Strategies for recruiting adolescents in rural areas in firearm injury research.

BACKGROUND: Participant recruitment is a central aspect of human sciences research. Barriers to participant recruitment can be categorised into participant, recruiter and institutional factors. Firearm injury research poses unique barriers to recruitment. This is especially true for rural adolescents, who are at high risk for firearm-related injury and death, and whose voice is often absent in firearms research. In particular, recruitment strategies targeting adolescents should align with developmental changes occurring during this life stage. Identifying strategies to address recruitment barriers tailored to firearm-related research can help future researchers engage rural adolescents in injury prevention efforts. PURPOSE: The purpose of the current methodology paper is to outline barriers and provide strategies for recruiting rural adolescents in firearms research informed by the Youth Experiences in Rural Washington: Research on Firearm Safety project, a mixed-methods, community-based participatory research study of 13-18 year-olds residing in rural Washington. STRATEGIES: Recruitment barriers and related strategies were organised by participant-related and recruiter-related/institutional-related factors. While carrying out the study, key considerations or strategies which addressed multiple participant and recruiter/institutional factors, emerged with potential to enhance firearm-related research with rural adolescents more broadly. Key considerations included logistics (ie, scheduling flexibility, adequate and aligned incentives), use of a community-based participatory research approach and accounting for developmental stage. CONCLUSION: Reducing the burden of firearm injury and death for rural adolescents and developing effective interventions requires understanding and navigating recruitment barriers. Strategies used in the current project can guide future qualitative or mixed methods data collection informing firearm injury prevention.

Addressing the Spectrum of Opioid Misuse Prevention, Treatment, and Recovery in Rural Washington State Communities: Provider Identified Barriers and Needs.

The opioid overdose epidemic has significantly impacted rural communities. Rural settings present unique challenges to addressing opioid misuse. The purpose of the current study was to understand the similarities and differences between rural and urban-based providers serving rural communities. Washington state-based opioid-related service providers who serve rural communities (N = 75) completed an online survey between July and September 2020. Chi-square tests of association were used to examine significant differences in proportions between rural providers and rural-serving urban providers across opioid prevention, treatment, and recovery training topics. Rural providers reported receiving significantly less opioid treatment and recovery training on the criminal legal system, workplace-based education on treatment and recovery, and co-occurring disorder treatment; and significantly higher prior opioid prevention training on the prevention programs for youth and accessing prevention funding. Differences between rural and rural-serving urban providers demonstrate ways in which rural-urban partnerships can be strengthened to enhance public health.

Bullying and physical violence and their association with handgun carrying among youth growing up in rural areas.

OBJECTIVES: This study builds on prior research showing a strong relationship between handgun carrying and delinquent behaviors among urban youth by examining the association between handgun carrying trajectories and various types of violence in a rural sample. METHODS: This study uses data from a longitudinal cohort study of 2002 public school students in the United States from 12 rural communities across 7 states from ages 12-26 (2005-2019). We used logistic regressions to assess associations of various bullying and physical violence behaviors with latent trajectories of handgun carrying from adolescence through young adulthood. RESULTS: Compared to youth with very low probabilities of carrying a handgun in adolescence and young adulthood, trajectories with high probabilities of handgun carrying during adolescence or young adulthood were associated with greater odds of using bullying (odds ratios (ORs) ranging from 1.9 to 11.2) and higher odds of using physical violence during adolescence (ORs ranging from 1.5 to 15.9) and young adulthood (ORs ranging from 1.9 to 4.7). These trajectories with higher probabilities of handgun carrying were also associated with greater odds of experiencing physical violence like parental physical abuse and intimate partner violence, but not bullying. CONCLUSION AND IMPLICATION: Experiencing and using bullying and physical violence were associated with specific patterns of handgun carrying among youth growing up in rural areas. Handgun carrying could be an important focus of violence prevention programs among those youth.

Exploring the associations between middle adolescent romantic activity and positive youth development.

INTRODUCTION: Although prior research has demonstrated romantic involvement can negatively impact adolescent well-being, it may also provide a context for developing characteristics of positive youth development (PYD). The present study explored the associations between adolescent romantic involvement and PYD. Study aim-1 determined if participation in different romantic activities was associated with PYD. Study aim-2 specifically focused on adolescents in romantic relationships, testing if relationship quality was associated with PYD. METHODS: The study was a secondary analysis of cross-sectional data from the age-15 assessment of the NICHD Study of Early Child Care and Youth Development. Study aim-1 used data from 826 15-year-olds (50% female) who reported their romantic socializing, dating, and relationship involvement. Study aim-2 used data from 190 15-year-olds (52% female) in romantic relationships who reported positive and negative interactions in their relationships. For both study aims, PYD was assessed as psychosocial maturity, peer competence, and school bonding. RESULTS: Based on hierarchical regression models, romantic socializing was positively associated with psychosocial maturity, peer competence, and school bonding; dating was positively associated with peer competence and school bonding; and relationship involvement was negatively associated with psychosocial maturity and school bonding. In terms of relationship quality, only one significant association emerged such that positive interactions were positively associated with peer competence. CONCLUSIONS: Overall, results supported the expectation that romantic involvement is associated with PYD during middle adolescence. However, the potential benefits of romantic involvement may be limited to the on-time romantic activities of romantic socializing and dating.

Parenting Practice, Leisure Experience, and Substance Use Among South African Adolescents.

There is limited understanding of parents' role in positive youth/adolescent development through leisure in developing countries. Using a sample of 6626 8th grade students in South Africa, this study examined the interrelationships among parenting practice, adolescents' leisure experience, and substance use. Results of structural equation modeling showed that parental leisure involvement was associated with less substance use, while parental leisure over-control was associated with greater substance use. The relationship of parental leisure involvement to substance use was mediated by healthy leisure engagement. The relationship of parental leisure over-control to substance use, on the other hand, was mediated by leisure boredom and healthy leisure engagement. The model path coefficients had little variation between genders and socioeconomic groups except that parental leisure over-control had a stronger positive relationship with leisure boredom for males than females. Theoretical and practical implications were discussed.

With a little help from my friends? A longitudinal look at the role of peers versus friends on adolescent alcohol use.

INTRODUCTION: Alcohol is the most commonly used substance by South African adolescents. Social norms play a key role in alcohol use, although distinctions are not always made between descriptive and injunctive norms and peer proximity. Additionally, little research identifies factors attenuating social norms, peer proximity, and alcohol use, such as one's ability to resist peer influence. METHODS: The current study investigates the relationship between adolescent alcohol use in 9th Grade and descriptive peer and injunctive friend norms in 8th grade, the moderating role of resistance to peer influence, and sex differences. Data were from South African students (N = 3592; Mage = 14) participating in the HealthWise South Africa implementation quality trial. RESULTS: Path model results indicated injunctive friend norms, but not peer norms, influenced alcohol use. Resistance to peer influence did not moderate relationships and group comparisons found no sex differences. CONCLUSION: Findings suggest social proximity shapes influences of alcohol use. Despite a differing cultural context, findings were consistent with those from the United States, indicating social proximity is relevant cross-culturally.

Moving Beyond Drinking to Have a Good Time: a Person-Centered Approach to Identifying Reason Typologies in Legal-Aged College Student Drinkers.

Alcohol use, reasons for use, and consequences of use continue to be a major concern in college student populations. This is especially true for students of legal drinking age who may experience different reasons for and greater negative consequences of alcohol use than students under 21 years old. Although multiple studies have used person-centered approaches to understand motivations for and ultimately prevent alcohol use, few have identified multiple typologies of reasons for alcohol use. The current study used latent class analysis to identify homogeneous subtypes of reasons for alcohol use and how classification was associated with alcohol-related consequences in college students aged 21 years old and older (N = 2300) from the 2013 Indiana College Substance Use Survey. Four profiles of reasons for alcohol use emerged across males and females: social drinkers, feel good drinkers, relaxed escaping drinkers, and emotion coping drinkers. Although the likelihood of consequences differed across gender, the emotion coping drinkers were more likely to experience all negative consequences, suggesting that it was a high-risk class. In general, this pattern of risk continued with the feel good drinkers and female relaxed escaping drinkers. These results can help optimize college substance use prevention and intervention efforts to (1) identify and understand characteristics of high- and low-risk student drinkers and (2) tailor the content of interventions to those specific profiles resulting in more effective approaches to reducing alcohol use.

Trajectories of adolescent substance use development and the influence of healthy leisure: A growth mixture modeling approach.

Considerable heterogeneity exists in adolescent substance use development. To most effectively prevent use, distinct trajectories of use must be identified as well as differential associations with predictors of use, such as leisure experience. The current study used a person-centered approach to identify distinct substance use trajectories and how leisure is associated with trajectory classes. Data came from a larger efficacy trial of 2.249 South African high school students who reported substance use at any time across 8 waves. Growth mixture modeling was used to identify developmental trajectories of substance use and the influence of healthy leisure. Results identified three increasing and one stable substance use trajectory and subjective healthy leisure served to protect against use. This study is the first of its kind to focus on a sample of South African adolescents and serves to develop a richer understanding of substance use development and the role of healthy leisure.

Perceptions of alcohol use by friends compared to peers: Associations with middle adolescents' own use.

BACKGROUND: In this study, the authors (a) distinguished between adolescents' perceptions of their peers' and friends' alcohol use to examine the unique associations these perceptions have on adolescents' own alcohol use and (b) tested if the ability to resist peer influence moderated those associations. METHODS: Data were from the Study of Early Child Care and Youth Development (N = 876, all aged 15). Adolescents reported (a) perceptions of alcohol use by their peers, (b) perceptions of alcohol use by their friends, (c) their own alcohol use in the last year, and (d) a measure of their ability to resist peer influence. Data were analyzed with hierarchical logistic regression (HLR), controlling for demographic variables and parental knowledge. RESULTS: Three HLR models were computed: 1 for the full sample, 1 for only males, and 1 for only females. In all models, perceptions of alcohol use by friends (odds ratios [ORs]: ORFull = 10.17, ORFemale = 15.51, ORMale = 7.25) were associated with a greater likelihood of adolescents using alcohol themselves. Perceptions of alcohol use by peers (ORFull = 1.13, ORFemale = 1.11, ORMale = 1.14) were not significantly associated with adolescents' own alcohol use. The ability to resist peer influence did not moderate any of those associations. CONCLUSIONS: It appears that when adolescents perceive more of their friends, but not their peers, consume alcohol, they themselves are at greater risk for alcohol use, and those associations do not depend upon their ability to resist peer influence.

The Role of Cooperative Extension in Delivering Training and Technical Assistance to Support Evidence-Based Behavioral Health Practices in Rural Communities.

The opioid epidemic in the United States continues to disproportionately affect those in rural, compared to urban, areas due to a variety of treatment and recovery barriers. One mechanism to increase capacity of rural-serving providers is through delivery of training and technical assistance (TTA) for evidence-based programs by leveraging the Cooperative Extension System. Guided by the Interactive Systems Framework, the current study evaluates TTA delivered by the Northwest Rural Opioid Technical Assistance Collabroative to opioid prevention, treatment, and recovery providers on short- (satisfaction, anticipated benefit), medium-, (behavioral intention to change current practice), and long-term goals (changes toward adoption of evidence-based practices). We also evaluated differences in short- and medium-term goals by intensity of TTA event and rurality of provider. Surveys of 351 providers who received TTA indicated high levels of satisfaction with TTA events attended, expressed strong agreement that they would benefit from the event, intended to make a professional practice change, and preparation toward implementing changes. Compared to urban-based providers, rural providers reported higher intention to use TTA information to change current practice. We conclude with a review of remaining gaps in the research to practice pipeline and recommendations for moving forward.

The association of alcohol use and heavy drinking with subsequent handgun carrying among youth from rural areas.

PURPOSE: Alcohol use and handgun carrying are more prevalent among youth in rural than urban areas and their association may be stronger among rural adolescents. Alcohol use may be modifiable with implications for reducing handgun carrying and firearm-related harm. We examined the association between lagged alcohol use and subsequent handgun carrying in rural areas and examined variation in the association by developmental stages, hypothesizing that it would be stronger among adolescents than youth adults. METHODS: We used a longitudinal sample of 2,002 adolescents from ages 12 to 26 growing up in 12 rural communities in 7 states with surveys collected from 2004 to 2019. We estimated the association of lagged past-month alcohol use on handgun carrying in the subsequent 12 months using population-average generalized estimating equations with logistic regression on multiply imputed data. FINDINGS: During adolescence (ages 12-18), those who drank heavily had 1.43 times the odds (95% CI = [1.01, 2.03]) of subsequent handgun carrying compared to those who did not drink alcohol, and those who consumed alcohol but did not drink heavily had 1.30 times the odds of subsequent handgun carrying compared to those who did not drink (95% CI = [0.98, 1.71]). During young adulthood (ages 19-26), associations of alcohol use (OR = 1.28; 95% CI = [0.94, 1.63]) and heavy drinking (OR = 1.38; 95% CI = [1.08, 1.68]) were similar to adolescence. CONCLUSIONS: Alcohol use and subsequent handgun carrying were positively associated during adolescence and young adulthood among individuals who grew up in rural areas, similar to findings in urban areas. Reducing alcohol use may be an important strategy to prevent handgun carrying and firearm-related harm among young people in rural areas.

Older and Wiser? Age-related Change in State and Trait Boredom During Adolescence and Associations with Neural Correlates of Self-regulation.

Purpose: The purpose of the current study was to examine age-related change in state and trait boredom in 12- to 17-year-old adolescents and test whether neurophysiological correlates of self-regulation relate to boredom during adolescence in the same way that has been found in adults. Methods: Eighty-nine 12- to 17-year-old adolescents participated. Three types of trait boredom were measured: boredom proneness, leisure boredom, and boredom susceptibility. State boredom was also measured after completing a boredom induction task while EEG was recorded. Slopes in frontal alpha asymmetry (FAA) were extracted from the EEG as a measure of approach (leftward shifts) or avoidance (rightward shifts). Results: A curvilinear relationship between age and boredom proneness and age and boredom susceptibility was observed, indicating trait boredom rises and falls across adolescence. State boredom, by contrast, increased linearly with age. Slopes in FAA inversely related only to boredom proneness, indicating higher levels of this type of trait boredom related to an avoidant response as a state of boredom ensues. Conclusion: We suggest the rise and fall of trait boredom across adolescence may be due to changes in person-environment fit during middle adolescence, whereas state boredom may increase with age due to improvements in attentional processes that mundane lab tasks do not satisfactorily engage. The link between FAA and only one type of trait boredom indicates self-regulatory processes and boredom are not yet strongly coupled in adolescence. Implications for prevention of negative behavioral health outcomes associated with high levels of trait boredom are discussed.

Associations Between Trait Boredom and Frequency of Cannabis, Alcohol, and Tobacco Use in College Students.

Objective: Boredom is a common emotion associated with substance use in college students - a group already at risk for substance misuse. The purpose of this study is to understand how two types of trait boredom (susceptibility and proneness) in college students are associated with frequency of cannabis, alcohol, and tobacco use. Method: Data were collected from an online survey completed by a sample of undergraduate students (N = 414, Mage = 19.55, 84.5% female; 64.3% White) enrolled at a large public university in the northwest. Multivariate logistic regression was used to evaluate the association between trait boredom and frequency of cannabis, alcohol, and tobacco use after controlling for age, sex, and race. Results: Boredom susceptibility was a significant predictor of annual, monthly, and weekly cannabis and alcohol use, but only annual and monthly tobacco use. Boredom proneness was only a significant predictor for monthly alcohol use. Conclusions: Findings were generally consistent across types of substances and frequency of use for boredom susceptibility, indicating students higher in susceptibility, rather than proneness, are a subgroup to target prevention interventions to alleviate boredom and subsequent maladaptive coping mechanisms.

School Handgun Carrying Among Youth Growing Up in Rural Communities.

PURPOSE: To characterize school handgun carrying and violence risk factors among rural youth. METHODS: Using a sample of rural youth (n = 1995), we quantified the proportion who carried a handgun to school, carried but not to school, and did not carry across grades 7-12 and endorsed risk factors for violence in individual, peer, school, and community domains. RESULTS: Overall, 3% (95% confidence interval [CI]: 2%-4%) of youth ever carried to school; 15% (95% CI: 14%-16%) carried but not to school; and 82% (95% CI: 80%-84%) never carried. Violence risk factors (e.g., attacking someone) were more commonly endorsed by youth who carried to school (84%; 95% CI: 73%-95%) than those who carried but not to school (51%; 95% CI: 44%-58%) and did not carry (23%; 95% CI: 20%-26%). DISCUSSION: Carrying a handgun to school in rural areas is not common; however, it is associated with risk factors for violence. Understanding violence risk factors among youth who carry handguns to school could inform violence prevention programs in rural areas.

Effect of the Communities That Care Prevention System on Adolescent Handgun Carrying: A Cluster-Randomized Clinical Trial.

Importance: There is little information on upstream community-based interventions that reduce the prevalence of handgun carrying among adolescents, especially those growing up in rural areas. Objective: To test whether Communities That Care (CTC), a community-based prevention system focusing on risk and protective factors for behavioral problems early in life, reduces handgun carrying prevalence among adolescents growing up in rural areas. Design, Setting, and Participants: Community-randomized trial of 24 small towns in 7 states assigned randomly to the CTC or control group with outcomes assessed from 2003 to 2011. Participants were youths attending public schools in grade 5 who received consent from their parents to participate (77% of the eligible population) and were repeatedly surveyed through grade 12 with 92% retention. Analyses were conducted from June to November 2022. Interventions: A coalition of community stakeholders received training and technical assistance to install CTC, used local epidemiologic data to identify elevated risk factors and low protective factors for adolescent behavioral problems, and implemented tested preventive interventions for youth, their families, and schools. Main Outcomes and Measures: Handgun carrying (never vs at least once) operationalized in 2 ways: (1) prevalence of past-year handgun carrying, and (2) cumulative prevalence of handgun carrying from grade 6 through grade 12. Results: Overall, the 4407 study participants' mean (SD) age was 12 (.4) years in both CTC (2405 participants) and control (2002 participants) communities in grade 6; about one-half of participants in each group were female (1220 [50.7 %] in the CTC group and 962 [48.1%] in the control group). From grade 6 through grade 12, 15.5% of participants in CTC communities and 20.7% of those in control communities reported carrying a handgun at least once. Youths in CTC communities were significantly less likely to report handgun carrying at a given grade than those in control communities (odds ratio [OR], 0.73; 95% CI, 0.65-0.82). The most pronounced effects were observed in grade 7 (OR, 0.70; 95% CI, 0.42-0.99), grade 8 (OR, 0.58; 95% CI, 0.41-0.74), and grade 9 (OR, 0.65; 95% CI, 0.39-0.91). Cumulatively from grade 6 through grade 12, youths in CTC communities were significantly less likely to report handgun carrying at least once than those in control communities (OR, 0.76; 95% CI, 0.70-0.84). Overall, CTC reduced the prevalence of past-year handgun carrying by 27% at a given grade and by 24% cumulatively through grade 12. Conclusions and Relevance: In this study, CTC reduced the prevalence of adolescent handgun carrying in participating communities. Trial Registration: ClinicalTrials.gov Identifier: NCT01088542.

Difficulties with Emotion Regulation during COVID-19 and Associations with Boredom in College Students.

COVID-19 related restrictions resulted in a significant lifestyle change for many young adults in the United States. Although boredom and emotional self-regulation are clearly connected in empirical research, the question remains of what this association looks like in unique circumstances, such as early in COVID-19 pandemic at the height of restrictions. The purpose of the current study is to identify the association between boredom proneness and emotion regulation in college students during the COVID-19 pandemic. College students who completed a Boredom Coping Survey between October and December 2019 (n = 481) were recruited for a follow-up COVID-19 Boredom Survey in April 2020. Data from this sub-sample (n = 58) were used in a hierarchical regression predicting the role of boredom proneness on COVID-19 pandemic emotion regulation difficulties while controlling for age, sex, and COVID-19 related lifestyle changes. Findings indicated higher levels of emotion regulation difficulties were associated with higher levels of boredom proneness above and beyond demographic variables and COVID-19 lifestyle changes. Results are in line with prior theory and research on the importance of the environment or situational factors to the experience of boredom.

Sound and Silence: The Effects of Environmental Conditions on State Boredom in an Online Study during the COVID-19 Pandemic.

Boredom is a negative emotion commonly experienced in mundane situations. Boredom is thought to arise from a mismatch between individuals and their expectation for environmental stimulation. People attempt to reduce boredom by increasing the stimulation in their environment (e.g., turning on TV or music). Theories of boredom suggest external stimulation may cue the individual to expect more stimulation than the mundane task offers-thereby increasing boredom. Researchers adapted lab-based tasks to online during the COVID-19 pandemic, which allowed participants to set the study's environmental conditions. Our method involved data collected online during the COVID-19 pandemic. We tested whether 137 college-age participants who reported being alone in a noisy room experienced more boredom after a mundane task than those who were alone in a quiet room. Results showed individuals in a noisier environment reported more boredom following a repetitive task than those in a quieter environment. Some people, high in trait boredom, experience boredom more frequently or cannot tolerate it. Our results revealed that the effects of environmental condition remained after controlling for the influence of trait boredom. In the discussion, we describe links to extant boredom research and implications for researchers collecting data online and individuals attempting to mitigate boredom.

Changes in Social, Economic, and Health Risk Factors Across the Lifespan during the COVID-19 Pandemic: A Latent Transition Analysis.

The COVID-19 pandemic led to unique, pervasive, and changing global impacts. It is imperative to characterize groups of individuals based on modifiable factors, and to describe how groups have been impacted by the continuing pandemic in the United States to promote health and well-being and to inform preventive interventions. We used latent transition analysis to identify subgroups of modifiable psychosocial, economic, and health risk factors; to explore subgroup shifts across time; and to assess the prevalence of non-modifiable factors associated with subgroup membership. We recruited 450 participants 18 years and older living in the United States to complete a longitudinal survey exploring health during the pandemic. Participants completed three waves of data collection from April to November 2020. We used latent transition analysis to identify statuses, shifts in prevalence over three waves, and the relationships of non-modifiable covariates with each status. Five statuses were identified: high risk together, low risk together, high risk alone, low risk alone, and financial risk together. Statuses were relatively stable over time; the majority (60%-66%) of participants were in statuses categorized by multiple indicators of high modifiable risk, and the largest transitions were to lower risk subgroups. Increasing age, being male, and living in an urban area were the only non-modifiable covariates associated with status membership. It is imperative to continue to scale up targeted interventions aimed at promoting resilience, well-being, financial well-being, delays in healthcare use, food insecurity, and depression among individuals in higher-risk subgroups to promote health and well-being.

Trajectories of Handgun Carrying in Rural Communities From Early Adolescence to Young Adulthood.

Importance: Characterizing patterns of handgun carrying among adolescents and young adults can inform programs to reduce firearm-related harm. Longitudinal patterns of handgun carrying among rural adolescents have not been identified. Objectives: To assess specific points of intervention by characterizing patterns of handgun carrying by youths in rural communities from early adolescence to young adulthood and to quantify how age at initiation, duration, and frequency of carrying differ across identified patterns. Design, Setting, and Participants: This cohort study uses the control group of the community-randomized trial of the Communities That Care prevention system, conducted among public school students in 12 rural communities across 7 states. Participants self-reported their handgun carrying at 10 data collection points from 12 to 26 years of age (2005-2019). Data were analyzed from January to July 2021. Main Outcomes and Measures: Handgun carrying in the past 12 months. Latent class growth analysis was used to estimate handgun carrying trajectories. Results: In this longitudinal rural sample of 2002 students, 1040 (51.9%) were male; 532 (26.6%) were Hispanic, Latino, Latina, or Latinx; 1310 (65.4%) were White; and the highest level of educational attainment of either parent was a high school degree or less for 649 students (32.4%). The prevalence of handgun carrying in the last 12 months ranged from 5.3% (95 of 1795) to 7.4% (146 of 1969) in adolescence and increased during the mid-20s (range, 8.9% [154 of 1722] to 10.9% [185 of 1704] from 23 to 26 years of age). Among the participants who reported handgun carrying at least once between 12 and 26 years of age (n = 601 [30.0%]), 320 (53.2%) reported carrying a handgun in only 1 wave. Latent class growth analysis indicated 6 longitudinal trajectories: never or low probability of carrying (1590 [79.4%]), emerging adulthood carrying (166 [8.3%]), steadily increasing carrying (163 [8.1%]), adolescent carrying (53 [2.6%]), declining carrying (24 [1.2%]), and high probability and persistent carrying (6 [0.3%]). The earliest mean (SD) age at initiation of handgun carrying occurred in both the adolescent and declining carrying groups at the ages of 12.6 (0.9) and 12.5 (0.7) years, respectively. More than 20% of some groups (emerging adulthood [age 26 years: 49 of 154 (31.8%)], steadily increasing [age 26 years: 37 of 131 (28.2%)], declining [age 13 years: 7 of 23 (30.4%)], and high probability and persistent carrying [age 15 years: 3 of 6 (50.0%)]) reported carrying 40 times or more in the past year by the age of 26 years. Conclusions and Relevance: This study found distinct patterns of handgun carrying from adolescence to young adulthood in rural settings. Findings suggest that promoting handgun safety in rural areas should start early. Potential high-risk trajectories, including carrying at high frequencies, should be the focus of future work to explore the antecedents and consequences of handgun carrying in rural areas.

Differing Experiences of Boredom During the Pandemic and Associations With Dietary Behaviors.

OBJECTIVE: To examine how changes in feeling bored and eating because of boredom during the coronavirus disease 2019 (COVID-19) pandemic relate to intuitive eating, diet quality, and snacking. METHODS: A representative sample of 360 US adults completed an online survey including changes in feeling bored and eating because of boredom since the COVID-19 pandemic. An ANCOVA and multivariate analysis of covariance were used to examine relationships between intuitive eating, diet quality, and snacking in individuals who experienced: (1) increases in feeling bored and eating because of boredom, (2) eating because of boredom only, (3) increases in feeling bored only, and (4) no change/decreases in feeling bored and eating because of boredom. RESULTS: Individuals who increased feeling bored and eating because of boredom and increased eating because of boredom only snacked more and scored lower in intuitive eating. Diet quality did not differ across groups. CONCLUSIONS AND IMPLICATIONS: Although diet quality did not differ, eating because of boredom is potentially a negative impact on diet quality. Programs enhancing intuitive eating may be helpful.