A Non-Randomized Trial of In-Person Versus Text/Telephone Screening, Brief Intervention and Referral to Treatment for Pregnant and Postpartum Women.

Background: Systems of care that improve mental health and substance use disorder Screening, Brief Intervention and Referral to Treatment (SBIRT) for pregnant and postpartum women are needed. Aims: The aim of this study is to determine if women receiving prenatal care from January 2020 to April 2021 are more likely to be screened, screen positive, be referred for treatment and attend treatment with technology facilitated SBIRT, compared to women receiving prenatal care and in-person SBIRT January 2017 to December 2019. Materials & Methods: Technology facilitated SBIRT, designated Listening to Women (LTW), includes text message-based screening, phone-based brief intervention, and referral to treatment by a remote care coordinator. A total of 3535 pregnant and postpartum women were included in the quasi-experimental study and data were collected via text message and Electronic Health Record. Results: In-person SBIRT was completed by 65.2% (1947/2988) of women while 98.9% (547/553) of women approached agreed to take part in LTW and 71.9% (393/547) completed SBIRT via LTW. After controlling for potentially confounding variables, women enrolled in LTW were significantly more likely to be screened (relative risk [RR]: 1.10, 95% CI 1.03-1.16), screen positive (RR 1.91, 95% CI 1.72-2.10), referred to treatment (RR 1.55, 95% CI 1.43-1.69) and receive treatment (RR 4.95, 95% CI 3.93-6.23), compared to women receiving in-person SBIRT. Black women enrolled in LTW were significantly more likely to screen positive (RR 1.65, 95% CI 1.35-2.01), be referred to treatment (RR 1.54, 95% CI 1.35-1.76) and attend treatment (RR 5.49, 95% CI 3.69-8.17), compared to Black women receiving in-person SBIRT. Discussion: LTW appears to increase the proportion of pregnant and postpartum women receiving key elements of SBIRT.

To help or punish in the face of unfairness: men and women prefer mutually-beneficial strategies over punishment in a sexual selection context.

Consistent with a sexual selection account of cooperation, based on female choice, men, in romantic contexts, in general display mutually-beneficial behaviour and women choose men who do so. This evidence is based on a two-choice-architecture (cooperate or not). Here we extend this to include punishment options using a four-choice-architecture ('punishing a transgressor', 'compensating a victim', 'both punishing and compensating' or 'doing nothing'). Both compensation (a self-serving mutually-beneficial behaviour) and self-serving punishment, are associated with positive mate qualities. We test which is preferred by males and chosen by female undergraduates. We further explore effects of trait empathy and political ideology on these preferences. In a series of three studies using a third-party punishment and compensation (3PPC) game we show (Study One), that romantically-primed undergraduate males, express a preference to either 'compensate' or 'both compensate and punish', and undergraduate women find males who 'compensate' or 'compensate and punish' the most attractive (Studies Two and Three). Compensating men are perceived as compassionate, fair and strong by undergraduate women (Study Three). High trait empathy (Studies One and Three) and a left-wing political ideology (Study Three) are associated with a preference for compensation. Thus, self-serving mutually-beneficial behaviour can be preferred over self-serving punishment as a signal of mate quality in undergraduates. Implications for the evolution of cooperation are discussed with respect to sexual selection.

HIV risk behaviors of male and female jail inmates prior to incarceration and one year post-release.

Individuals cycling in and out of the criminal justice system are at high risk for contracting HIV/AIDS. Most infections are contracted in the community, not during incarceration, but little is known about the profile of risk behaviors responsible for this elevated infection rate. This study investigated pre-incarceration and post-release HIV risk behaviors in a longitudinal study of 542 male and female inmates in a Northern Virginia jail. Although there was a significant decrease in risky behavior from pre-incarceration to post-incarceration, participants reported high levels of unprotected sexual activity and risky IV drug behaviors at both time points, emphasizing the need for prevention programming among this at-risk population. Gender differences in participants' pre-incarceration and post-release HIV risk behaviors suggest the need for gender-specific interventions to reduce overall HIV risk. Identifying specific HIV risk behaviors of jail inmates is vital to improve treatment and intervention efforts inside and outside of correctional settings.