A Gentle Introduction to Bayesian Network Meta-Analysis Using an Automated R Package.

Network meta-analysis is an extension of standard meta-analysis. It allows researchers to build a network of evidence to compare multiple interventions that may have not been compared directly in existing publications. With a Bayesian approach, network meta-analysis can be used to obtain a posterior probability distribution of all the relative treatment effects, which allows for the estimation of relative treatment effects to quantify the uncertainty of parameter estimates, and to rank all the treatments in the network. Ranking treatments using both direct and indirect evidence can provide guidance to policy makers and clinicians for making decisions. The purpose of this paper is to introduce fundamental concepts of Bayesian network meta-analysis (BNMA) to researchers in psychology and social sciences. We discuss several essential concepts of BNMA, including the assumptions of homogeneity and consistency, the fixed and random effects models, prior specification, and model fit evaluation strategies, while pointing out some issues and areas where researchers should use caution in the application of BNMA. Additionally, using an automated R package, we provide a step-by-step demonstration on how to conduct and report the findings of BNMA with a real dataset of psychological interventions extracted from PubMed.

Psychosocial predictors of changes in adolescent girls' physical activity and dietary behaviors over the course of the Go Girls! group-based mentoring program.

Changes in social cognitions targeted within a group-based mentoring program for adolescent girls were examined as predictors of changes in physical activity (PA) and dietary behavior (in two separate models) over the course of the 7-week program. Data were collected from 310 participants who participated in the program. Multilevel path models were used to assess changes in psychosocial variables predicting changes in behavioral outcomes from pre- to post-program. Analyses revealed that 24.4 and 12.3% of the variance in increases in PA and dietary behavior, respectively, was explained by increases in affective and instrumental attitudes, self-regulatory efficacy (SRE), and intentions. Increases in intentions partially mediated the effects of increases in SRE and affective attitudes on increases in PA behavior. In relation to improvements in dietary behavior, increases in intentions and SRE directly predicted improvements in dietary behavior. These findings suggest potential psychological mechanisms through which a group-based mentoring program may lead to changes in adolescent girls' health-enhancing PA and dietary behaviors.

Differential adsorption of small molecules in spatially functionalized porous silicon nanostructures.

An experimental approach to rapidly quantify the relative affinity of a small molecule analyte for two different surfaces is described. The method uses optical measurements of high surface area porous Si thin films that contain two spatially distinct surface chemistries. The chemistries are placed on the walls of the ∼10 nm diameter pores of the porous Si film by means of microdroplet patterning, where a chemical resist is drop-coated on the porous Si sample to define distinct regions across the plane of the chip. In this work, the two chemistries consist of a hydrophilic silicon oxide surface and a hydrophobic methyl-terminated silicon surface. Detection is achieved by simultaneous optical reflectance measurements of both regions, where the reflectance spectrum contains a convolution of the Fabry-Pérot interference spectrum of both the oxide and the methyl-grafted layers. The differential partitioning of a test analyte (2-acetoxybenzoic acid or diphenyl ether) from aqueous solution is determined from the Fourier transform of the optical interference spectrum. The approach is rapid and nondestructive, and it can be performed on a small sample volume as a means to quantify the partition behavior of small molecules.

Drosophila larvae lacking the bcl-2 gene, buffy, are sensitive to nutrient stress, maintain increased basal target of rapamycin (Tor) signaling and exhibit characteristics of altered basal energy metabolism.

BACKGROUND: B cell lymphoma 2 (Bcl-2) proteins are the central regulators of apoptosis. The two bcl-2 genes in Drosophila modulate the response to stress-induced cell death, but not developmental cell death. Because null mutants are viable, Drosophila provides an optimum model system to investigate alternate functions of Bcl-2 proteins. In this report, we explore the role of one bcl-2 gene in nutrient stress responses. RESULTS: We report that starvation of Drosophila larvae lacking the bcl-2 gene, buffy, decreases survival rate by more than twofold relative to wild-type larvae. The buffy null mutant reacted to starvation with the expected responses such as inhibition of target of rapamycin (Tor) signaling, autophagy initiation and mobilization of stored lipids. However, the autophagic response to starvation initiated faster in larvae lacking buffy and was inhibited by ectopic buffy. We demonstrate that unusually high basal Tor signaling, indicated by more phosphorylated S6K, was detected in the buffy mutant and that removal of a genomic copy of S6K, but not inactivation of Tor by rapamycin, reverted the precocious autophagy phenotype. Instead, Tor inactivation also required loss of a positive nutrient signal to trigger autophagy and loss of both was sufficient to activate autophagy in the buffy mutant even in the presence of enforced phosphoinositide 3-kinase (PI3K) signaling. Prior to starvation, the fed buffy mutant stored less lipid and glycogen, had high lactate levels and maintained a reduced pool of cellular ATP. These observations, together with the inability of buffy mutant larvae to adapt to nutrient restriction, indicate altered energy metabolism in the absence of buffy. CONCLUSIONS: All animals in their natural habitats are faced with periods of reduced nutrient availability. This study demonstrates that buffy is required for adaptation to both starvation and nutrient restriction. Thus, Buffy is a Bcl-2 protein that plays an important non-apoptotic role to promote survival of the whole organism in a stressful situation.

Safety of Fixed-Combination Bimatoprost 0.03%/Timolol 0.5% Ophthalmic Solution at 6 Months in Chinese Patients with Open-Angle Glaucoma or Ocular Hypertension.

INTRODUCTION: Fixed-combination bimatoprost 0.03%/timolol 0.5% ophthalmic solution (FCBT; Ganfort®, Allergan, an AbbVie company) effectively reduces intraocular pressure (IOP) via complementary mechanisms of action of the agents, but long-term (> 12 weeks) safety evaluations of FCBT remain limited. FCBT safety is evaluated herein, with particular focus on hyperemia and eyelash growth, at 24 weeks in Chinese patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). METHODS: In this multicenter, open-label, noncomparative, phase 4 study conducted in China, patients diagnosed with OAG or OHT having insufficient response to ß-blocker- or prostaglandin analogue/prostamide (PGA)-based IOP-lowering monotherapy in one or both eyes were switched from their current IOP-lowering treatment to FCBT (one drop per eye every evening) without prior washout. Assessment visits were scheduled at baseline and weeks 4, 12, and 24 (or study exit). The primary outcome measure was adverse event (AE) incidence through 24 weeks. RESULTS: Of 725 patients enrolled, 632 (87.2%) completed the study; 93 (12.8%) patients discontinued, including 29 (4.0%) due to AEs. Of 1326 FCBT-treated eyes (total), 594 (44.8%) experienced ≥ 1 ocular treatment-related AE during the study. Conjunctival hyperemia (the most common AE overall) and eyelash growth were reported in 269 (20.3%) and 54 (4.1%) FCBT-treated eyes, respectively. The incidence of other known PGA-related AEs (including blepharal pigmentation and erythema of eyelid) was < 10% each. Most conjunctival hyperemia reports were mild in severity (214/259; 82.6%) and only 1/259 (0.4%) was severe. Similarly, most cases of eyelash growth were mild (46/52; 88.5%); none were severe. One (< 0.1%) FCBT-treated eye had a serious ocular AE (OAG) considered FCBT-related. CONCLUSIONS: The frequency and severity of FCBT-related AEs, including conjunctival hyperemia and eyelash growth, are consistent with previously published findings. No new safety concerns were raised. This prospective study reaffirms that once-daily FCBT is a safe and well-tolerated therapy for OAG and OHT. GOV IDENTIFIER: NCT02571712.

Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models.

The incidence of chronic kidney disease (CKD) is increasing among people living with HIV (PLWH). Routine monitoring of indicators such as CD4:CD8 ratio might improve the early detection of CKD. Our objective was to identify clinically relevant CD4:CD8 ratio trajectories indicative of CKD risk. Participants were ≥ 18 years old, initiated antiretroviral therapy between 2000 and 2016, and were followed for ≥6 months until 31 March 2017 or last contact date. Outcome was incidence of CKD. Growth mixture models (GMMs) and decay models were used to compare CD4:CD8 ratio trajectories. Following GMM, 4547 (93.5%) participants were classified in Class 1 with 5.4% developing CKD, and 316 (6.5%) participants were classified in Class 2 with 20.9% developing CKD. The final model suggested that participants in Class 2 had 8.72 times the incidence rate of developing CKD than those in Class 1. Exponential decay models indicated a significant CD4:CD8 ratio decline among Class 2 participants who developed CKD. Among those who developed CKD in Class 2, starting at 5.5 years of follow-up, the slope of their ratio trajectory curve changed significantly, and the rate of decline increased dramatically. Routine monitored CD4:CD8 ratios can be an effective strategy to identify early CKD risk among PLWH.

Massive Ascites Causing Presumed Abdominal Compartment Syndrome During Open Heart Surgery With Cardiopulmonary Bypass.

Abdominal compartment syndrome (ACS) is a potentially fatal condition and a known cause of morbidity and mortality in critically ill patients. It can be primary, due to abdominal trauma and/or surgical procedures, or secondary, due to excessive abdominal fluid and/or bowel edema. Intra-abdominal hypertension (IAH) is defined as intra-abdominal pressure (IAP) greater than 12 mm Hg. ACS occurs when increased IAP results in organ dysfunction. Although IAPs are known to increase in cardiac surgery, ACS is uncommon, and reports are limited in the literature. We describe a fatal case of presumed ACS during an aortic valve and root replacement with coronary artery bypass grafting (CABG).

Comparison of Iridocorneal Angle Assessments in Open-Angle Glaucoma and Ocular Hypertension Patients: Anterior Segment Optical Coherence Tomography and Gonioscopy.

Purpose: To quantitatively compare iridocorneal angle assessments using gonioscopy and anterior segment optical coherence tomography (AS-OCT). Patients: US and Chinese patients with open-angle glaucoma (OAG) and/or ocular hypertension (OHT). Methods: Analysis was pooled from 2 multicenter, noninterventional studies conducted in the US and China. Gonioscopy Shaffer grade and an AS-OCT method that approximates the angle width relative to local morphologic variations were compared by measuring the same iridocorneal angles. A third, separate, single-center, noninterventional study was conducted to verify results observed from the pooled analysis. Results: From the pooled studies, a total of 239 eyes were measured using Shaffer grade and AS-OCT. Of these, 6 were Shaffer grade 2, 37 in Shaffer grade 3, and 196 in Shaffer grade 4. There was a trend of increasing Shaffer grade with increasing AS-OCT angle width. Open iridocorneal angles, Shaffer grade ≥3, had a ~98% sensitivity and 88% positive predictive value for identifying AS-OCT angle width ≥300 µm, using the AS-OCT method. To verify these results, a total of 28 right eyes were imaged for the third study. A trend of increasing Shaffer grade with increasing AS-OCT angle width was observed, and angles with Shaffer grade ≤2 had AS-OCT angle width <300 µm. Conclusion: The AS-OCT method can determine the space in the anterior chamber and can potentially identify angles that are the appropriate size for certain glaucoma devices. Information gathered from AS-OCT can provide additional comprehensive and quantitative assessment to gonioscopy.

Charge-gated transport of proteins in nanostructured optical films of mesoporous silica.

The admission into and diffusion through nanoscale pores by molecules is a fundamental process of great importance to biology and separations science. Systems (e.g., chromatography, electrophoresis) designed to harness such processes tend to remove the separation process from the detection event, both spatially and temporally. Here, we describe the preparation and characterization of thin optical Fabry-Pérot films of mesoporous silica (pSiO(2)) that can detect protein infiltration by optical interferometry, which probes the separation process in real time and in the same ultrasmall physical volume (5 nL). Admission of a protein into the pores is controlled by the diameter (∼50 nm) and the surface charge of the pores, and both the rate and the degree of protein infiltration are a function of solution pH. Test proteins bovine serum albumin (BSA, 66 kDa), bovine hemoglobin (BHb, 65 kDa), and equine myoglobin (EMb, 18 kDa) are admitted to or excluded from the nanophase pores of this material based on their size and charge. The rate of protein transport within the pores of the pSiO(2) film is slowed by 3 orders of magnitude relative to the free-solution diffusion values, and it is maximized when pH = pI.

Phase 3, Randomized, 20-Month Study of the Efficacy and Safety of Bimatoprost Implant in Patients with Open-Angle Glaucoma and Ocular Hypertension (ARTEMIS 2).

OBJECTIVE: To evaluate the intraocular pressure (IOP)-lowering efficacy and safety of 10 and 15 µg bimatoprost implant in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). METHODS: This randomized, 20-month, multicenter, masked, parallel-group, phase 3 trial enrolled 528 patients with OAG or OHT and an open iridocorneal angle inferiorly in the study eye. Study eyes were administered 10 or 15 µg bimatoprost implant on day 1, week 16, and week 32, or twice-daily topical timolol maleate 0.5%. Primary endpoints were IOP and IOP change from baseline through week 12. Safety measures included treatment-emergent adverse events (TEAEs) and corneal endothelial cell density (CECD). RESULTS: Both 10 and 15 µg bimatoprost implant met the primary endpoint of noninferiority to timolol in IOP lowering through 12 weeks. Mean IOP reductions from baseline ranged from 6.2-7.4, 6.5-7.8, and 6.1-6.7 mmHg through week 12 in the 10 µg implant, 15 µg implant, and timolol groups, respectively. IOP lowering was similar after the second and third implant administrations. Probabilities of requiring no IOP-lowering treatment for 1 year after the third administration were 77.5% (10 µg implant) and 79.0% (15 µg implant). The most common TEAE was conjunctival hyperemia, typically temporally associated with the administration procedure. Corneal TEAEs of interest (primarily corneal endothelial cell loss, corneal edema, and corneal touch) were more frequent with the 15 than the 10 µg implant and generally were reported after repeated administrations. Loss in mean CECD from baseline to month 20 was ~ 5% in 10 µg implant-treated eyes and ~ 1% in topical timolol-treated eyes. Visual field progression (change in the mean deviation from baseline) was reduced in the 10 µg implant group compared with the timolol group. CONCLUSIONS: The results corroborated the previous phase 3 study of the bimatoprost implant. The bimatoprost implant met the primary endpoint and effectively lowered IOP. The majority of patients required no additional treatment for 12 months after the third administration. The benefit-risk assessment favored the 10 over the 15 µg implant. Studies evaluating other administration regimens with reduced risk of corneal events are ongoing. The bimatoprost implant has the potential to improve adherence and reduce treatment burden in glaucoma. CLINICALTRIALS. GOV IDENTIFIER: NCT02250651.

Multicenter, Prospective, Randomized Study of Dexamethasone Intravitreal Implant in Patients with Center-Involved Diabetic Macular Edema in the Asia-Pacific Region.

PURPOSE: To evaluate the safety and efficacy of dexamethasone intravitreal implant 0.7 mg (DEX) compared with laser photocoagulation in patients with diabetic macular edema (DME). PATIENTS AND METHODS: This Phase 3, multicenter, randomized, efficacy evaluator-masked, parallel-group, 12-month clinical study enrolled adults in China and the Philippines with reduced visual acuity secondary to fovea-involved DME in the study eye. Participants were randomized 1:1 to study eye treatment with laser photocoagulation every 3 months as needed (n = 139) or DEX every 5 months (n = 145). The main efficacy measures were best-corrected visual acuity (BCVA), central retinal thickness (CRT), and leakage area. The primary endpoint was the average change in BCVA from baseline over 12 months (area-under-the-curve method). Preplanned subgroup analyses evaluated outcomes in Chinese patients. RESULTS: Mean average change in BCVA from baseline during the study (letters) was 4.3 with DEX (n = 145) versus 1.4 with laser (n = 127) overall (P = 0.001) and 4.6 with DEX (n = 129) versus 0.6 with laser (n = 113) in Chinese patients (P < 0.001). At Month 12, mean change in CRT from baseline was -209.5 µm with DEX versus -120.3 µm with laser (P < 0.001) and mean change in total leakage area from baseline was -8.367 mm2 with DEX versus -0.637 mm2 with laser (P < 0.001). The most common treatment-emergent adverse events in the DEX group were increased intraocular pressure and cataract. CONCLUSION: DEX administered every 5 months provided significantly greater improvement in BCVA, CRT, and total leakage area compared with laser treatment. DEX demonstrated an acceptable safety profile, consistent with an intraocular corticosteroid, and similar to that reported in completed global registration studies.

Sustained Release of a Monoclonal Antibody from Electrochemically Prepared Mesoporous Silicon Oxide.

Nanostructured mesoporous silica (SiO(2)) films are used to load and release the monoclonal antibody bevacizumab (Avastin) in vitro. A biocompatible and biodegradable form of mesoporous SiO(2) is prepared by electrochemical etching of single crystalline Si, followed by thermal oxidation in air at 800 °C. Porous SiO(2) exhibits a negative surface charge at physiological pH (7.4), allowing it to spontaneously adsorb the positively charged antibody from an aqueous phosphate buffered saline solution. This electrostatic adsorption allows bevacizumab to be concentrated by >100× (300 mg bevacziumab per gram of porous SiO(2) when loaded from a 1 mg mL(-1) solution of bevacziumab). Drug loading is monitored by optical interferometric measurements of the thin porous film. A two-component Bruggeman effective medium model is employed to calculate percent porosity and film thickness, and is further used to determine the extent of drug loading into the porous SiO(2) film. In vitro drug release profiles are characterized by an enzyme-linked immunosorbent assay (ELISA), which confirms that the antibody is released in its active, VEGF-binding form. The nanostructured delivery system described here provides a sustained release of the monoclonal antibody where approximately 98% of drug is released over a period of one month.

A Propensity Score Method for Investigating Differential Item Functioning in Performance Assessment.

This study introduces a novel differential item functioning (DIF) method based on propensity score matching that tackles two challenges in analyzing performance assessment data, that is, continuous task scores and lack of a reliable internal variable as a proxy for ability or aptitude. The proposed DIF method consists of two main stages. First, propensity score matching is used to eliminate preexisting group differences before the test, ideally creating equivalent groups as in a randomized experimental study. Then, linear mixed effects models are adopted to perform DIF analysis based on the matched data set. We demonstrate this propensity DIF method using a high-stakes functional English language proficiency test. DIF due to education was investigated in the writing component, which consists of two continuously scored performance-based tasks. Although the proposed method is demonstrated in the context of language testing, it can be applied to other types of performance assessments.

Using Corpus Analyses to Help Address the DIF Interpretation: Gender Differences in Standardized Writing Assessment.

Addressing differential item functioning (DIF) provides validity evidence to support the interpretation of test scores across groups. Conventional DIF methods flag DIF items statistically, but often fail to consolidate a substantive interpretation. The lack of interpretability of DIF results is particularly pronounced in writing assessment where the matching of test takers' proficiency levels often relies on external variables and the reported DIF effect is frequently small in magnitude. Using responses to a prompt that showed small gender DIF favoring female test takers, we demonstrate a corpus-based approach that helps address DIF interpretation. To provide linguistic insights into the possible sources of the small DIF effect, this study compared a gender-balanced corpus of 826 writing samples matched by test takers' performance on the reading and listening components of the test. Four groups of linguistic features that correspond to the rating dimensions, and thus partially represent the writing construct were analyzed. They include (1) sentiment and social cognition, (2) cohesion, (3) syntactic features, and (4) lexical features. After initial screening, 123 linguistic features, all of which were correlated with the writing scores, were retained for gender comparison. Among these selected features, female test takers' writing samples scored higher on six of them with small effect sizes in the categories of cohesion and syntactic features. Three of the six features were positively correlated with higher writing scores, while the other three were negative. These results are largely consistent with previous findings of gender differences in language use. Additionally, the small differences in the language features of the writing samples (in terms of the small number of features that differ between genders and the small effect size of the observed differences) are consistent with the previous DIF results, both suggesting that the effect of gender differences on the writing scores is likely to be very small. In sum, the corpus-based findings provide linguistic insights into the gender-related language differences and their potential consequences in a testing context. These findings are meaningful for furthering our understanding of the small gender DIF effect identified through statistical analysis, which lends support to the validity of writing scores.

Fixed-combination Bimatoprost/Brimonidine/Timolol in Glaucoma: A Randomized, Masked, Controlled, Phase III Study Conducted in Brazil☆.

PURPOSE: Many patients with open-angle glaucoma eventually require >2 medications to lower their intraocular pressure (IOP). Fixed-combination ophthalmic solutions can be advantageous in patients who require multiple medications, but the number of fixed combinations combining 3 complementary IOP-lowering agents remains limited. This study assessed the efficacy and safety of a triple fixed combination (TFC) of bimatoprost 0.01%/brimonidine 0.15%/timolol 0.5% ophthalmic solution in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT), compared with a dual fixed combination (DFC) of brimonidine 0.2%/timolol 0.5%. METHODS: Patients with a baseline IOP of 23-34 mm Hg in both eyes and no history of IOP-lowering procedures were eligible for participation in this multicenter, double-masked, randomized, Phase III study. After washout of previous treatment (if applicable), patients were randomized to receive TFC or DFC twice daily in each eye for 3 months. The primary efficacy variable was the change from baseline in mean IOP in the worse eye at week 12 in the modified intent-to-treat (mITT) population. TFC was superior to DFC if the treatment difference (TFC - DFC) favored TFC at week 12 (P ≤ 0.05; 2-sample t test). Secondary and sensitivity analyses were also performed. Safety, including adverse events, was assessed at all visits. FINDINGS: The mITT/safety population included 185 patients (TFC, n = 90; DFC, n = 95). TFC superiority was demonstrated at all postbaseline visits (all, P < 0.001) through week 12 (week 12 treatment difference: ─2.17 mm Hg; 95% CI, ─3.12 to ─1.22). While treatment-related conjunctival hyperemia was more frequent with TFC than with DFC (47.8% vs 23.2%; P < 0.001), consistent with the additional presence of bimatoprost in TFC, most cases were mild and the numbers of patient discontinuations at week 12 were similar between the TFC and DFC groups (11 [12.2%] vs 7 [7.4%] patients; P = 0.266). No unexpected adverse events were reported. IMPLICATIONS: Compared with DFC, TFC provided superior IOP lowering throughout the primary efficacy period. An acceptable tolerability profile was observed through 12 months of use of TFC, offering an effective therapeutic option in patients with POAG or OHT who require multiple medications to control their IOP. Additional studies are required for the assessment of the long-term effects of TFC. ClinicalTrials.gov identifier: NCT01217606.

Multiplexed DNA detection using spectrally encoded porous SiO2 photonic crystal particles.

A particle-based multiplexed DNA assay based on encoded porous SiO(2) photonic crystal disks is demonstrated. A "spectral barcode" is generated by electrochemical etch of a single-crystal silicon wafer using a programmed current-time waveform. A lithographic procedure is used to isolate cylindrical microparticles 25 microm in diameter and 10 microm thick, which are then oxidized, modified with a silane linker, and conjugated to various amino-functionalized oligonucleotide probes via cyanuric chloride. It is shown that the particles can be decoded based on their reflectivity spectra and that a multiple analyte assay can be performed in a single sample with a modified fluorescence microscope. The homogeneity of the reflectivity and fluorescence spectra, both within and across the microparticles, is also reported.

Researching multiple publics through latent profile analysis: Similarities and differences in science and technology attitudes in China, Japan, South Korea and the United States.

How science and technology attitudes vary across the United States, China, South Korea and Japan - all of which top Bloomberg's list of high-tech centralization - is explored through data from the sixth wave of the World Values Survey (2010-2014). The following study examines the presence of different types of attitudinal groups using latent profile analysis. Not only do unique attitudinal groups exist in each country, but each group is uniquely influenced by select demographic characteristics, including education, age, gender, religiosity, employment status and individual interaction with technology. The findings provide insight into public attitudes towards science and technology across social and cultural contexts and generate nuanced understandings of similar and different attitudinal groups in East Asia and the United States.

"Go Girls!": psychological and behavioral outcomes associated with a group-based healthy lifestyle program for adolescent girls.

The objective of this study was to assess changes in adolescent girls' health-enhancing cognitions and behaviors targeted by the Go Girls! group-based mentorship lifestyle program. Three hundred and ten adolescent girls (nested within 40 Go Girls! groups) completed questionnaires that assessed cognitions (attitudes, self-regulatory efficacy, and intentions) and behaviors (physical activity and dietary) at four time points (two pre-program, one at the end of the program, and one at 7-week follow-up). Hierarchical linear modeling was used to examine changes in the outcome variables among Go Girls! participants (M age = 11.68 years, SD = 0.80). No significant changes occurred in the outcome variables during the baseline comparison period (Time 1-2). When compared to the average of the baseline assessments, 7 weeks after completing the program, girls reported significant improvements in physical activity (M Baseline PAtotal = 3.82, SD = 3.49; M T4 PAtotal = 4.38, SD = 3.75) and healthy eating (M Baseline = 10.71, SD = 1.13; M T4 = 11.35, SD = 1.05) behavior and related cognitions (d values ≥0.65). Findings provide preliminary support for programs that foster belongingness and target health behaviors through mentorship models.