Understanding Ohio X-Waivered Advanced Practice Registered Nurses' Rate of Naltrexone Prescription for Alcohol Use Disordered Patients.

BACKGROUND: Alcohol use disorder (AUD) is overrepresented within the United States. Naltrexone, a recommended treatment for AUD, is underutilized. However, the prescribing behaviors of advanced practice registered nurses (APRNs) regarding naltrexone for AUD patients have not been studied. The purpose of our study was to explore the prescriptive practices of a sample of APRNs. AIMS: To describe and analyze survey responses of a sample of Ohio APRNs with training in medication for addiction treatment (MAT) for substance use disorders (as evidenced by DEA x-waiver receipt) regarding prescribing practices of naltrexone for AUD patients. METHOD: Public information collected from the first author's Nursing Board (list of APRNs in Ohio) was checked against the public information of x-waivered providers nationally from the Substance Abuse and Mental Health Services Administration's (SAMHSA) website. This generated a potential sample size of 824 APRNs, all of whom were sent email solicitations to complete a Qualtrics survey. After 3 weeks, 55 surveys were completed, and the data were analyzed. Descriptive statistics were generated as well as a logistic regression with five potential predictor variables against the outcome variable (defined as use of naltrexone for AUD patients). RESULTS: Years practicing as an APRN was found to negatively predict naltrexone prescribing behavior for AUD patients. Practice setting and work experience with an addiction specialist physician were not found to predict naltrexone prescribing behavior for AUD patients. CONCLUSION: Implications for further study were discussed, with emphasis on regulatory variance between states.

Dimensionality, variance composition, and development of a brief form of the duke health profile, and its measurement invariance across five gender identity groups.

OBJECTIVE: To conduct advanced psychometric analyses on the Duke Health Profile, a popular measure of health-related quality of life. DESIGN: Online survey. Data (N = 1233, 34.3% transgender) were from community and college participants. Dimensionality was assessed for the first time using exploratory factor analysis (EFA) with part of the sample, followed by single- and multi-group confirmatory factor analyses (CFA) with the balance of the sample. RESULTS: EFA resulted in a 14-item three factor structure: mental, physical and social health. CFA estimated four models (common factors, bifactor, hierarchical, unidimensional), none demonstrated adequate fit. From another EFA specifying one factor, the 6-item Duke Health Profile-Brief Form was developed based on updated guidelines for shortening composite measurement scales, which was assessed using CFA, finding good fit to the data. Measurement invariance by gender was assessed across the diverse gender spectrum, finding evidence for configural, metric, and partial scalar invariance. CONCLUSIONS: There is insufficient evidence to use the general, mental, social and physical health scores of the DUKE Health Profile. However, there is evidence supporting the use of the unidimensional DUKE-BF, which is largely invariant between cisgender men and women, transgender men and women, and transgender men and non-binary participants.

Measurement invariance by race (black, white) of the femininity ideology scale-short form.

The Femininity Ideology Scale - Short Form (FIS-SF) assesses traditional femininity ideology (TFI), which is the internalization of White, Western, heteronormative norms about how women are supposed to think, feel, and behave. As TFI applies to both in-group and out-group members, it is important to examine the FIS-SF's psychometric properties in different populations who might have unique gender ideologies that compete with TFI, such as the Strong Black Woman ideology (SBWI). This study investigated the measurement invariance of the FIS-SF in a sample of Black (N = 185) and White (N = 944) respondents, who were college students and community-dwellers recruited using internet advertisements. Ages ranged from 18 to 90 years (Mean = 27.10, SD = 11.59). Results indicated that the FIS-SF had a statistically equivalent pattern of items loading on factors, item factor loadings and model fit for White and Black participants. Four of the twelve intercepts of the items regressed on their respective factors were invariant between groups, with Black participants having higher intercepts for all non-invariant items, but their effect size was small. Future research is needed to investigate relationships between SBWI and TFI as well as FIS-SF measurement invariance in other populations.

Moderation and mediation of the relationships between masculinity ideology and health status.

OBJECTIVE: The purpose of this study was to assess the direct and indirect relationships between the endorsement of traditional masculinity ideology (TMI) and self-reported health status through potential mediating variables of expectations of benefits from health risk behaviors and actual health risk behaviors. In addition, the objective was to test the moderating effect of gender identity, broadly defined (including cisgender and transgender men and women and nonbinary persons). METHOD: Participants (N = 1233; 34.3% transgender) participated in an online survey, responding to measures of TMI, expectations of benefits, health behaviors, health status, and demographics. Data were analyzed using conditional process modeling. RESULTS: TMI was positively and directly associated with general health status for self-identified men (regardless of their sex assigned at birth), and with mental health for both men and women, but was not associated with physical health for persons of any gender identity. TMI was positively and directly associated with expectations of benefits for both men and women. Expectations of benefits from engaging in health risk behaviors was positively associated with health risk behaviors, and health risk behaviors had a large negative association with health status, for people of all gender identities. CONCLUSIONS: TMI may be a general and mental health protective factor for self-identified men, and a mental health protective factor for women, regardless of assigned sex at birth. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Variance composition, measurement invariance by gender, and construct validity of the Femininity Ideology Scale-Short Form.

The current study extended prior work on the Femininity Ideology Scale (FIS), a multidimensional measure of traditional femininity ideology (TFI), in several ways. First, we conducted exploratory factor and bifactor analyses, which revealed a general TFI factor and 3 specific factors: dependence/deference, purity, and emotionality/traditional roles. Second, based on these results we developed the 12-item FIS-Short Form (FIS-SF). Third, we assessed the FIS-SF using confirmatory factor analysis on a separate sample, finding that the items loaded on the general factor and 3 specific factors as hypothesized, and that the bifactor model fit better than common factors and unidimensional models. Fourth, model-based reliability estimates tentatively support the use of raw scores to represent the general TFI factor and the emotionality/traditional roles specific factor, but the other 2 specific factors are best measured using SEM or by ipsatizing their scores. Fifth, we assessed measurement invariance across 2 gender groups, finding evidence for configural invariance for all factors, and for partial metric invariance for the specific factors. Sixth, we found evidence for the convergent construct validity of the FIS-SF general factor and the emotionality/traditional roles specific factors by examining relationships with the latent variables of several constructs in the nomological network. The results are discussed in relationship to prior literature, future research directions, applications to counseling practice, and limitations. Data (N = 1,472, 907 women, 565 men, 530 people of color) were from community and college participants who responded to an online survey. (PsycINFO Database Record

Confirmatory factor analytic investigation of variance composition, gender invariance, and validity of the Male Role Norms Inventory-Adolescent-revised (MRNI-A-r).

Confirmatory factor analysis of responses to the Male Role Norms Inventory-Adolescent-revised (MRNI-A-r) from 384 middle school students (163 boys, 221 girls) indicated that the best fit to the data was a bifactor model incorporating the hypothesized 3-factor structure while explicitly modeling an additional, general factor. Specifically, each item-level indicator loaded simultaneously on 2 factors: a general traditional masculinity ideology factor and a specific factor corresponding to 1 of the 3 hypothesized masculine norms for adolescents: Emotionally Detached Dominance, Toughness, and Avoidance of Femininity. Invariance testing across gender supported metric invariance for the general factor only. Although item loadings on the general factor were similar across boys and girls, the specific factor loadings varied substantially, with many becoming nonsignificant in the presence of the general factor for girls. A structural regression analysis predicting latent variables of the Meanings of Adolescent Masculinity Scale (MAMS), the Rosenberg Self-esteem Scale, and the Discipline, School Difficulties, and Positive Behavior Scale (DSDPBS) indicated that the general factor was a strong predictor of MAMS for both genders and DSDPBS for girls. Findings indicate that the MRNI-A-r general factor is a valid and reliable indicator of overall internalization of traditional masculinity ideology in adolescents; however, the specific factors may have different meanings for boys as compared with girls and lack validity in the presence of the general factor. These findings are consistent with a developmental perspective of gender ideology that views adolescence as a time when a differentiated cognitive schema of masculine norms is beginning to develop. (PsycINFO Database Record