Experiences of Adverse Childhood Events and Racial Discrimination in Relation to Depressive Symptoms in College Students.

PROBLEM: The college years mark a critical period for experiencing multiple stressors and mental health problems. This study applied minority stress theory to examine adverse childhood events (ACEs) and experiences of racial discrimination, and their relationships to depressive symptoms among racially/ethnically diverse college students. METHODS: We analyzed cross-sectional data from 2,685 college students attending seven colleges/universities in the state of Georgia. Measures included sociodemographics, ACEs, experiences of racial discrimination, and depressive symptoms. RESULTS: Participants' average age was 20.51 (SD=1.94) years; 63.9% were female, 21.9% Black, and 7.8% Hispanic. Multivariable regression indicated that more ACEs predicted more experiences of racial discrimination, and both ACEs and discrimination experiences predicted greater depressive symptoms (p's<.001). Experiencing more ACEs was associated with being older, female, sexual minorities, White (vs. Asian), Hispanic, having less educated parents, and students at public colleges/universities or technical colleges (vs. private colleges/universities, p's<.05). More reports of racial discrimination were associated with being sexual and/or racial/ethnic minorities (p's<.05). Greater depressive symptoms were associated with being younger, female, sexual minorities, White (vs. Black), and students from public (vs. private) colleges/universities (p's<.01). CONCLUSIONS: College campuses should provide resources to address ACEs, racial discrimination, and mental health to support students' academic and psychosocial success.

Exploring the Point-of-Sale Among Vape Shops Across the United States: Audits Integrating a Mystery Shopper Approach.

INTRODUCTION: Vape shops represent prominent, unique retailers, subject to Food and Drug Administration (FDA) regulation in the United States. AIMS AND METHODS: This study assessed compliance of US vape shop retail marketing strategies with new regulations (eg, required age verification, prohibited free samples) and pre-implementation conditions for other regulations (eg, health warning labels on all nicotine products, required disclosures of e-liquid contents). RESULTS: 95.0% of shops displayed minimum-age signage; however, mystery shoppers were asked for age verification at 35.6% upon entry and at 23.4% upon purchase. Although 85.5% of shops had some evidence of implementing FDA health warnings, 29.1% had signage indicating prohibited health claims, 16.3% offered free e-liquid samples, 27.4% had signage with cartoon imagery, and 33.3% were within two blocks of schools. All shops sold open-system devices, 64.8% sold closed-system devices, 68.2% sold their own brand of e-liquids, 42.5% sold e-liquids containing cannabidiol, 83.2% offered price promotions of some kind, and 89.9% had signage for product and price promotions. CONCLUSIONS: Results indicated that most shops complied with some implementation of FDA health warnings and with free sampling bans and minimum-age signage. Other findings indicated concerns related to underage access, health claims, promotional strategies, and cannabidiol product offerings, which call for further FDA and state regulatory/enforcement efforts.

Vape shop owners'/managers' attitudes about CBD, THC, and marijuana legal markets.

Over the past decade in the US there have been marked pivotal changes in the policy and retail environment regarding cannabinoids, particularly cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC). Many vape shops may carry products relevant to these two markets. This study interviewed vape shop owners/managers to assess their perceptions of consumer interests/behaviors regarding CBD and THC and of the impact of legalized marijuana retail on vape shops. The current study involved phone-based semi-structured interviews of 45 vape shop owners/managers in six metropolitan statistical areas (MSAs; Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, and Seattle) during Summer 2018. Overall, 82.2% of participants were male, 77.8% were non-Hispanic White, 64.4% were managers, 8.9% reported past 30-day smoking, and 95.6% reported past 30-day vaping. Overall, 44.4% sold e-liquids containing CBD. Vape shop owners/managers indicated minimal perceived risk and some beliefs in therapeutic benefits of CBD products; however, there was a broader range of perspectives regarding marijuana retail and selling marijuana for recreational use. Some chose to distance themselves from marijuana products, their use, and the possibility of entering marijuana retail if it were to evolve in their state, while some indicated high levels of enthusiasm for the growing retail marijuana market. Future research should examine how vape shops and other retailers of CBD and marijuana communicate with consumers about products and modes of using such products, as well as how various industry sectors (e.g., vape shops) adapt or evolve with increasing regulation of nicotine and increasing legalization of marijuana retail.

Vape shop identification, density and place characteristics in six metropolitan areas across the US.

Vaping is increasingly prevalent and controversial. Vape shops and convenience stores are common but distinct sources of vaping products, and where they locate may reflect likely target markets. This study examined the density and neighborhood demographics of vape shops and convenience stores in six metropolitan statistical areas (MSAs): Atlanta, Boston, Minneapolis, Oklahoma City, San Diego, Seattle. We identified 459 vape shops using Yelp and Google application programming interfaces and 10,777 convenience stores using ReferenceUSA and Dun & Bradstreet. Retailers were geocoded to census tracts (n = 4,442), and logistic regressions were conducted using as predictors percent non-White, percent youth (5-17 years or 5-20 years), and median household income from the American Community Survey, 2013-2017. Per 10,000 young adults, vape shop density ranged from 0.6 (Boston, San Diego) to 1.7 (Oklahoma City), and convenience store density ranged from 12.6 (San Diego) to 26.3 (Oklahoma City). Logistic regressions indicated that vape shops more likely resided in tracts with lower percentages of youth in Boston, but higher percentages of youth in Atlanta, as well as with lower incomes in Boston and Seattle. Convenience stores more likely resided in tracts with lower percentages of non-Whites in Atlanta and Boston; lower incomes in Atlanta, Boston, San Diego, and Seattle; and higher percentages of youth in Atlanta, Boston, and Minneapolis. These common retail sources of vaping products differentially locate in relation to neighborhood sociodemographics across MSAs. Findings suggest that, in some MSAs, vape shops and convenience stores may target youth and lower income populations.

A Hope-Based Intervention to Address Disrupted Goal Pursuits and Quality of Life Among Young Adult Cancer Survivors.

Over 70,000 US young adults are diagnosed with cancer annually, disrupting important life transitions and goal pursuits. Hope is a positive psychology construct associated with better quality of life (QOL) that focuses on goal-oriented thinking. We developed and tested Achieving Wellness After Kancer in Early life (AWAKE), a scalable 8-week app-based program consisting of educational videos, mood/activity tracking, and telephone-based coaching to promote hope and QOL in young adult cancer survivors (YACS, 18-40 years old). A two-arm RCT was used to examine the feasibility, acceptability, and potential efficacy of AWAKE (n = 38) versus attention control (AC; n = 18) among YACS within 2 years of completing treatment and recruited from two NCI-designated cancer centers. Outcomes including hope (Trait Hope Scale), QOL (36-Item Short Form Health Survey; Functional Assessment of Cancer Therapy-General), depressive symptoms (Patient Health Questionnaire-9), and substance use were assessed at baseline, 8 weeks, and 6 months. Participants were an average of 32.55 (SD = 5.45) years old; 75.0% were female, and 80.4% White. The most common cancers were breast cancer (28.6%), melanoma (16.1%), and leukemia/lymphoma (12.5%). High retention, engagement, and satisfaction rates were documented in both conditions; AWAKE versus AC participants rated video content as more relevant (p = 0.007) and reported greater likelihood of talking positively about the program (p = 0.005). Many efficacy change scores showed positive trends in AWAKE versus AC. Reorienting to one's goal pursuits after cancer diagnosis and treatment is critical and may be supported through hope-based interventions. Findings suggest that the AWAKE warrants subsequent research testing its efficacy, effectiveness, and scalability.