Anxiety, depression and global distress among African American young adults with uncontrolled asthma.

BACKGROUND: Anxiety and depression are mental health disorders that are often comorbid with asthma. Urban African American young adults with asthma often experience increased risk of anxiety and depression. OBJECTIVE: To explore relationships between symptoms of psychological distress and asthma-related anxiety with asthma outcomes among urban African American young adults with poorly controlled persistent asthma. METHODS: A secondary analysis of baseline data from a larger study of 141 African American young adults with uncontrolled persistent asthma was examined. Participants completed the Brief Symptom Inventory (BSI-18), Youth Asthma-related Anxiety Scale, Asthma Control Test (ACT), a daily diary to assess asthma symptoms; and number of asthma attacks. Spirometry assessed airway obstruction. Generalized linear models tested associations. RESULTS: In multivariable models testing, higher somatization scores were significantly associated with lower ACT scores (adjusted ß = -0.49; 95% CI = -0.69, -0.28; p < 0.01), and higher symptoms (adjusted ß = 0.39; 95% CI = 0.14, 0.65; p < 0.01). After adding asthma-related anxiety to the model, the somatization subscale and asthma-related anxiety were significantly associated with ACT scores (adjusted ß = -0.36; 95% CI = -0.57, -0.15; p < 0.01), (adjusted ß = -0.32; 95% CI = -0.50, -0.14; p < 0.01), respectively. Asthma-related anxiety was also significantly associated with asthma attacks (adjusted ß = 0.24; 95% CI = 0.05, 0.43; p < 0.05). CONCLUSION: This study suggests, asthma-related anxiety may differ from general anxiety and be related to poorly controlled asthma among African American young adults.

Healthy Choices Intervention is Associated with Reductions in Stigma Among Youth Living with HIV in the United States (ATN 129).

Considering the lack of validated stigma reduction interventions for youth living with HIV (YLWH), we evaluated effects of the Healthy Choices intervention on HIV-related stigma among YLWH. We analyzed data from the Adolescent Medicine Trials Network protocol 129, multi-site randomized controlled trial, applying latent growth curve modeling with two linear slopes estimating changes in Berger's Stigma Scale pre-intervention, 16, 28, and 52 weeks post-intervention, as well as the trajectory of stigma scores over the follow-up period (N = 183). Expected value for the growth intercept was statistically significant (Bintercept = 2.53; 95% CI 2.32, 2.73; p < 0.001), as were differences in the change from baseline to 16-week follow-up (Bintercept slope1 = - 0.02; 95% CI - 0.04, 0.01; p = 0.034). Expected value of the slope factor measuring growth over the follow-up period was non-significant suggesting that stigma scores were stable from 28 to 52 weeks. Our findings warrant replication and additional research comparing effects of this intervention to counterfactual controls.

RESUMEN: Teniendo en cuenta la falta de intervenciones validadas de reducción del estigma para los jóvenes que viven con el VIH (PVVS), evaluamos los efectos de la intervención Healthy Choices sobre el estigma entre los PVVS. Analizamos los datos del ensayo controlado aleatorio de múltiples sitios del protocolo 129 de Adolescent Medicine Trials Network, aplicando un modelo de curva de crecimiento latente con dos pendientes lineales que estiman los cambios de Berger's Stigma Scale antes de la intervención, ya a las 16, 28 y 52 semanas después de la intervención, así como la trayectoria de los niveles de estigma durante el período de seguimiento (N = 183). El valor esperado para el intercepto de crecimiento fue estadísticamente significativo (Bintercept = 2.53 IC del 95%: 2.32, 2.73 p < 0.001), así como las diferencias en el cambio desde el inicio hasta el seguimiento de 16 semanas (Bintercept slope 1 = -0.02 IC del 95% IC: -0.04, 0.01 p = 0.034). El valor esperado del factor que mide el crecimiento durante el período de seguimiento no fue significativo, sugiere que los niveles de estigma se mantuvieron estables de 28 a 52 semanas. Nuestros resultados justifican la replicación y la investigación adicional al comparar la intervención con comparativos.

Feasibility of Ethyl Glucuronide Nail Testing Biomarker for Alcohol Use Among Youth Living With HIV.

PURPOSE: We assessed the feasibility of the ethyl glucuronide biomarker (EtG) through nail sampling to measure alcohol use among youth living with HIV in the United States (YLWH, N = 183); we also evaluated concordance between this EtG biomarker and self-reported measures of alcohol use, specifically, the Alcohol Timeline Followback (TFLB) and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). METHODS: EtG, TFLB, and ASSIST were collected at 4 points over 1 year. At baseline and 52 weeks, 78.1% and 70.1%, respectively, provided a valid (full or partial) sample. RESULTS: At 16 weeks, EtG was associated with ASSIST (r = .25, p < .05). At 28 weeks and 52 weeks, TFLB and ASSIST were correlated with EtG (at 28 weeks r = .23, p < .05 and r = .41, p < .01, respectively; at 52 weeks r = .34, p < .01 and r = .25, p < .05, respectively). CONCLUSIONS: We found that nail-based EtG biomarker was feasible to measure alcohol use among YLWH; we also found concordance between EtG, TLFB, and ASSIST, supporting ongoing use of self-reported alcohol use measures with YLWH.