Youth Knowledge and Perspectives on Expedited Partner Therapy.

PURPOSE: Expedited partner therapy (EPT) is an effective sexually transmitted infection (STI) treatment and prevention practice that allows clinicians to provide treatment to the sexual partner(s) of individuals diagnosed with chlamydia and/or gonorrhea infections without a clinical evaluation. Due to the high incidence of STIs among youth, we sought to understand youth awareness and beliefs about EPT use. METHODS: MyVoice, a national text message survey of youth aged 14-24 years, posed 5 questions on EPT knowledge and perceptions to 1,115 youth in August 2018. Responses were reviewed to identify themes and iteratively develop a codebook. Two reviewers independently coded each question, and a third reviewer resolved discrepancies. Summary statistics were calculated for demographic and thematic analysis. RESULTS: A total of 835 participants responded to at least 1 question (74.9% response rate). Majority of youth (91.9%, n = 730/794) felt that it would be important to help their partners get treatment if they tested positive for chlamydia or gonorrhea. Although most participants were unaware of EPT (86.4%, n = 657/760), 81.3% (n = 624/768) supported the policy stating that it is "pretty darn convenient." Youth also noted they would be interested in asking their provider for EPT. Participants opposing EPT (6.9%, n = 53/768) noted that "they [sexual partner] are responsible for their own health" and preferred to "tell my partner to go to [their] doctor." CONCLUSIONS: Most youth in the MyVoice cohort felt that EPT was a good way to get treatment for their partners, even though the majority were not aware that EPT was available as an STI treatment option.

The future of STI screening and treatment for youth: a National Survey of youth perspectives and intentions.

BACKGROUND: Sexually transmitted infection (STI) rates continue to rise in the U.S., with disproportionately high rates among those aged 15-24 years. Effective programs and policies are necessary to address this growing public health problem. The purpose of this study is to assess the perspectives of a national sample of youth on access to STI care and behaviors regarding STIs. METHODS: MyVoice, a national text message survey of youth, was used to pose four open-ended questions on STI screening and treatment to 1115 youth aged 14-24 in August 2018. A mixed-methods strategy was employed for the study. Qualitative data was analyzed using a modified grounded theory approach. Summary statistics were calculated for demographic data and prevalence of themes. RESULTS: Of the 800 participants who responded to at least one question (72% response rate), mean age was 19 years (SD = 3.1), 55% identified as female, 61% identified as non-Hispanic white, and 33% qualified for free/reduced lunch. A majority felt it would be easy to get screened (69%) or treated (68%) for an STI. Nearly all respondents (95%) stated they would share an STI diagnosis with their sexual partners. CONCLUSIONS: Despite high rates of STIs among youth, most respondents reported that STI screening and treatment is accessible, and they would share an STI diagnosis with their partner.

Targeted self-regulation interventions in low-income children: Clinical trial results and implications for health behavior change.

Self-regulation, known as the ability to harness cognitive, emotional, and motivational resources to achieve goals, is hypothesized to contribute to health behaviors across the lifespan. Enhancing self-regulation early in life may increase positive health outcomes. During pre-adolescence, children assume increased autonomy in health behaviors (e.g., eating; physical activity), many of which involve self-regulation. This article presents results from a clinical trial (NCT03060863) that used a factorial design to test behavioral interventions designed to enhance self-regulation, specifically targeting executive functioning, emotion regulation, future-oriented thinking, and approach biases. Participants were 118 children (9-12 years of age, M = 10.2 years) who had a history of living in poverty. They were randomized to receive up to four interventions that were delivered via home visits. Self-regulation was assayed using behavioral tasks, observations, interviews, and parent- and child-report surveys. Results were that self-regulation targets were reliably assessed and that interventions were delivered with high fidelity. Intervention effect sizes were very small to moderate (d range = .02-.65, median = .14), and most were not statistically significant. Intercorrelation analyses indicated that associations between measures within each target varied based on the self-regulation target evaluated. Results are discussed with regard to the role of self-regulation-focused interventions in child health promotion. Implications of findings are reviewed for informing next steps in behavioral self-regulation interventions among children from low-income backgrounds.

Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol.

BACKGROUND: Self-regulation (SR), or the capacity to control one's thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition that requires SR to ensure adherence to daily treatment regimens that can be arduous and effortful (e.g., monitoring blood glucose). Adolescents, in particular, have poor adherence to T1D treatment regimens, yet it is essential that they assume increased responsibility for managing their T1D as they approach young adulthood. Adolescence is also a time of rapid changes in SR capacity and thus a compelling period for intervention. Promoting SR among adolescents with T1D may thus be a novel method to improve treatment regimen adherence. The current study tests a behavioral intervention to enhance SR among adolescents with T1D. SR and T1D medical regimen adherence will be examined as primary and secondary outcomes, respectively. METHODS: We will use a randomized control trial design to test the impact of a behavioral intervention on three SR targets: Executive Functioning (EF), Emotion Regulation (ER), and Future Orientation (FO); and T1D medical regimen adherence. Adolescents with T1D (n = 94) will be recruited from pediatric endocrinology clinics and randomly assigned to treatment or control group. The behavioral intervention consists of working memory training (to enhance EF), biofeedback and relaxation training (to enhance ER), and episodic future thinking training (to enhance FO) across an 8-week period. SR and treatment regimen adherence will be assessed at pre- and post-test using multiple methods (behavioral tasks, diabetes device downloads, self- and parent-report). We will use an intent-to-treat framework using generalized linear mixed models to test our hypotheses that: 1) the treatment group will demonstrate greater improvements in SR than the control group, and 2) the treatment group will demonstrate better treatment regimen adherence outcomes than the control group. DISCUSSION: If successful, SR-focused behavioral interventions could improve health outcomes among adolescents with T1D and have transdiagnostic implications across multiple chronic conditions requiring treatment regimen adherence. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03688919; registered September 28, 2018.

Self-Regulation Mitigates the Association between Household Chaos and Children's Behavior Problems.

Given the potential negative effects that early childhood behavioral problems have on later development, it is important to elucidate risk and protective factors. This study examined household chaos as a predictor of externalizing and internalizing problems among young children from low-income families. Additionally, self-regulation was examined as a moderator of the association between chaos and behavior problems. One hundred young adult mother-toddler dyads participated. Moderation analyses indicated that self-regulation buffered the association between household chaos and child behavior problems. Specifically, greater household chaos was associated with more behavior problems, but only among children with poorer self-regulation. Notably, this pattern was observed for both externalizing and internalizing problems. These findings suggest that early interventions targeting young children's self-regulation skills could help prevent behavior problems among children living in chaotic home environments.

Maternal Depressive Symptoms and At-Risk Young Children's Internalizing Problems: The Moderating Role of Mothers' Positivity.

Maternal depressive symptoms predict negative child behaviors, including internalizing problems. However, protective factors, such as positive emotionality and positive parenting behaviors, may play an important a role in attenuating associations between maternal depressive symptoms and child behavior problems. This manuscript presents two studies that examined buffers of links between maternal depressive symptoms and child internalizing problems. Each study examined samples of primarily African American families with young children in an impoverished large city in the Midwestern United States. Families were recruited from kindergarten classes and Women, Infants, and Children (WIC) centers. In both studies, indicators of mothers' positivity, as measured by text based analysis of positive emotion word use or behavioral observation of positive parenting behaviors, attenuated links between maternal depressive symptoms and child internalizing problems. The results suggest that risk for internalizing problems within the context of maternal depressive symptoms is reduced when parents experience and express more positive emotions and behaviors.