicate that 18.68% of our study participants meet the criteria for winter-pattern SAD and 43.96% meet the criteria for subsyndromal SAD ("winter blues"). We conducted two regressions to understand experiences of SAD and predictors of seasonality more generally. Gender was a significant predictor of SAD, with women more likely than men to experience SAD (p = .04). Being social at the gym, whether going to the gym with others or participating in activities with others, was associated with higher seasonality than being independent at the gym (p = .03). Younger age was also associated with higher seasonality (p < .001). This study contributes new insights about the relationship between engagement in physical activities and experiences of seasonality among adults in a northern latitude.

Perceived barriers to health care and health behaviours: implications for Native American elders' self-rated health.

Little is known about how Native American adults appraise their health in later life. Perceived barriers to health care and health behaviours were examined among 6813 Native elders to determine their unique associations with self-rated health (SRH). Hierarchical regression results showed inability to access needed medical care predicted poorer SRH. Statistically accounting for sociodemographics and barriers to care, health behaviours predicted SRH. The current findings suggest opportunities to improve Native elders' SRH particularly via exercise and good nutrition. In turn, enhanced SRH may lead to improved quality of life.

The Relationship Between Mixed Race/Ethnicity, Developmental Assets, and Mental Health Among Youth.

This study assessed whether high school youth with mixed race/ethnicity are at greater risk for poor mental health conditions compared to their single race/ethnic counterparts and whether this mental health risk can be mitigated by youth developmental assets regardless of one's race/ethnicity. Methods involved secondary data analysis of the 2009-2013 Youth Risk Behavioral Survey-Anchorage, Alaska subsample. Difference in rates of mental health conditions and mean number of developmental assets (protective factors) were assessed among three racial/ethnic groups. Logistic regression models tested whether race/ethnicity has an independent association with mental health conditions and whether there is an interaction effect between race/ethnicity and protective factors. Results show that, compared to white students, mixed race/ethnic students have significantly higher rates of poor mental health condition and significantly fewer protective factors. A significant interaction effect between race/ethnicity and protective factors was also found, showing decreasing likelihood of poor mental health condition with increasing number of protective factors among all racial/ethnic groups. However, this effect was more pronounced among white students compared to both mixed and single race/ethnicity minority students. Study findings indicate that youth of mixed race/ethnicity are more likely to be at risk for poor mental health outcomes, yet less likely to mitigate this risk even with similar number of external developmental assets as their single race/ethnic counterparts. More research is needed to further understand the differential effect of certain developmental assets among different racial/ethnic groups.

Key Stakeholders' Perceptions of Motivators for Research Participation Among Individuals Who Are Incarcerated.

Understanding motivations of research participants is crucial for developing ethical research protocols, especially for research with vulnerable populations. Through interviews with 92 institutional review board members, prison administrators, research ethicists, and researchers, we explored key stakeholders' perceptions of what motivates incarcerated individuals to participate in research. Primary motivators identified were a desire to contribute to society, gaining knowledge and health care, acquiring incentives, and obtaining social support. The potential for undue influence or coercion were also identified as motivators. These results highlight the need for careful analysis of what motivates incarcerated individuals to participate in research as part of developing or reviewing ethically permissible and responsible research protocols. Future research should expand this line of inquiry to directly include perspectives of incarcerated individuals.

Conducting Ethical Research with Correctional Populations: Do Researchers and IRB Members Know the Federal Regulations?

Conducting or overseeing research in correctional settings requires knowledge of specific federal rules and regulations designed to protect the rights of individuals in incarceration. To investigate the extent to which relevant groups possess this knowledge, using a 10-item questionnaire, we surveyed 885 IRB prisoner representatives, IRB members and chairs with and without experience reviewing HIV/AIDS correctional protocols, and researchers with and without correctional HIV/AIDS research experience. Across all groups, respondents answered 4.5 of the items correctly. Individuals who have overseen or conducted correctional research had the highest scores; however, even these groups responded correctly only to slightly more than half of the items. These findings emphasize the need for ongoing training in federal guidelines governing correctional research, particularly for those individuals who are embarking on this type of research.

The role of positive thinking in social perceptions of cancer outcomes.

Pressure for 'positive thinking' (PT; i.e., focusing on positive thoughts/suppressing negative thoughts to 'fight' cancer) burdens cancer patients facing health deterioration. It was determined whether PT exposure enhanced effort, control and responsibility attributions assigned to an individual for his/her cancer trajectory. Within an online blog a hypothetical same-gender person describes a personal cancer experience. 482 participants were assigned to one of six experimental conditions in which we manipulated PT exposure (blogger learns about 'power of PT' but does not try it, blogger tries PT, control/no PT) and cancer outcome (successful/unsuccessful treatment). A 3 × 2 × 2 multivariate analysis of covariance (with personal cancer experience covariates) tested PT exposure × cancer outcome × gender effects on attributions for the blogger's cancer outcome. Results indicate that PT exposure enhanced effort and responsibility attributions assigned to individuals for their cancer outcomes and that responsibility attributions differed as a function of gender. Findings suggest that exposure to the idea of PT may lead to cancer patients being perceived as culpable if they do not recover from the disease.

Later life health optimism, pessimism and realism: psychosocial contributors and health correlates.

Prior research has established positive outcomes of health optimism (appraising one's health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over one's health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.