Vales+Tú: a cluster-randomized pilot study to reduce workplace injuries among US Latino day laborers.

Latino day laborers (LDL) are a vulnerable population of workers facing considerable risk for occupational injury. Under the guidance of our Community Advisory Board, we developed and tested the feasibility, acceptability and preliminary effects of Vales+Tú (You Are Worth More), a workplace injury risk-reduction program implemented by promotores on street-corners where LDL seek employment. The program was informed by theoretical perspectives emphasizing individual and group agency and self-determination. A pilot three-arm cluster-randomized community trial was conducted among 75 LDL. The intervention arms consisted of an individualized Brief Motivational Interview, a Group Problem Solving activity and a standard of care control (OSHA safety cards). We met our study goal of 25 LDL per intervention arm, and contacted 88% of participants post intervention. Participants evaluated the interventions favorably. At post-test, the Brief Motivational Interview group reported significant reductions in exposure to workplace hazards and increases in risk-reduction practices. The Group Problem Solving participants showed significant reductions in exposure to hazards (t-test -4.16, p < 0.001). Both intervention groups increased their reliance on corner peers, a measure of social support. Standard of care participants increased in self-efficacy to work safely. Overall, the only significant different between the three study conditions was in self-efficacy. These findings provide evidence of the feasibility and acceptability of Vales+Tú and show preliminary program efficacy. A large-scale replication trial will permit a more formal modeling of the study findings. Clinical Trial Registration (ClinicalTrials.gov): NCT04378348.

This pilot-randomized trial tested the feasibility and initial efficacy of an injury risk-reduction program among Latino day laborers (LDL). The study tested two alternative interventions consisting of a Brief Motivational Interview (Individual) and a Group Problem Solving (Group) conditions that were compared with a Standard-of-Care control group receiving safety cards. We then tested the extent to which the study conditions reduced exposure to workplace hazards and increased safety practices at work. Results indicate that intervening at day labor corners is a feasible intervention strategy acceptable to these immigrant workers. Initial results also indicate that there were multiple within-group significant differences in risk reduction, mostly in the individual condition, and that there was one significant between-group difference in safety self-efficacy at post-test. A larger more rigorous trial can further test the stability of these results and determine the extent to which these intervention approaches can reduce the risk for injury that LDL confront at work.

Effects of Cogmed working memory training on cognitive performance.

Research on the cognitive benefits of working memory training programs has produced inconsistent results. Such research has frequently used laboratory-specific training tasks, or dual-task n-back training. The current study used the commercial Cogmed Working Memory (WM) Training program, involving several different training tasks involving visual and auditory input. Healthy college undergraduates were assigned to either the full Cogmed training program of 25, 40-min training sessions; an abbreviated Cogmed program of 25, 20-min training sessions; or a no-contact control group. Pretest and posttest measures included multiple measures of attention, working memory, fluid intelligence, and executive functions. Although improvement was observed for the full training group for a digit span task, no training-related improvement was observed for any of the other measures. Results of the study suggest that WM training does not improve performance on unrelated tasks or enhance other cognitive abilities.

Perception during use of force and the likelihood of firing upon an unarmed person.

Stress can impact perception, especially during use-of-force. Research efforts can thus advance both theory and practice by examining how perception during use-of-force might drive behavior. The current study explored the relationship between perceptual judgments and performance during novel close-combat training. Analyses included perceptual judgments from close-combat assessments conducted pre-training and post-training that required realistic use-of-force decisions in addition to an artificially construed stress-inoculation event used as a training exercise. Participants demonstrated significant reductions in situational awareness while under direct fire, which correlated to increased physiological stress. The initial likelihood of firing upon an unarmed person predicted the perceptual shortcomings of later stress-inoculation training. Subsequently, likelihood of firing upon an unarmed person was reduced following the stress-inoculation training. These preliminary findings have several implications for low or zero-cost solutions that might help trainers identify individuals who are underprepared for field responsibilities.

Documenting and Understanding Workplace Injuries Among Latino Day Laborers.

BACKGROUND: Latino day laborers face substantial injuries at work. We present a comprehensive assessment of their injury experience and explore the predictors of selfreported injuries. METHODS: Worker and injury characteristics were collected from 331 day laborers using an innnovative injury assessment tool. The odds of injury were estimated using a logistic regression. RESULTS: Participants were foreign-born, Spanish monolingual, and employed in construction. Sixty-seven individuals reported 88 past-year injuries, mostly involving the upper or lower extremities. Injuries were caused by moving heavy objects, falling, or being struck an object. Of the documented injuries, 24% were not reported at work due to fear of being fired; 64.4% resulted in missed workdays, 54.0% in temporary incapacitation, and 34.5% in permanent incapacitation. Being married significantly reduced the odds of reporting an injury. DISCUSSION: Better documentation can inform the development of better policy protections that ameliorate injuries experienced by Latino day laborers at the workplace.

Information, Motivation, and Self-Efficacy Among Men Who Have Sex With Men and Transgender Women in the State of Maharashtra, India.

BACKGROUND: India's National AIDS Control Programme calls for, among other things, targeted behavioral interventions that address determinants contributing to new infections among men who have sex with men (MSM) and hijras (transgender women). AIM: To determine if the information-motivation-behavioral skills model was transferable to an Indian context. METHODS: We recruited 442 MSM and 7 hijras into an online cross-sectional study that asked questions about condom use knowledge, motivation, self-efficacy, and sexual behavior. Structural equation modeling was used to test the overall information-motivation-behavioral skills structure. RESULTS: Condom use and HIV risk knowledge did not significantly predict condom use self-efficacy or having condomless anal sex with more than one male partner in the past 3 months, and knowledge was not significantly correlated with attitudes toward barebacking. Despite this, the final structural model explained 14.4% of the variance in condom use self-efficacy and 20.0% of the variance in risky sexual behavior. Overall fit of the model was good: χ2(201, N = 447) = 445.002, p < .0001, root mean square error of approximation = .052, 90% CI [.046, .059], comparative fit index = .989, Tucker-Lewis Index = .987. CONCLUSION: The public health response to India's HIV epidemic is currently different than in the West due to differences in medication access and public health infrastructure. As Indian MSM and hijras learn more about the effectiveness of viral suppression and hopefully have greater access to preexposure prophylaxis, researchers should monitor for changing attitudes toward condoms and be prepared to collaborate with the public health infrastructure in order to develop interventions that reinforce positive attitudes toward condom use.

Differentially classified methamphetamine-using men who have sex with men: A latent class analysis.

CONTEXT: Substance use interventions for methamphetamine-using men who have sex with men (MSM) are limited by the assumption that they are a uniform group. We hypothesized that an LCA would identify distinct patterns of substance use and demographic and psychosocial variables associated with different substance-using groups would aid in understanding distinctions. Using cross-sectional data from 343 methamphetamine-using MSM, we conducted an LCA to model the patterns of polysubstance use then examined how the classes varied on psychosocial variables defined by the Information-Motivation-Behavioral Skills (IMB) model. FINDINGS: Because we were interested in identifying patterns of polysubstance use (PSU) among our sample, we identified four classes: minimal PSU, marijuana PSU, cocaine/hallucinogens PSU, and designer drugs/heroin PSU. Men in the marijuana PSU class were less likely to have positive attitudes towards methamphetamine than participants in the other three classes. Men in the Cocaine and Hallucinogens PSU class were more likely to have higher PANAS scores (OR = 13.00 [3.25, 52.07]) compared to the other classes, and they were more likely to have higher self-efficacy to enact safer substance use strategies (OR = 10.72 [3.23, 35.47]). MSM in the Designer Drug and Heroin PSU class were more likely to have a diagnosis of Hepatitis B (OR = 4.07 [0.86, 19.36] despite having higher knowledge of sexual health practices (OR = 0.55 [0.36, 0.84]. CONCLUSIONS: Differential classification for methamphetamine-using MSM suggests an opportunity for tailored interventions and secondary prevention programs. By understanding how men vary on illicit substance use, interventionists can routinely screen and link men before they potentially progress to another classification.

Harassment and Violence Among Men Who Have Sex with Men (MSM) and Hijras After Reinstatement of India's "Sodomy Law".

On December 11, 2013, the Indian Supreme Court recriminalized non-peno-vaginal sex under Sec. 377 of the Indian Penal Code (IPC), overturning a 2009 ruling that deemed IPC Sec. 377 unconstitutional. Similar "sodomy laws" in other countries have been associated with increased violence, harassment, and other discrimination against men who have sex with men (MSM) and transgender women. However, few studies have looked at the effects of such a law in an Indian context. This study examined experiences of victimization among MSM and hijra/transgender women (MSM-H) in the State of Maharashtra using a mixed-method approach. Data came from a quantitative survey and qualitative focus groups and interviews from an HIV prevention study as well as qualitative media and case reports from a local MSM-H-serving community-based organization. MSM-H in Maharashtra reported experiencing a high frequency of harassment, violence, and extortion, particularly from male sex partners met online and police. IPC Sec. 377 was implicated across qualitative sources as creating a culture of protection for harassment against MSM-H by being used directly as a tool for harassment, hindering victims of harassment from seeking legal recourse, and adversely impacting HIV and healthcare services. The reinstated IPC Sec. 377 may directly and indirectly facilitate negative health outcomes among MSM-H. Health agencies and advocates should continue to monitor the impact of IPC Sec. 377, incorporate rights-based approaches to protect MSM-H identities while addressing their health and well-being, and explore avenues to initiate discussions with the government to work toward repealing the law.

Sexual Preferences and Presentation on Geosocial Networking Apps by Indian Men Who Have Sex With Men in Maharashtra.

BACKGROUND: The affordability of smartphones and improved mobile networks globally has increased the popularity of geosocial networking (GSN) apps (eg, Grindr, Scruff, Planetromeo) as a method for men who have sex with men (MSM) to seek causal sex partners and engage with the queer community. As mobile penetration continues to grow in India, it is important to understand how self-presentation on GSN app is relevant because it offers insight into a population that has not been largely studied. There is very little information about how Indian MSM discuss their sexual preferences and condom preferences and disclose their human immunodeficiency virus (HIV) status with potential sex partners on Web-based platforms. OBJECTIVE: The objective of this study was to describe how self-presentation by Indian MSM on GSN apps contributes to sexual preferences, HIV or sexually transmitted infection (STI) disclosure, and if the presentation differs due to proximity to the Greater Mumbai or Thane region. METHODS: Between September 2013 and May 2014, participants were recruited through banner advertisements on gay websites, social media advertisements and posts, and distribution of print materials at outreach events hosted by lesbian, gay, bisexual, transgender (LGBT) and HIV service organizations in Maharashtra, India. Eligible participants self-identified as being MSM or hijra (transgender) women, living in Maharashtra, aged above 18 years, having regular Internet access, and having at least one male sex partner in the previous 90 days. RESULTS: Indian MSM living inside and outside the Greater Mumbai or Thane region reported an average of 6.7 (SD 11.8) male sex partners in the last 3 months; on average HIV status of the sex partners was disclosed to 2.9 (SD 8.9). The most commonly used websites and GSN apps by MSM living inside Greater Mumbai or Thane region were Planetromeo, Grindr, and Gaydar. Results demonstrated that MSM used smartphones to access GSN apps and stated a preference for both condomless and protected anal sex but did not disclose their HIV status. This low level of HIV disclosure potentially increases risk of HIV or STI transmission; therefore, trends in use should be monitored. CONCLUSIONS: Our data helps to fill the gap in understanding how Indian MSM use technology to find casual sex partners, disclose their sexual preference, and their HIV status on Web-based platforms. As mobile penetration in India continues to grow and smartphone use increases, the use of GSN sex-seeking apps by MSM should also increase, potentially increasing the risk of HIV or STI transmission within the app's closed sexual networks.

Recruitment Strategies of Indian Men Who Have Sex with Men in the State of Maharashtra Into an Online Survey.

In this manuscript, we report lessons learned from our efforts to recruit Indian men and transgender women/hijras who have sex with men into an online cross sectional study. Between September 2013 and May 2014, we implemented a seven-phased recruitment strategy that included the use of online and offline strategies to enroll a total of 449 participants into an online survey about recent sexual behavior and various psychosocial measures. The phases were implemented sequentially and cost-per-eligible participant was calculated. Using social media and collaborating with organizers of community events proved the most effective strategies for recruiting Indian MSM into online research.