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1.
J Trauma Stress ; 37(2): 243-256, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38109146

RESUMEN

Prior research with young adults has demonstrated clear associations between experiences of sexual assault, symptoms of posttraumatic stress disorder (PTSD), and alcohol use, but most studies have been cross-sectional or have not considered multiple theoretical pathways to understand these associations. Using six waves of data from a longitudinal cohort sample of 1,719 young adults, we examined associations among experiences of past-year sexual assault (i.e., rape, unwanted sexual touching, and physical intimidation in a sexual way), PTSD symptoms, and the frequency of binge drinking over time, allowing for the exploration of symptom-induced, interpersonal risk, and substance-induced pathways for male and female participants. For both male, ßs = 2.84 to 6.55, and female participants, ßs = 2.96 to 10.1, higher prior levels of PTSD symptoms were associated with larger increases in binge drinking over time. For female participants, higher prior levels of sexual assault were associated with larger increases in PTSD symptoms over time, ßs = 3.48 to 4.25, whereas for male participants, higher prior levels of past-year binge drinking were associated with decreases in PTSD symptoms over time, ßs = -2.75 to -0.53. Continued efforts are needed to prevent sexual assault among young adults and address PTSD symptoms among those who experience sexual assault. Interventions that target binge drinking are also needed for individuals who experience PTSD symptoms, especially young adults, to address potentially hazardous drinking before problems escalate and become chronic.


Asunto(s)
Consumo Excesivo de Bebidas Alcohólicas , Víctimas de Crimen , Delitos Sexuales , Trastornos por Estrés Postraumático , Femenino , Adulto Joven , Masculino , Humanos , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/complicaciones , Estudios Transversales , Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Consumo Excesivo de Bebidas Alcohólicas/complicaciones , Etanol
2.
Pain Med ; 24(2): 122-129, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-36165692

RESUMEN

BACKGROUND: Long-term prescription opioid use is a significant risk factor for opioid morbidity and mortality, and severe traumatic injury is an important initiation point for prescription opioid use. This study examines predictors of long-term prescription opioid use among a racially and ethnically diverse population of patients hospitalized for traumatic injury. METHODS: Study participants (N= 650) from two urban Level I trauma centers were enrolled. Baseline information on demographics, injury characteristics, self-reported pre-injury substance use and mental health, and personality characteristics and attitudes was collected through interviews during the initial hospitalization. Patients were interviewed again at 3 months and 12 months and asked about prescription opioid use in the prior 7 days. Multivariable logistic regressions assessed participants' baseline characteristics associated with opioid use at one or more follow-up interviews. RESULTS: Pre-injury use of prescription painkillers had the strongest association with prescription opioid use at follow-up (adjusted odds ratio: 3.10; 95% confidence interval: 1.86-5.17). Older age, health insurance coverage at baseline, length of hospitalization, higher current pain level, pre-injury post-traumatic stress disorder symptoms, and discharge to a location other than home were also associated with significantly higher odds of prescription opioid use at follow-up. CONCLUSIONS: Providers could consider screening for past use of prescription pain relievers and post-traumatic stress disorder before hospital discharge to identify patients who might benefit from additional resources and support. However, providers should ensure that these patients' pain management needs are still being met and avoid abrupt discontinuation of prescription opioid use among those with a history of long-term use.


Asunto(s)
Analgésicos Opioides , Trastornos Relacionados con Opioides , Humanos , Analgésicos Opioides/uso terapéutico , Trastornos Relacionados con Opioides/epidemiología , Trastornos Relacionados con Opioides/tratamiento farmacológico , Factores de Riesgo , Alta del Paciente , Dolor/tratamiento farmacológico
3.
AIDS Care ; 34(10): 1249-1256, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-34802352

RESUMEN

Supporting Treatment Adherence Readiness through Training (START) is an HIV antiretroviral adherence intervention, based on the Information Motivation and Behavioral skills (IMB) model, that significantly improved adherence in our randomized controlled trial. To understand how and for whom START had its effects on adherence, we examined mediators and moderators. Ninety-nine HIV-patients (53 control, 46 intervention) who enrolled in the trial and provided month 6 electronic monitored adherence data. The intervention was associated with increased adherence-related knowledge and lower impulsive/careless problem solving, but had no effects on other IMB-related constructs. Neither of these variables mediated the adherence effects of the intervention (based on linear regression models with bootstraping for unbiased standard errors). Four variables interacted with the intervention to moderate its effects: the intervention group had consistent high adherence across the range of depression and time since HIV diagnosis, compared to lower adherence with higher values in the usual care control; those with unstable housing or frequent drug use had higher adherence if in the intervention group compared to the control group. These findings suggest that START provides support that enables its recipients to cope with and overcome challenges (e.g., depression, unstable housing, drug use) that would typically impede adherence.Trial registration: ClinicalTrials.gov identifier: NCT02329782.


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Trastornos Relacionados con Sustancias , Fármacos Anti-VIH/uso terapéutico , Antirretrovirales/uso terapéutico , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Humanos , Cumplimiento de la Medicación , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Cumplimiento y Adherencia al Tratamiento
4.
J Behav Med ; 45(2): 260-271, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-34981307

RESUMEN

Emerging adults (18-25 years), particularly racially/ethnically diverse and sexual and gender minority populations, may experience loneliness following major life transitions. How loneliness relates to health and health disparities during this developmental period is not well understood. We examine associations of loneliness with physical (self-rated health), behavioral (alcohol/marijuana consequences; nicotine dependence), and health behavior outcomes (weekday and weekend sleep; trouble sleeping), and investigate moderating effects by sex, race/ethnicity, and sexual/gender minority (SGM) status. Adjusted models using cross-sectional data from 2,534 emerging adults, predominantly in California, examined associations between loneliness and each outcome and tested interactions of loneliness with sex, race/ethnicity, and SGM status. Higher loneliness was significantly associated with worse self-rated health, higher marijuana consequences, less weekday sleep, and greater odds of feeling bothered by trouble sleeping. None of the interactions were significant. Findings suggest that interventions to reduce loneliness may help promote healthy development among emerging adults across subgroups.


Asunto(s)
Soledad , Minorías Sexuales y de Género , Adulto , Estudios Transversales , Identidad de Género , Humanos , Conducta Sexual
5.
Behav Sleep Med ; 20(3): 294-303, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35642294

RESUMEN

OBJECTIVES: Since the beginning of the COVID-19 pandemic, there has been concern that the pandemic and associated mitigation efforts would have a particularly adverse effect on communities that are marginalized. This study examined disparities in the perceived impacts of the pandemic on sleep, mental and physical health, social functioning, and substance use among young adults based on sexual/gender minority (SGM) status and race/ethnicity. METHOD: Participants were 2,411 young adults (mean age = 23.6) surveyed between July 2020-July 2021. A linear regression analysis tested SGM and racial/ethnic group differences on 17 outcomes. RESULTS: Most young adults reported little-to-no effect of the pandemic on sleep or other indicators of health and functioning. However, SGM young adults reported more adverse effects than non-SGM young adults on their sleep and most other outcomes. Hispanic young adults reported shorter sleep duration - but less pandemic-related depression, loneliness, and relationship problems - compared to non-Hispanic white young adults. We found no evidence that young adults with multiple minority statuses had especially poor pandemic-related outcomes. CONCLUSIONS: While most young adults did not perceive much impact of the pandemic, results highlight disparities across certain demographic subgroups that may need to be addressed through targeted interventions and close monitoring for long-term effects.


Asunto(s)
COVID-19 , Etnicidad , Adulto , Minorías Étnicas y Raciales , Humanos , Pandemias , Sueño , Adulto Joven
6.
Fam Community Health ; 45(3): 163-173, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35536714

RESUMEN

Churches can be important settings for promoting physical activity (PA) among Latinx populations. Little is known about what factors across the church context-social, organizational, and physical (outdoor spaces)-are associated with Latinx PA to inform faith-based PA interventions. This study investigated associations of church contextual factors with Latinx PA. We used cross-sectional data from a Latinx adult sample recruited from 6 churches that each had a nearby park in Los Angeles, California (n = 373). Linear or logistic regression models examined associations of church PA social support, PA social norms, perceived quality and concerns about the park near one's church, and church PA programming with 4 outcomes: accelerometer-based moderate-to-vigorous PA (MVPA) and self-reported adherence to PA recommendations, use of the park near one's church, and park-based PA. Park quality and concerns were positively associated with using the park near one's church. Church PA programming was positively associated with park-based PA. None of the factors were related to accelerometer-based MVPA or meeting PA recommendations. Findings suggest targeting church PA programming and nearby parks may be key to improving Latinx park use. Church and local parks department partnerships may help enhance park conditions to support churchgoing Latinx PA and health.


Asunto(s)
Ejercicio Físico , Apoyo Social , Adulto , Estudios Transversales , Humanos , Los Angeles , Autoinforme
7.
AIDS Behav ; 25(10): 3159-3171, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33811266

RESUMEN

The START (Supporting Treatment Adherence Readiness through Training) intervention was examined for its effects on ART adherence and virologic suppression relative to usual care. A sample of 176 clients about to start or restart ART were randomized (83 to START, 93 to usual care) at HIV clinics in the Los Angeles area. Primary outcomes included electronically monitored dose-taking adherence and HIV viral load; primary end points were months 6 and 24, with group differences examined using nonresponse-weighted means or proportions, effect sizes, and significance testing. Item nonresponse was addressed using multiple imputation. 166 (94.3%) participants started ART, of whom 124 (74.7%) were still in care at month 6, and 90 (54.2%) at month 24. In comparison to the usual care control group, the START group had higher dose-taking adherence at month 6 (86.2% vs. 71.6%, d = 0.56, p = 0.01), which was sustained through month 24 (86.0% vs. 61.1%, d =1.01, p < 0.0001). While rates of undetectable viral load did not differ between groups at month 6 or 24, the mean reduction in viral load (log10 copies/mm3) at month 24 was significantly greater in the intervention arm (3.0 vs. 2.7; d = 0.40, p = 0.047). An estimated cost of $132 per person was needed to obtain a 10% increase in dose-taking adherence over 24 months from the intervention. These findings suggest that START is cost effective in producing a medium to large effect on dose-taking adherence that is durable over 24 months, and a modest long-term effect on viral reduction.Trial registration Clinicaltrials.gov NCT02329782 (registered December 22, 2014).


Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Fármacos Anti-VIH/uso terapéutico , Antirretrovirales/uso terapéutico , Análisis Costo-Beneficio , Infecciones por VIH/tratamiento farmacológico , Humanos , Cumplimiento de la Medicación , Cumplimiento y Adherencia al Tratamiento , Carga Viral
8.
Am J Addict ; 30(2): 122-130, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33378105

RESUMEN

BACKGROUND AND OBJECTIVES: To expand on epidemiologic studies examining associations between the legalization of recreational cannabis and use among young adults, we examined the associations between licensed and unlicensed cannabis outlet density and cannabis outcomes. METHODS: A total of 1097 young adults aged 21 and older living in Los Angeles County were surveyed before licensed recreational cannabis outlets opened (Time 1: July to December 2017) and after (Time 2: July 2018 to June 2019). Using a database of open licensed and unlicensed cannabis retailers to calculate individual-level cannabis outlet density measures, we examined associations between outlet density within a 4-mile radius of participants' residences with Time 2 outcomes of any past-month use, daily use, intentions to use, quantity used, consequences, and cannabis use disorder (CUD) symptoms. RESULTS: After controlling for demographic factors and cannabis outcomes at a time point prior to their opening (Time 1), licensed cannabis outlets were associated with young adults' cannabis use, heavy use, and intentions, and unlicensed outlets were associated with young adults' heavy cannabis use and CUD symptoms. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: This study expands beyond studies of outlet prevalence to find that, after controlling for outcomes 1 year prior, licensed and unlicensed outlets were associated with young adults' cannabis outcomes. The current study is among the first to find associations between cannabis use outcomes and density of cannabis outlets among young adults using data from two time points: preopening and postopening of recreational cannabis retailers. Findings can inform policies around the density and placement of cannabis outlets. (Am J Addict 2020;00:00-00).


Asunto(s)
Cannabis , Comercio/estadística & datos numéricos , Drogas Ilícitas/legislación & jurisprudencia , Concesión de Licencias/estadística & datos numéricos , Fumar Marihuana/epidemiología , Comercio/organización & administración , Femenino , Humanos , Los Angeles/epidemiología , Masculino , Encuestas y Cuestionarios , Adulto Joven
9.
Muscle Nerve ; 62(1): 60-69, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32304244

RESUMEN

INTRODUCTION: The quality of electrodiagnostic tests may influence treatment decisions, particularly regarding surgery, affecting health outcomes and health-care expenditures. METHODS: We evaluated test quality among 338 adults with workers' compensation claims for carpal tunnel syndrome. Using simulations, we examined how it influences the appropriateness of surgery. Using regression, we evaluated associations with symptoms and functional limitations (Boston Carpal Tunnel Questionnaire), overall health (12-item Short Form Health Survey version 2), actual receipt of surgery, and expenditures. RESULTS: In simulations, suboptimal quality tests rendered surgery inappropriate for 99 of 309 patients (+32 percentage points). In regression analyses, patients with the highest quality tests had larger declines in symptoms (-0.50 point; 95% confidence interval [CI], -0.89 to -0.12) and functional impairment (-0.42 point; 95% CI, -0.78 to -0.06) than patients with the lowest quality tests. Test quality was not associated with overall health, actual receipt of surgery, or expenditures. DISCUSSION: Test quality is pivotal to determining surgical appropriateness and associated with meaningful differences in symptoms and function.


Asunto(s)
Síndrome del Túnel Carpiano/cirugía , Electrodiagnóstico/normas , Gastos en Salud/normas , Servicios de Salud del Trabajador/normas , Medición de Resultados Informados por el Paciente , Indicadores de Calidad de la Atención de Salud/normas , Adulto , Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Carpiano/economía , Electrodiagnóstico/economía , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Servicios de Salud del Trabajador/economía , Indicadores de Calidad de la Atención de Salud/economía , Resultado del Tratamiento
10.
Nicotine Tob Res ; 22(12): 2178-2187, 2020 12 12.
Artículo en Inglés | MEDLINE | ID: mdl-32047910

RESUMEN

INTRODUCTION: Tobacco companies have devoted increased resources in recent years to developing and marketing heated tobacco products (HTPs) as alternatives to combustible products like cigarettes. However, little is known about correlates of awareness and use of these products in American young adults. METHODS: Two thousand four hundred ninety-seven young adults (mean age = 21.6) completed survey items on HTP awareness and lifetime use in 2018-2019. Logistic regression models compared young adults who were (1) unaware of HTPs (reference group) with those who were, (2) aware of HTPs, and (3) had ever used HTPs on demographic, tobacco, and other substance use characteristics. Among current smokers, these groups were compared on cigarette use, dependence, and readiness to quit. RESULTS: Approximately 12% of respondents (n = 293) were aware of HTPs, and 5% (n = 134) reported lifetime HTP use. Controlling for demographics, HTP awareness and use were both associated with greater use of all types of tobacco products, number of different tobacco products, and use of marijuana and other drugs. Among current smokers, HTP awareness and use correlated with heavier cigarette consumption, greater dependence, and past-month marijuana use, but not with recent quit attempts or thinking about quitting cigarettes. CONCLUSIONS: Awareness and use of HTPs among young adults were associated with greater use of tobacco products and other substances and, among current smokers, with greater cigarette dependence (but not cessation-related factors). As these products become increasingly available in the United States, additional surveillance and monitoring activities are needed to better understand use patterns, consequences, and reasons for using HTPs. IMPLICATIONS: Few studies have examined factors associated with awareness and use of heated tobacco products (HTPs) among US young adults. HTP awareness and lifetime use correlated with a range of factors, including male gender, white race/ethnicity, and tobacco and other substance use. Lifetime use of HTPs was low (5%); most lifetime HTP users reported history of other tobacco use, but a sizeable minority (14%) reported no other tobacco product use history. Among current cigarette smokers, cigarette dependence, poly-tobacco use, and marijuana use-but not cigarette cessation attempts or contemplation-were associated with greater likelihood of awareness and use of HTPs.


Asunto(s)
Comportamiento del Consumidor , Conocimientos, Actitudes y Práctica en Salud , Productos de Tabaco/estadística & datos numéricos , Tabaquismo/epidemiología , Adulto , Estudios Transversales , Utilización de Equipos y Suministros , Femenino , Calor , Humanos , Estudios Longitudinales , Masculino , Factores de Riesgo , Encuestas y Cuestionarios , Factores de Tiempo , Tabaquismo/psicología , Estados Unidos/epidemiología , Adulto Joven
11.
J Behav Med ; 43(2): 318-328, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31396821

RESUMEN

Use of alternative tobacco products, as well as regular cigarettes, is widespread among unaccompanied youth experiencing homelessness. However, little is known about their level of motivation for quitting use of these products, factors associated with motivation to quit, or how these might vary by type of tobacco product. Unaccompanied homeless youth were sampled from 25 street and service sites in Los Angeles County (N = 469). All participants were past month tobacco users who completed a survey on their tobacco-related behaviors and cognitions, including motivation to quit, as well as background characteristics. Among self-reported users of each product, motivation to quit in the next 30 days was highest for regular cigarettes (33%), followed by e-cigarettes/vaporizers (30%), little cigars/cigarillos (25%), cigars (20%), and natural cigarettes (20%). Between 33 and 49% of youth, depending on product, were not thinking about quitting at all. Correlates of lower motivation to quit differed somewhat by product type, with the most consistent being race, more frequent use, lower perceived riskiness of the product, and using the product because of its good taste or smell. Results from this study identify a set of psychosocial and behavioral factors, some that are common across tobacco products and others that are product-specific, that may be particularly important to address in efforts to reduce tobacco use among youth experiencing homelessness. Future regulations on the sale of flavored tobacco products may also serve to increase motivation to quit in this population.


Asunto(s)
Personas con Mala Vivienda/estadística & datos numéricos , Motivación , Cese del Hábito de Fumar/psicología , Dispositivos para Dejar de Fumar Tabaco , Uso de Tabaco/epidemiología , Adolescente , Sistemas Electrónicos de Liberación de Nicotina , Femenino , Personas con Mala Vivienda/psicología , Jóvenes sin Hogar/psicología , Jóvenes sin Hogar/estadística & datos numéricos , Humanos , Masculino , Prevalencia , Encuestas y Cuestionarios , Nicotiana , Productos de Tabaco , Uso de Tabaco/psicología
12.
Prev Sci ; 21(4): 530-544, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31960260

RESUMEN

The changing legal landscape of cannabis in the USA has coincided with changes in how cannabis is used, including its co-use with other substances. This study analyzed 10 years of data from a diverse cohort of youth (N = 2429; 54% Hispanic, 16% Asian, 16% white, 3% black, 10% multiracial) to examine predictors in early and late adolescence of co-use of alcohol with cannabis (AC) and tobacco with cannabis (TC) at age 21. Two forms of co-use were examined: concurrent (use of both substances in past month) and sequential (use of one substance right after the other). Analyses focused on four predictor domains: individual (e.g., resistance self-efficacy), peer (e.g., time spent around peers who use), family (e.g., sibling use), and neighborhood (i.e., perceived alcohol and drug problems in neighborhood). For each co-use combination (AC or TC), we estimated parallel process piecewise latent growth models in a structural equation modeling framework using Mplus v8. The final AC and TC co-use models included all predictor variables from the four domains. Increases in positive expectancies and time spent around peers who use AC, as well as steeper decreases in resistance self-efficacy, were all related to a greater likelihood of AC co-use in young adulthood. Increases in sibling TC use and time spent around peers who use TC, as well as steeper decreases in resistance self-efficacy, were all related to a greater likelihood of TC co-use in young adulthood. Overall, findings highlight the importance of addressing peer influence in prevention programming during both early and late adolescence.


Asunto(s)
Conducta del Adolescente , Consumo de Bebidas Alcohólicas , Fumar Marihuana , Uso de Tabaco , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , California , Estudios Transversales , Femenino , Humanos , Masculino , Fumar Marihuana/epidemiología , Medición de Riesgo , Factores de Riesgo , Encuestas y Cuestionarios , Uso de Tabaco/epidemiología , Adulto Joven
13.
Nicotine Tob Res ; 21(10): 1414-1422, 2019 09 19.
Artículo en Inglés | MEDLINE | ID: mdl-30277535

RESUMEN

BACKGROUND: Longitudinal studies report associations between use of electronic cigarettes (ECs) and cigarettes over time among young people, but do not distinguish within- from between-person effects, which complicates interpretation of findings. Further, the role of shared risk factors, such as substance use and mental health, in explaining longitudinal associations between EC and cigarette use remains unclear. This study used within- and between-person analyses to assess longitudinal associations between youths' EC and cigarette use and shared risk factors. METHODS: Between 2015 and 2017, 2039 youths completed three Web-based surveys, allowing us to model EC and cigarette use from ages 16 to 20. Auto-regressive latent growth models with structured residuals (ALT-SR) examined both between-person and within-person associations between past-month frequency of EC use, cigarette use, and third variables (alcohol and marijuana use, mental health symptoms) over time. RESULTS: Models revealed robust reciprocal associations between EC and cigarette use, such that more frequent EC use at one time predicted more frequent cigarette use at the subsequent time, and vice versa. Between-person analyses showed associations between shared risk factors and both EC and cigarette use. However, shared risk factors did not predict frequency of subsequent EC and cigarette use in within-person analyses. CONCLUSIONS: Findings add to a growing body of research suggesting that EC use among youth is prospectively associated with progression toward greater cigarette use. Shared risk factors may help explain differences in EC and cigarette use patterns between young people, but do not appear to influence longitudinal trajectories of EC and cigarette use within individuals. IMPLICATIONS: This study examined within- and between-person associations between e-cigarette use, cigarette use, and shared risk factors (alcohol use, marijuana use, mental health symptoms) in a longitudinal cohort of youths. Within- and between-person analyses revealed reciprocal prospective associations between e-cigarette and cigarette use, suggesting a progression toward more frequent use of both products over time. The shared risk factors examined here did not affect escalations in e-cigarette or cigarette use over time within individuals, but likely influence which youths use these products. Findings add to a growing body of evidence suggesting that e-cigarette use increases subsequent cigarette use in young people.


Asunto(s)
Fumar Cigarrillos/epidemiología , Vapeo/epidemiología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Encuestas Epidemiológicas , Humanos , Fumar Marihuana , Factores de Riesgo , Adulto Joven
14.
J Youth Adolesc ; 48(7): 1311-1326, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31025156

RESUMEN

Adolescents and young adults in the United States are constantly exposed to substance-related media and advertising content. The current study seeks to explore, developmentally, how exposure to substance-related media content influences both normative beliefs about peer alcohol use and individual alcohol use. Youth (N = 4'840; 50.6% female) were followed for ten years from age 12 to 22. Auto-regressive latent trajectory with structured residual (ALT-SR) models were used to explore within-person reciprocal associations between substance-related media content, descriptive norms, and alcohol use. Results indicated that' across adolescence and young adulthood, exposure to substance-related media content was associated with increased alcohol use via perceived alcohol norms. The pathway from media exposure to alcohol use was mediated by increased perceived norms for adolescents only. With screen time increasing over the last decade, it is important to invest resources into real-time interventions that address substance-related social media content as it relates to misperceived norms and to begin these interventions in early adolescence.


Asunto(s)
Conducta del Adolescente/psicología , Publicidad/estadística & datos numéricos , Medios de Comunicación Sociales/estadística & datos numéricos , Normas Sociales , Consumo de Alcohol en Menores/psicología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Grupo Paritario , Psicología del Adolescente , Trastornos Relacionados con Sustancias/psicología , Estados Unidos , Adulto Joven
15.
Muscle Nerve ; 57(6): 896-904, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29272038

RESUMEN

INTRODUCTION: Higher quality care for carpal tunnel syndrome (CTS) may be associated with better outcomes. METHODS: This prospective observational study recruited adults diagnosed with CTS from 30 occupational health centers, evaluated physicians' adherence to recommended care processes, and assessed results of the Boston Carpal Tunnel Questionnaire (BCTQ) and Short Form Health Survey version 2 (SF-12v2) at recruitment and at 18 months. RESULTS: Among 343 individuals, receiving better care (80th vs. 20th percentile for adherence) was associated with greater improvements in BCTQ Symptom Severity scores (-0.18, 95% confidence interval [CI] -0.32 to -0.05), BCTQ Functional Status scores (-0.21, 95% CI -0.34 to -0.08), and SF12-v2 Physical Component scores (1.75, 95% CI 0.33-3.16). Symptoms improved more when physicians assessed and managed activity, patients underwent necessary surgery, and employers adjusted job tasks. DISCUSSION: Efforts should be made to ensure that patients with CTS receive essential care processes including necessary surgery and activity assessment and management. Muscle Nerve 57: 896-904, 2018.


Asunto(s)
Síndrome del Túnel Carpiano/terapia , Satisfacción del Paciente , Calidad de la Atención de Salud , Adulto , Anciano , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Medición de Resultados Informados por el Paciente , Estudios Prospectivos , Encuestas y Cuestionarios
16.
Soc Psychiatry Psychiatr Epidemiol ; 53(3): 299-308, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29196773

RESUMEN

PURPOSE: Mental illness stigma disproportionately affects help seeking among youth, men, and ethnic minorities. As part of a comprehensive statewide initiative to reduce mental illness stigma and discrimination in California, a broad set of contact-based educational programs were widely disseminated. This study examined whether the effects of contact-based educational programs varied depending on the age, gender, and race-ethnicity of participants. METHODS: Participants (N = 4122) attended a contact-based educational program that was delivered as part of the statewide initiative to reduce mental illness stigma and discrimination. Self-administered surveys assessing beliefs, attitudes, and intentions toward mental illnesses and treatment were conducted immediately before and after participation in contact-based educational programs. RESULTS: Participant age, gender, and race-ethnicity significantly moderated pre-post changes in mental illness stigma. Although all groups exhibited significant pre-post changes across most of the stigma domains assessed, young adults, females, and Asian and Latino American participants reported larger improvements compared to older adults, males, and Whites, respectively. CONCLUSIONS: Findings suggest that contact-based educational programs can achieve immediate reductions in mental illness stigma across a variety of sociodemographic groups and may particularly benefit young adults and racial-ethnic minorities. Further research is needed to assess whether contact-based educational programs can sustain longer-term changes and aid in the reduction of disparities in mental illness stigma and treatment.


Asunto(s)
Asiático/educación , Etnicidad/educación , Educación en Salud/estadística & datos numéricos , Hispánicos o Latinos/educación , Trastornos Mentales/psicología , Estigma Social , Población Blanca/educación , Adolescente , Factores de Edad , Anciano , Asiático/psicología , Etnicidad/psicología , Femenino , Educación en Salud/métodos , Hispánicos o Latinos/psicología , Humanos , Masculino , Trastornos Mentales/etnología , Evaluación de Programas y Proyectos de Salud , Factores Sexuales , Encuestas y Cuestionarios , Estados Unidos , Población Blanca/psicología , Adulto Joven
18.
Soc Sci Med ; 352: 117004, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38815285

RESUMEN

Health-related social control (HRSC) includes efforts to regulate or influence others' health behaviors and is an important way interpersonal relationships can affect individual-level health. This study used egocentric network data to describe the size and composition of HRSC networks, identify trajectories of HRSC receipt, and examine how HRSC is related to binge drinking and alcohol-related problems. Data come from a U.S. nationally representative sample of 1235 adults age 30 and older (baseline mean age = 52, 52% female, 64% White) who completed four annual surveys between 2019 and 2022. On average, 30% of adults' network members were HRSC agents who told or reminded them to do things to protect their health. At baseline, 50% of respondents identified a spouse/partner as a HRSC agent, 56% a relative, 46% a friend, and 12% someone else. Respondents' relationships with HRSC agents were generally strong, 93% of agents were described as people "whose opinion matters," and only 10% were described as hassling or making life difficult for the respondent. Growth mixture modeling identified five trajectories of HRSC receipt over the four-year period: Stable High (36% of sample), Stable Moderate (47%), Stable Low (14%), Decreasing (2%), and Increasing (2%). Binge drinking was relatively consistent for the three Stable HRSC classes (ranging from 11% to 15% of individuals), decreased steadily for the Increasing HRSC class (32%-16%), and fluctuated for the Decreasing HRSC class (decreasing from 10% to 2%, then increasing to 8%). For alcohol problems, the Increasing HRSC class showed the largest increase (2%-21%) before dropping to near-baseline levels (4%), whereas the Decreasing HRSC class fluctuated during the first three waves followed by no individuals reporting alcohol problems at the last wave. Results highlight the importance of examining heterogeneity in adults' HRSC experiences because of its implications for understanding social influences on health-related behaviors.


Asunto(s)
Consumo de Bebidas Alcohólicas , Humanos , Femenino , Masculino , Persona de Mediana Edad , Adulto , Anciano , Estados Unidos/epidemiología , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Anciano de 80 o más Años , Conductas Relacionadas con la Salud , Relaciones Interpersonales , Encuestas y Cuestionarios , Consumo Excesivo de Bebidas Alcohólicas/epidemiología , Consumo Excesivo de Bebidas Alcohólicas/psicología
19.
Community Health Equity Res Policy ; : 2752535X241235992, 2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-38406923

RESUMEN

BACKGROUND: Faith-based interventions are promising for promoting healthy behaviors among adults, but their ripple effects on participants' children are unknown. This study is one of the first to assess the effects of a faith-based multilevel obesity intervention on adult participants' children. METHODS: We analyzed quantitative data from a cluster randomized controlled trial with two African American and two Latino churches in South Los Angeles, California, which invited adult participants to enroll one child (5-17 years) in a sub-study. At baseline and 6-7 months follow-up, parents completed a child health survey, which included the family nutrition and physical activity screening tool, and child height and weight were measured (n = 50). RESULTS: Results from linear regression models showed children of intervention participants, compared to control, had significantly better dietary patterns at follow-up. CONCLUSIONS: Findings suggest the health benefits of a faith-based multilevel obesity intervention for adults can extend to children and may help address obesity disparities.

20.
J Stud Alcohol Drugs ; 85(2): 201-209, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37917023

RESUMEN

OBJECTIVE: Thus far, behavioral health research in the United States has not explored the prevalence or correlates of sober curiosity (SC; exploratory or experimental abstinence or moderation) or temporary alcohol abstinence challenges (TAACs; e.g., "Dry January"), despite significant attention in media and popular discourse. We explored these activities in a sample of U.S. emerging adults (e.g., ages 18-29), a population with higher-risk drinking behavior yet some of the lowest rates of treatment engagement for alcohol use problems. METHOD: Survey data were collected in 2021-2022 among participants (n = 1,659; M age = 24.7 years). We assessed SC awareness/engagement and past-year TAAC participation, and differences across demographics and behavioral characteristics. RESULTS: Overall, 9% of emerging adults were familiar with SC and 7% had participated in a TAAC in the past year. Half of TAAC participants reported drinking less after the TAAC, and 15% remained abstinent after the TAAC ended. SC familiarity and TAAC were both associated with past-month heavy drinking, cannabis use, higher Alcohol Use Disorders Identification Test (AUDIT) scores, more past-year alcohol and cannabis consequences, past-year substance use treatment, and greater readiness to quit alcohol. CONCLUSIONS: Both SC and TAACs may have potential to engage young people with a desire to moderate or eliminate their alcohol consumption. This may occur directly through use of these strategies or by helping them connect to additional services. Future research can help the field understand the uptake of SC and TAACs, gauge efficacy, and identify avenues to link young people to resources and interventions.


Asunto(s)
Alcoholismo , Trastornos Relacionados con Sustancias , Adulto , Humanos , Estados Unidos/epidemiología , Adolescente , Adulto Joven , Alcoholismo/epidemiología , Alcoholismo/terapia , Conducta Exploratoria , Abstinencia de Alcohol , Consumo de Bebidas Alcohólicas/epidemiología
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