Investment in Social Marketing Campaign to Reduce Stigma and Discrimination Associated with Mental Illness Yields Positive Economic Benefits to California

This article examines the potential impact of the California Mental Health Services Authority's stigma and discrimination reduction social marketing campaign on the use of adult behavioral health services, and it estimates the benefit-cost ratios.

Racial and Ethnic Differences in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental Health Challenges

Reports racial and ethnic differences on the California Well-Being Survey, a surveillance tool that tracks mental illness stigma and discrimination among a sample of California adults experiencing psychological distress.

Factors associated with younger adolescents' exposure to online alcohol advertising

Little is known about the extent and nature of youth exposure to online alcohol advertising, or factors that may be associated with exposure. The current study recruited middle school students who completed a paper survey and then logged each alcohol advertisement that they encountered over a 2-week period using cell phones as part of an ecological momentary assessment design. We examined the percentage of youth who reported exposure to online alcohol advertising in the past 2 weeks, average weekly rate of exposure, types of online alcohol advertisements youth reported seeing, and factors that increased youths' risk of exposure to online alcohol advertising. Analyses are based on 485 participants (47% female; 25% Hispanic, 25% White, 27% Black; 6% Asian, 16% other). Youth logged exposures to a total of 3,966 (16,018 weighted for underreporting) alcohol advertisements across the monitoring period; 154 (568 weighted) or 3.6% were online ads. Seventeen percent of youth reported seeing any online alcohol ad; the majority of online ads seen were video commercials (44.8%) and banner/side ads (26.6%). Factors associated with greater ad exposure were being older, rebellious, and Black race; greater parental monitoring and more hours spent on social media were associated with less exposure. Findings provide important information about adolescents' exposure to online alcohol advertising and what might contribute to a greater likelihood of exposure. Given that online ad exposure is linked to drinking behavior, prevention programming for younger adolescents should continue to address this issue to help youth make healthy choices regarding alcohol use. (PsycINFO Database Record

Adolescent Predictors of Generalized Health Risk in Young Adulthood: A 10-Year Longitudinal Assessment

We conducted a prospective examination of multiple adolescent predictors of generalized health risk in early adulthood. Data were used from 3,392 members of a longitudinal cohort surveyed at ages 13 and 23. A measure of generalized risk was constructed using confirmatory factor analysis to represent shared variance among substance use, sexual risk, and victimization. Multiple regression analysis indicated several robust sociodemographic, behavioral, and environmental early predictors of generalized adult risk, including gender, age, race, not coming from a nuclear family, engaging in smoking and deviant behavior as an adolescent, having poor grades in high school, alcohol and cigarette use by an adult important to the adolescent, and being offered substances as an adolescent. Results support the existence of an underlying risk construct in early adulthood, the importance of early adolescent deviance and substance use exposure in predicting risk, and the use of early comprehensive interventions that prevent several risks simultaneously.

Effects of the Integrated Behavioral Health Project's Efforts to Promote Integrated Care Under Funding from the California Mental Health Services Authority

Describes the methods and results of a RAND evaluation of the Integrated Behavioral Health Project's efforts to promote the integration of mental and physical health care among various health care stakeholders in California.

Effects of Stigma and Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority: An Evaluation of the National Alliance on Mental Illness Adult Programs

This study evaluated three National Alliance on Mental Illness (NAMI) programs aimed at reducing mental illness stigma and discrimination among adult audiences.

Effects of Stigma and Discrimination Reduction Programs Conducted Under the California Mental Health Services Authority: An Evaluation of Runyon Saltzman Einhorn, Inc., Documentary Screening Events

Describes the methods and results of a RAND evaluation of stigma and discrimination reduction efforts by Runyon Saltzman Einhorn, Inc., involving screenings of a documentary film called "A New State of Mind: Ending the Stigma of Mental Illness."

Effects of Stigma and Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority: An Evaluation of NAMI's Ending the Silence

This article evaluates the short-term outcomes of students attending the National Alliance on Mental Illness' Ending the Silence presentations, delivered across three high schools in a Northern California school district.

The Mental Health Association of San Francisco Partner Organizations Meet Their Goals in Stigma Reduction Efforts: Results of a Qualitative Evaluation of the Technical Assistance Process

This article describes the results of RAND's evaluation of the San Francisco-based Center for Dignity, Recovery, and Empowerment's technical assistance program for stigma-reduction programs through interviews with community-partner participants.

CalMHSA Stigma and Discrimination Reduction Online Resources: Highlights from an Evaluation of Web Analytic Data

Reports on an evaluation of online resources developed by the California Mental Health Services Authority's stigma and discrimination reduction initiative program partners and provides an overview of these resources and the use of partner websites.

Effects of Stigma and Discrimination Reduction Trainings Conducted Under the California Mental Health Services Authority: An Evaluation of Disability Rights California and Mental Health America of California Trainings

Describes the methods and results of a RAND evaluation of stigma and discrimination reduction trainings delivered by two program partners, Disability Rights California and Mental Health America of California.

Stigma, Discrimination, and Well-Being Among California Adults Experiencing Mental Health Challenges

Presents results of the 2014 California Well-Being Survey, which tracks mental illness stigma and discrimination, well-being, and exposure to prevention and early intervention activities among Californians experiencing psychological distress.

Changes in Mental Illness Stigma in California During the Statewide Stigma and Discrimination Reduction Initiative

Presents results of a one-year follow-up to the 2014 California Statewide Survey, which was developed to track attitudes, beliefs, and behaviors related to mental illness. This article focuses on items measuring stigma.

Reviewing the Evidence Base for Mental Health First Aid: Is There Support for Its Use with Key Target Populations in California?

This article reviews the current state of evidence for Mental Health First Aid's effectiveness in key target populations, to help the California Mental Health Services Authority's planning for future prevention and early intervention activities.

Evaluation of California's Statewide Mental Health Prevention and Early Intervention Programs: Summary of Key Year 2 Findings

This article summarizes key findings from the second year of an evaluation of the California Mental Health Services Authority's statewide prevention and early intervention programs.

Using a Grocery List Is Associated With a Healthier Diet and Lower BMI Among Very High-Risk Adults

OBJECTIVE

Examine whether use of a grocery list is associated with healthier diet and weight among food desert residents.

METHODS

Cross-sectional analysis of in-person interview data from randomly selected household food shoppers in 2 low-income, primarily African American urban neighborhoods in Pittsburgh, PA with limited access to healthy foods.

RESULTS

Multivariate ordinary least-square regressions conducted among 1,372 participants and controlling for sociodemographic factors and other potential confounding variables indicated that although most of the sample (78%) was overweight or obese, consistently using a list was associated with lower body mass index (based on measured height and weight) (adjusted multivariant coefficient = 0.095) and higher dietary quality (based on the Healthy Eating Index-2005) (adjusted multivariant coefficient = 0.103) (P < .05).

CONCLUSIONS AND IMPLICATIONS

Shopping with a list may be a useful tool for low-income individuals to improve diet or decrease body mass index.

Associations between depressive symptomatology, diet, and body mass index among participants in the supplemental nutrition assistance program

BACKGROUND

Participation in the Supplemental Nutrition Assistance Program (SNAP) has been shown to increase food security, or access to adequate food; however, SNAP participation has also been associated with obesity among certain demographic groups (eg, women, but not men and children), possibly due to poorer dietary quality. Depressive symptomatology is an understudied factor, which is associated with obesity across the lifespan.

OBJECTIVE

This study examined the relationship between depressive symptomatology, dietary quality, and body weight among a sample of SNAP participants (n=639).

DESIGN

The analysis was cross-sectional; survey data were collected in May to December 2011 by trained data collectors.

PARTICIPANTS/SETTING

Adults who self-identified as the primary food shopper of the household in two predominantly low-income African-American neighborhoods characterized as "food deserts" in Pittsburgh, PA, were recruited to participate in this study.

MEASURES

Dietary quality was calculated using the US Department of Agriculture's Healthy Eating Index-2005. Body mass index (BMI; calculated as kg/m(2)) was based on objective measurements taken by the interviewer. Current depressive symptomatology was assessed by a trained interviewer using the Patient Health Questionnaire-2.

STATISTICAL ANALYSES PERFORMED

Descriptive statistics (means and percentages); two multivariate ordinary least-square regression analyses predicting BMI and dietary quality from depressive symptomatology while controlling for sociodemographic factors and food insecurity were performed.

RESULTS

Depression was a strong and statistically significant predictor of both dietary quality and BMI; higher score in depressive symptomatology was associated with lower scores in dietary quality (β=-1.26; P<0.0001). A higher score in depressive symptomatology was associated with higher BMI (β=.63; P=0.0031).

CONCLUSIONS

These findings show that depressive symptomatology is significantly associated with weight-related outcomes and suggests that understanding the risk of depression among SNAP participants could be important to understanding the relationships among SNAP participation, diet, and weight. The association between depressive symptomology, elevated BMI, and lower dietary quality among low-income, primarily African-American residents living in a food desert suggests the potential for mental health interventions to have broader benefits in this population. However, the directionality of this association is unclear and improving diet and reducing weight might also improve mental health symptoms. Additional longitudinal studies should assess these possibilities.

Recommendations for Sustaining California's Statewide Mental Health Prevention and Early Intervention Programs

Provides preliminary advice about which of the California Mental Health Services Authority's Prevention and Early Intervention activities seem most valuable to sustain or, in some cases, enhance.

Beliefs Related to Mental Illness Stigma Among California Young Adults

This study examines mental illness stigma and related beliefs among young adults in California, especially whether levels of stigma are higher or lower than those observed in older adults.

Findings from the School-Based Theatrical Performance Walk In Our Shoes

This article examines the effects of a school-based theatrical performance, Walk In Our Shoes, designed to educate youth about and reduce stigma and discrimination toward mental illness.

Are our actions aligned with our evidence? The skinny on changing the landscape of obesity

Recent debate about the role of food deserts in the United States (i.e., places that lack access to healthy foods) has prompted discussion on policies being enacted, including efforts that encourage the placement of full-service supermarkets into food deserts. Other initiatives to address obesogenic neighborhood features include land use zoning and parks renovations. Yet, there is little evidence to demonstrate that such policies effect change. While we suspect most researchers and policymakers would agree that effective neighborhood change could be a powerful tool in combating obesity, we desperately need strong and sound evidence to guide decisions about where and how to invest.

Interventions to Reduce Mental Health Stigma and Discrimination: A Literature Review to Guide Evaluation of California's Mental Health Prevention and Early Intervention Initiative

A number of programs aim to reduce the stigma and discrimination associated with mental illness, and they can include a variety of components such as training, education, media campaigns, and contact with people with mental illness. Stigma and discrimination reduction activities are evaluated in this article, using evidence from an extensive literature review. Specific areas reviewed include relevant theories of stigma and prejudice reduction, what is and is not known about the effectiveness of various approaches to reducing the stigma of mental illness, the kinds of methodologies previously used in evaluating these approaches, and the methodologies that should be employed in the future. The authors also introduce a conceptual model of mental health stigma reduction based on a variety of existing theories and evidence.

Understanding and Reducing Off-Duty Vehicle Crashes Among Military Personnel

The authors review traffic safety in the United States, with specific reference to military personnel, focusing on safety interventions and attempts to change driver behavior and decisions. Overall, driving has become safer over the last 20 years: A variety of factors seem to have contributed to this increased safety-better vehicle safety features, better road safety features, decreases in teenage drunk driving, more seat belt use, and at least recently, fewer vehicle miles traveled. In contrast, motorcycle riding, a topic of particular interest to the military, is becoming more dangerous. The main difference between the military and civilian population is the proportion of military crash fatalities on motorcycles-the U.S. rate is currently about 15 percent of fatalities, while in some military branches the rate is on average 35-40 percent. This review shows that the following safety interventions tend to help in the reduction of vehicle crashes and that some in particular may be useful in the military setting: (1) better enforcement of underage drinking laws and continuation of alcohol deglamorization campaigns (Department of Defense regulations exist, but underage drinking seems to be relatively common); (2) high-visibility enforcement techniques for sobriety checkpoints; (3) high-visibility enforcement techniques for seat belt use; (4) adoption of a lower blood alcohol concentration level (such as 0.05) for motorcyclists, since the evidence shows that motorcyclists' ability to drive safely begins declining at lower levels than those for car drivers; (5) screening-perhaps as part of military medical assessment-and brief intervention with a trained counselor for at-risk drinkers, since they are at higher risk for drinking and driving; (6) media campaigns that are paired with community activities that also emphasize driver safety, such as workshops or fairs and with enforcement of driving regulations, and targeted at the drivers at highest risk (men in their teens and early 20s); (7) requirements that motorcyclists be licensed and own their vehicles.

Propensity scoring and the relationship between sexual media and adolescent sexual behavior: comment on Steinberg and Monahan (2011)

Longitudinal research has demonstrated a link between exposure to sexual content in media and subsequent changes in adolescent sexual behavior, including initiation of intercourse and various noncoital sexual activities. Based on a reanalysis of one of the data sets involved, Steinberg and Monahan (2011) have challenged these findings. However, propensity score approaches-especially the version of this method used by Steinberg and Monahan, which lacks covariates-do not necessarily result in more accurate estimates of treatment effects than does the regression with covariates approach employed by prior research. There are also a number of problems with the specific set of analyses presented by Steinberg and Monahan and the conclusion they draw from them. In contrast to Steinberg and Monahan's claim, there is substantial evidence of an association between sexual media exposure and adolescent sexual initiation.

Relationships Between Adolescent Sexual Outcomes and Exposure to Sex in Media: Robustness to Propensity-Based Analysis

Adolescent sexual health is a substantial problem in the U.S., and two recent studies have linked adolescent sexual behavior and/or outcomes to youths' exposure to sex in the media. Both studies had longitudinal survey designs and used covariate-adjusted regression analysis. Steinberg and Monahan (2010) reanalyzed data from one of these studies (Brown et al., 2006) using a propensity-score approach, arguing that this method better addresses the possibility of unobserved confounders. Based on their reanalysis, which found no relationship between media exposure and sexual behavior, they concluded that "Adolescents' Exposure to Sexy Media Does Not Hasten the Initiation of Sexual Intercourse." We subject data from the second study (Collins et al., 2004; Chandra et al., 2008) to reanalysis using a propensity-score approach. We find only modest reductions in two of the three previously documented associations, and no reduction in the third. Based on these findings, we conclude that there is an association between exposure to sex in the media and adolescent sexual outcomes. While the evidence does not prove causality, it is sufficient to advise caution among parents, develop interventions for youth, and work with media producers and distributors to reduce youth exposure to sexual content.