Psychosocial Factors Associated With Past Month Gambling Among Adolescents: Results From the 2016-2020 PRIDE Survey

The present study sought to identify psychosocial factors associated with recent gambling (gambling within the past 30 days). The 2016, 2018, and 2020 Parents' Institute for Drug Education (PRIDE) data sets were pooled and analyzed, consisting of 108,690 adolescents in 13 local public schools. A sizable percentage (13.1%) of adolescents reported gambling in the past 30 days. Multiple logistic regression analyses found differences based on demographic factors, previous substance use, and psychosocial factors. Adolescents at highest risk were male, non-White, in high school; sold drugs; and participated in violent activities in the past 30 days. The study also found worrying rates of substance use. Findings from the present study can inform harm reduction efforts, prevention messaging, and clinical interventions related to adolescent gambling.

Derived psychoactive cannabis products and 4/20 specials: An assessment of popular brands and retail price discounts in Fort Worth, Texas, 2023

BACKGROUND

Retail sales of derived psychoactive cannabis products (DPCPs) have increased in the U.S. since passing the 2018 Farm Bill and is unregulated in most states. This study investigated the types and commonly sold brands of DPCPs as well as promotional pricing on April 20th, a day associated with cannabis use.

METHODS

On April 19-20, 2023, investigators conducted telephone surveys with 98 retail stores that sold DPCPs in Fort Worth, Texas (where the market was largely unregulated).

RESULTS

Delta-8, Delta-9, and Delta-10 THC products were widely available, with 97%, 72%, and 82% of stores selling each type, respectively. Fifteen additional DPCPs were identified, and selling blends containing multiple types of THC was common. Frequently sold brands included Cake, Medusa/Modus, Torch, Urb, Kik, Tyson, 3Chi, Casper, Hidden Hills, Esco Bars, Happi, Hometown Hero, STNR, Bomb Bars, Baked, Hi On Nature, Looper, and Space God. Overall, 45% reported having 4/20 specials discounting prices on DPCPs, smoking devices/accessories, or everything in the store. Several stores also sponsored 4/20 promotional events including free THC gummies and "live delta demos where people can test cartridges and try smoking flower in the store."

CONCLUSIONS

Findings highlight the growing complexity of the DPCP market, including numerous different intoxicating compounds and blends. Policymakers, researchers, and public health professionals should consider these complexities, as well as the commonly sold brands, when developing strategies to regulate DPCPs and protect consumer safety. Pricing policies may be an especially important form of harm reduction during events associated with heavy cannabis use, including 4/20.

The most common types of nontraumatic dental conditions among emergency department visits in North Carolina before and during the COVID-19 pandemic

BACKGROUND

This study aimed to identify the most common types of nontraumatic dental conditions (NTDCs) before and during the COVID-19 pandemic and assess the variations in the most common NTDCs by patient age groups and rural or urban locations and the impact of COVID-19 on emergency department (ED) visits for NTDCs in North Carolina.

METHODS

The authors conducted a retrospective data analysis of ED data from the North Carolina Disease Event Tracking and Epidemiology Collection Tool. The authors estimated the proportions of NTDCs of all ED visits in 2019 and 2021 and ranked the proportions of the major categories of NTDCs by age groups and rural or urban locations. They used a multiple logistic regression model to assess the impact of COVID-19 on NTDCs.

RESULTS

By the first diagnosis, the proportion of NTDCs dropped from 1.1% in 2019 to 0.99% in 2021 (P < .001). Caries was specified as the third most common NTDC. Oral infection was the top NTDC among young (≤ 17 years) and older patients (≥ 65 years). No significant differences were found in NTDCs between rural and urban areas (P = .68). Children younger than 2 years (adjusted odds ratio, 4.36) and adults aged 18 through 44 years (adjusted odds ratio, 4.54) were more likely to visit the ED for NTDCs than those 75 years and older.

CONCLUSIONS

The proportion of NTDCs seen at the ED was lower during the COVID-19 pandemic in 2021 than in 2019. The common NTDCs varied by age group but were similar in rural and urban areas. The most common NTDCs were related to toothache, oral infection, and caries.

PRACTICAL IMPLICATIONS

More efforts are needed to reduce ED visits for NTDCs.

Kratom Retail Availability in Fort Worth, Texas

Kratom use is associated with cannabis use, so retail availability may also be related. Kratom and Delta-8 THC (a psychoactive cannabis product) are federally unregulated, marketed as "natural," and often used for pain relief and/or relaxation. Kratom may have greater retail availability in more socioeconomically deprived areas because harmful substances are frequently marketed to lower-income communities. This study examined kratom retail availability in Fort Worth, Texas. Locations with alcohol, tobacco, and/or CBD licenses were called in July 2022: 1,025/1,223 (84%) answered the phone. T-tests examined potential differences in socioeconomic deprivation scores surrounding outlets by whether they sold kratom. Cross-tabulations examined overlap in kratom and Delta-8 THC availability. Kratom was available in 6% of locations. Most kratom retailers had a tobacco license (92%). However, most stores with a tobacco license did not sell kratom (14%), whereas most stores with a CBD license did (55%). Kratom availability was not associated with area deprivation scores. Most kratom retailers (95%) sold Delta-8 THC and two-thirds (65%) of Delta-8 THC retailers sold kratom. This study was the first to examine retail availability of kratom. Findings indicate the presence of niche stores specializing in the retail of federally unregulated substances.

Distracted and Impaired Driving Among U.S. Adolescents, 2019, USA

Distracted driving, the act of focusing on something else while operating a vehicle, is a significant health problem among adolescents. Although some studies have reported on prevalence among adolescents in the United States, limited studies have examined differences by sexual identity status. The purpose of the present study was to examine past 30-day distracted driving by sexual identity status among a large, national sample of adolescents ages 14 to 18 years. A secondary analysis was conducted on the 2019 Youth Risk Behavioral Surveillance System (YRBSS) data, and associations between distracted driving and demographics (e.g., biological sex, age, race/ethnicity) were assessed with weighted logistic regression analyses. A total of 13,590 adolescents ages 14 to 18 years were part of the final analytic sample. Twenty-three percent of adolescents reported distracted driving in the past 30 days. Compared with heterosexual adolescents, gay/lesbian (14.3%), bisexual (18.1%), and questioning (12.9%) adolescents reported lower distracted driving in the past 30 days. Findings through a health equity approach may inform harm reduction efforts and behavioral interventions.

The Sexual and Gender Minority Adverse Childhood Experiences Scale

INTRODUCTION

Sexual and gender minority (SGM) adverse childhood experiences (ACEs) are identity-based forms of early life adversity. Exposure to SGM ACEs is associated with increased odds of depression, anxiety, and post-traumatic stress disorder in SGM adults. The purpose of this study was to further test a revised version of the measure in a U.S. sample with more robust and clinically relevant mental health outcomes.

METHODS

In May and June 2022, a national sample of SGM adults (N=4,445) was recruited from a Qualtrics Panel to complete a 20-minute online survey that included questions regarding ACEs, SGM ACEs, depression, anxiety, and post-traumatic stress disorder. Exploratory factor analysis and confirmatory factor analysis were used to examine factor structure. Multivariable regression was used to assess criterion validity, and a sensitivity analysis was conducted. Data were analyzed in February 2023.

RESULTS

Respondents indicate that vicarious trauma (81%) and school bullying (67%) were the most common experiences and that all SGM ACEs were frequently occurring before adulthood. Confirmatory factor analysis determined a 1-factor solution. Participants with more SGM adverse childhood experiences exposure had worse anxiety, depression, and post-traumatic stress disorder symptoms (β=0.16, β=0.18, β=0.26, respectively, p<0.0001) after controlling for ACEs exposure and demographic factors. A sensitivity analysis indicated that estimates were similar in terms of magnitude and direction.

CONCLUSIONS

SGM ACEs commonly and frequently occur before adulthood and impact adult SGM mental health. Overall, the measure had good-to-excellent psychometric properties. Future research should consider integrating SGM ACEs and Minority Stress Theory.

Network analysis of posttraumatic stress disorder in a treatment-seeking sample of US firefighters and emergency medical technicians

BACKGROUND

First responders, including firefighters and emergency medical technicians (EMTs), are under extreme stress from repeated exposure to potentially traumatic events. To optimize treatment for this population, it is critical to understand how the various posttraumatic stress disorder (PTSD) symptom factors are associated with one another so these relations may be targeted in treatment.

METHOD

Using a sample of treatment-seeking firefighters/EMTs (N = 342), we conducted a partial correlation network analysis of the eight-factor model. A Bayesian directed acyclic graph (DAG) was used to estimate causal associations between clusters.

RESULTS

Approximately 37 % of the sample screened positive for probable PTSD. Internal re-experiencing and external re-experiencing had the strongest edges. In the DAG, internal re-experiencing was the parent node and was potentially predictive of external re-experiencing, negative affect, dysphoric arousal, and avoidance.

LIMITATIONS

Data were drawn from a treatment-seeking sample that may not generalize to all firefighters/EMTs.

CONCLUSIONS

The current findings are consistent with prior research suggesting re-experiencing plays a critical role in developing and maintaining PTSD symptoms. Future research should investigate non-treatment-seeking first responders, as well as EMTs and firefighters as individual populations.

A national examination of suicidal ideation, planning, and attempts among United States adults: Differences by military veteran status, 2008-2019

There is a widening disparity in suicide deaths between United States (U.S.) military veterans and nonveterans. However, it is unclear if there are similar differences in suicidal ideation, planning, and attempts that often precipitate these deaths. A better understanding of trends in suicidal thoughts and behaviors could illuminate opportunities for prevention. We examined pooled cross-sectional data (N = 479,801 adults) from the 2008 to 2019 National Survey on Drug Use and Health. We examined differences in past-year suicidal ideation, suicide planning, and suicide attempts between U.S. veterans (n = 26,508) and nonveterans (n = 453,293). We conducted post hoc analyses to examine for differences in these relationships by race/ethnicity and sex. Lastly, we examined trends in these outcomes over time and tested for differences in trends by veteran status. Overall, veterans had significantly greater odds of past-year suicidal ideation (aOR = 1.33, 95% CI 1.20 to 1.47) and suicide planning (aOR = 1.52, 95% CI 1.30 to 1.78) compared to nonveterans. However, the association between veteran status and past-year suicide attempt was not statistically significant (aOR = 1.29, 95% CI 1.00 to 1.68). These relationships did not differ by race/ethnicity or sex (ps > 0.05). Among all adults, there were significant linear increases in past-year suicidal ideation, planning, and attempts (ps < 0.001). However, these trends did not differ between veterans and nonveterans (ps > 0.05). Veterans may be more likely to experience suicidal thoughts and behaviors than nonveteran adults. Upward trends in suicidal thoughts and behaviors among both veterans and nonveterans from 2008 to 2019 highlight opportunities for intervention.

Validation of the PCL-5, PHQ-9, and GAD-7 in a Sample of Veterans

OBJECTIVE

Veterans can present at nongovernment (Department of Defense, Department of Veterans Affairs) mental health agencies with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no veteran study has validated these measures on a treatment-seeking sample of veterans outside the DoD and VA.

METHODS

We used a treatment-seeking sample of veterans ( N = 493) to validate measures that assess these constructs (PTSD Checklist 5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7).

RESULTS

The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting model of the depression measure was a two-factor structure, cognitive-affective, and somatic depression. The measure of generalized anxiety was a unidimensional model.

LIMITATIONS

Follow-up studies should validate these measures on nontreatment-seeking discharged veterans.

CONCLUSIONS

We interpret these findings within the veteran scholarship and explore clinical implications for providers.

School Factors Associated With Past 30-Day E-Cigarette Use Among Hispanic Youth

E-cigarettes are a popular type of nicotine product among youth in the United States. Hispanic youth, one of the fastest growing populations in the United States, are second only to white youth for e-cigarette use. Analysis of the Parents' Resource Institute for Drug Education data was conducted to determine past 30-day e-cigarette use among Hispanic youth (n = 4,602) and also examined school factors related to such use. Findings indicated that 13.8% of Hispanic youth used e-cigarettes in the past 30 days. Multivariate logistic regression analysis determined several school factors (e.g., poor grades, grade level) related to e-cigarette use. School-based prevention programs are needed to reduce and eliminate e-cigarette use among Hispanic youth.

Predictors of Suicide and Differences in Attachment Styles and Resilience Among Treatment-Seeking First-Responder Subtypes

OBJECTIVE

To identify the predictors of suicide for firefighters (FFs), emergency medical technicians (EMTs), and law enforcement officers (LEOs).

METHODS

We used baseline data from FFs/EMTs (n = 69) and LEOs (n = 81) to investigate the unique predictors for both first-responder subtypes. We conducted confirmatory factor analysis on validated assessments of posttraumatic stress disorder (PTSD) and depression. Measures of attachment, resilience, PTSD, depression, generalized anxiety, trauma history, and substance use were the independent variables in two backward stepwise regressions predicting suicide.

RESULTS

Substance use and somatic depression were significant predictors for LEOs, whereas affective depression, anhedonia, externalizing behaviors, trauma history, and generalized anxiety were significant predictors for FFs/EMTs.

LIMITATIONS

These data are cross-sectional and should be modeled longitudinally over the course of treatment.

CONCLUSION

Separate constructs influence suicide for LEOs and FFs/EMTs.

Methamphetamine-Related Mortality in the United States: Co-Involvement of Heroin and Fentanyl, 1999-2021

Objectives. To examine trends in methamphetamine-related mortality in the United States from 1999 to 2021 and the extent to which these deaths co-involved heroin or fentanyl. Methods. We obtained final and provisional data from the CDC WONDER (Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research) multiple causes of death database for deaths that involved methamphetamine and deaths that involved both methamphetamine and heroin or fentanyl mong US residents aged 15 to 74 years. We plotted the age-adjusted methamphetamine-related mortality rate by year and quantified the proportion of deaths with heroin or fentanyl co-involvement. Finally, we used joinpoint regression to quantify trends in the methamphetamine mortality rate and proportion of deaths with heroin or fentanyl co-involvement. Results. From 1999 to 2021, there was a 50-fold increase in the methamphetamine mortality rate, which was accompanied by an increasing proportion of deaths that co-involved heroin or fentanyl, peaking at 61.2% in 2021. Conclusions. Unprecedented increases in methamphetamine-related mortality have occurred during the last decade, and an increasing proportion of these deaths co-involved heroin or fentanyl. Public Health Implications. Stark increases in methamphetamine-related mortality and heroin or fentanyl co-involvement warrant robust harm reduction efforts, especially for people who engage in polysubstance use. (Am J Public Health. 2023;113(4):416-419. https://doi.org/10.2105/AJPH.2022.307212).

National Trends in Past-Year Marijuana Use among Veterans in the United States, 2013-2019

Background: The legal landscape surrounding marijuana use in the United States (US) is ever changing. Although substantial research has investigated risk factors of use among different populations, much is to be gleaned among veteran populations, who are at heightened risk for mental and physical health problems, which may be precipitated or relieved by marijuana use. The present study investigated correlates and trends of recreational and medical marijuana use among a large national sample of US Veterans. Methods: Data from the National Survey on Drug Use and Health (2013-2019) comprised of 16,350 veterans 18 years or older were analyzed. We tested for weighted linear and quadratic trends in past-year use. Results: Weighted analyses revealed a significant increase (56%) in overall marijuana use from 2013-2019, with nearly one in 10 veterans (9.79%) reporting past-year marijuana use. Compared to 18 to 25-year-old veterans, veterans who were aged 35-49 years (aPR: 1.44, 95% CI 1.05, 1.97), 50-64 years (aPR: 1.68, 95% CI 1.11, 2.55), and 65 years or older (aPR: 1.90, 95% CI 1.24, 2.90) were more likely to report using medical marijuana in the past year. Conclusions: This increase, in the context of federal VA provider restrictions, has implications for issues of care coordination and safe supply for veterans. Given the rapidly changing and heterogenous landscape of recreational and medical marijuana policy in the US, the present study may inform harm reduction efforts and behavioral interventions.

Typical Sources and Locations of Marijuana among US Young Adults: Differences by Sexual Minority Status

Background: With the widespread legalization of cannabis and use among all age groups, location and source of cannabis remains to be researched, especially among minority populations. Methods: We pooled data from the 2018-2019 National Survey on Drug Use and Health and investigated differences by sexual minority status of where individuals obtained cannabis. Results: Results found that gay/lesbian and bisexual individuals who reported use were more likely to get marijuana from buying it, trading it for something else and getting it for free or sharing someone else's, compared to heterosexual individuals. Furthermore, more than one in five lesbian/gay individuals reported obtaining marijuana from someone they just met while nearly 25% of bisexual women reported obtaining marijuana from a friend. Conclusions: Findings from the present study may inform harm reduction and policy initiatives.

Psychometric Properties of Scales Measuring Resilience in U.S. Latinx Populations: A Systematic Review

Objectives

Instruments used to measure resilience have typically been developed in European or Anglosphere countries and emphasize personal factors of resilience. In addition to being a quickly growing ethnic minority group in the United States, Latinx individuals face unique stressors and protective factors that may contribute to resilience. This review sought to determine the extent to which instruments measuring resilience have been validated in U.S. Latinx populations and what domains of resilience those scales capture.

Methods

A systematic literature review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and included studies describing psychometric properties of resilience scales for Latinx individuals living in the United States. Articles were assessed for quality of psychometric validation; scales used in the final studies were assessed for representation of domains of the social ecological resilience model.

Results

Nine studies were included in the final review examining eight separate resilience measures. The populations of these studies were heterogeneous geographically and demographically; more than half the studies only included Latinx populations as a subgroup. The breadth and quality of psychometric validation were variable across studies. The domains represented by the scales in the review most heavily assessed individual domains of resilience.

Conclusion

The literature to date on psychometric validation of resilience measures in Latinx populations in the United States is limited and does not robustly capture aspects of resilience that may be particularly meaningful for Latinx populations, such as community or cultural factors. Instruments that are developed with and for Latinx populations are necessary to better understand and measure resilience in this population.

The Impact of Cannabis Packaging Characteristics on Perceptions and Intentions

INTRODUCTION

As cannabis increasingly becomes a consumer product in the U.S., its product packaging has become critically important to regulators. This study examined the influence of recreational cannabis packaging characteristics.

METHODS

Five online between-subjects experiments were conducted in April 2021, and data were analyzed in May 2021-July 2021. Experiments randomized participants to view different (1) types of cannabis, (2) visual displays of tetrahydrocannabinol content, (3) cannabis packages designed around brand personality research, (4) health warnings, and (5) health claims. Outcomes included cognitive, affective, and behavioral responses.

RESULTS

A total of 841 adults from the U.S. (49% male, 50% young adults, 44% White, 17% Hispanic) were included in the study. Edible gummies were perceived as healthier (β=0.32, 95% CI=0.03, 0.62), less grown up (β= -0.58, 95% CI= -0.86, -0.28), and more socially acceptable to consume (β=0.30, 95% CI=0.01, 0.59) than cannabis concentrate in a medical dropper. Participants also had more interest in trying edible gummies (β=1.33, 95% CI=1.04, 1.62) and trying a free sample (β=1.30, 95% CI=1.01, 1.60) than trying cannabis concentrate. Cannabis packages with a helps-you-relax health claim elicited more happy (β=0.34, 95% CI=0.04, 0.64) and good (β=0.37, 95% CI=0.07, 0.67) feelings than cannabis packages without this claim. Minimal effects were found for visual displays of tetrahydrocannabinol content and health warnings.

CONCLUSIONS

Edibles are a unique type of cannabis that should be given special consideration under state laws, and lawmakers should consider limiting and governing the use of both implicit and explicit health claims on recreational cannabis packages when implementing laws.

A Systematic Literature Review of Community-Based Participatory Health Research with Sexual and Gender Minority Communities

Purpose:

The objective was to review sexual and gender minority (SGM) health research studies to gain an understanding of how the community-based participatory research (CBPR) framework has been operationalized.

Methods:

We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct a review of all SGM health research studies published in the past 10 years that cited a CBPR approach (PROSPERO Registration No. CRD42016036608). CINAHL, PubMed, and PsycINFO databases were systematically searched in October 2020. Dimensions of community involvement (e.g., shared decision-making; flexibility to community needs and priorities) and the strength of evidence for each dimension were rated using guidance from the Agency of Healthcare Research and Quality.

Results:

The 48 eligible articles identified reported a range of 0–11 (out of 13) community elements. Seven studies reported zero elements. Qualitative studies (n=28; 58.3%) had an average quality score of 2.32 (range: 1.43–2.5). The 15 (31.3%) cross-sectional studies had an average quality score of 2.08 (range: 1.64–2.27).

Conclusion:

Adhering to the CBPR framework is challenging. The benefits of striving toward its principles, however, can move us toward transformative and sustainable social change within SGM communities.

Dietary genistein and 17β-estradiol implants differentially influence locomotor and cognitive functions following transient focal ischemia in middle-aged ovariectomized rats at different lengths of estrogen deprivation

Genistein possesses estrogenic activity and has been considered a potential replacement for estrogen replacement therapy after menopause. In the current study, we investigated the neuroprotective effects of dietary genistein at varied lengths of estrogen deprivation in middle-aged ovariectomized Sprague-Dawley rats under ischemic conditions. Two weeks of treatment with dietary genistein at 42 mg/kg but not 17β-estradiol implants improved cognitive flexibility (Morris water maze test) after short-term estrogen deprivation (2 weeks) but not long-term estrogen deprivation (12 weeks). 17β-estradiol implants but not dietary genistein improved locomotor asymmetry (cylinder test) after long-term but not short-term estrogen deprivation. Dietary genistein but not 17β-estradiol implant improved early phase motor learning (rotarod test) after long-term estrogen deprivation. Neither 17β-estradiol implant nor dietary genistein reduced infarct size after either short-term or long-term estrogen deprivation. Genistein, however, reduced ionized calcium-binding adaptor molecule-1 (Iba1) expression, a marker of brain inflammation, at the ipsilateral side of stroke injury after short-term but not long-term estrogen deprivation. This study suggests that the neuroprotective effects of dietary genistein on motor and cognitive functions are distinctly influenced by the length of estrogen deprivation following focal ischemia. SIGNIFICANCE: There is an increasing postmenopausal population opting for homeopathic medicines for the management of menopausal symptoms due to the perceived distrust in estrogen use as hormone replacement. Basic and clinical studies support the notion that early, but not delayed, hormone replacement after menopause is beneficial. Furthermore, evidence suggests that delaying hormone replacement augments the detrimental, rather than the beneficial effects of estrogens. Because of the active consideration of soy isoflavones including genistein as alternatives to estrogen replacement, it is necessary to understand the ramifications of soy isoflavones use when their administration is begun at various times after menopause.

Family and Parent Correlates to Anxiety in a National Sample of 12 to 17 Year Olds

Anxiety is a common mental health issue among adolescents. Family is one influence on adolescent anxiety that warrants attention. We investigated the relationship between adolescent anxiety, demographic, and familial and parental factors using data from the 2017 National Child Health Survey. We found an estimated one adolescent in seven reported anxiety, and nearly one in five reported anxiety related to witnessing family violence. Our study's findings may aid in the creation of family level programs aimed at preventing and reducing anxiety among adolescents.

Past-Year Ketamine Use: Evidence from a United States Population, 2015-2019

Ketamine is an analgesic that has gained notoriety in nightclub scenes. Yet, a paucity of research exists on the prevalence and associated factors in the United States (US). The present study estimated the prevalence of past-year ketamine use among a national sample of US adults and investigated sociodemographic characteristics and past-year use of other substances associated with past-year ketamine use. Data from the 2015-2019 National Survey on Drug Use and Health was conducted among 210,392 adults over the ages of 18 years old. An estimated 0.13% of adults used ketamine in the past year, with males more likely to use. Significant risk factors included past-year drug use and sexual minority status, with sexual minority males reporting more than use of one substance at highest risk for ketamine use. Findings from the present study may inform harm reduction efforts and policy initiatives.

The Influence of Loneliness on the Smoking and Physical Activity of Community-Dwelling Older Adults: Results from the Health and Retirement Study

PURPOSE

To use the loneliness model in examining the influence of loneliness on the number cigarettes smoked per day and the different intensity levels of physical activity among community-dwelling older Americans in the United States.

DESIGN, SETTING, SAMPLE

This study analyzed a nationally representative sample of older adults aged 65+ in two waves (2010 and 2012) of data from the Health and Retirement Study. Response rates for the two waves were 81% and 89.1%. The sample size for smoking model was 199, and for physical activity models was 3018.

MEASURES

Outcomes included number of cigarettes smoked per day and physical activity at three intensity levels: light, moderate, and vigorous. Independent variable was the UCLA loneliness scale.

ANALYSIS

A lagged dependent approach for modeling longitudinal data was adopted. Models controlled for outcomes at the first timepoint (Wave 1), health/physical functioning, and demographic variables.

RESULTS

Loneliness was associated with an increased number of cigarettes smoked per day (β = 2.93, P < .05) and decreased engagement in moderate and vigorous physical activity for older adults (β = .12, P < .05; β = .12, P <. 05), after controlling for these behaviors at baseline and other covariates.

CONCLUSION

The findings call for smoking reduction and physical activity enhancement interventions targeting older adults who have high levels of loneliness. Efforts to enhance social support will be crucial to eradicating the harmful health impact of loneliness. Critical limitations include self-reported measures and unobserved confounders.

Training Mental Health Professionals in Gender-Affirming Care: A Survey of Experienced Clinicians

Purpose

Transgender and gender nonconforming (TGNC) individuals have difficulty accessing mental health professionals (MHPs) prepared to deliver culturally informed care. This study aims to (1) explore the training experiences that had been available to MHPs who are actively providing care to TGNC individuals, (2) define which opportunities had been most beneficial in TGNC career development, and (3) determine the reasons MHPs sought training when it was absent in graduate curricula.

Methods

A voluntary cross-sectional electronic survey was distributed through professional Listservs and public referral lists to interdisciplinary MHPs, who self-identified as having experience in providing care to TGNC individuals.

Results

Two hundred eighty-one (n=281) counselors, marriage/family therapists, social workers, psychologists, psychiatrists, or psychiatric nurse practitioners responded to the survey. The two most common motivators for seeking training in gender-affirming care were filling a need in the community (68.8%) and having met a TGNC person in a clinical setting, who requested care (67.2%). Only 20.0% of our sample were exposed to relevant content in a graduate course, and 25.2% during clinical training. The most commonly available training opportunities were professional conferences (76.4%) and mentorship (41.2%). Respondents were most likely to recommend that others in their field be trained through structured clinical experience.

Conclusion

This study identifies key strategies for graduate and post-graduate educators to better prepare MHPs to serve TGNC individuals. Wider availability of structured clinical experiences, didactic content delivered during graduate school or at professional conferences, and direct clinical mentorship will increase access to welcome and prepared mental health care providers for the TGNC population.

Long-term hypogonadism diminishes the neuroprotective effects of dietary genistein in young adult ovariectomized rats after transient focal ischemia

Increasing age disproportionately increases the risk of stroke among women compared to men of similar age, especially after menopause. One of the reasons for this observation is a sharp drop in circulating estrogens. However, the timing of initiation of estrogen replacement after menopause is associated with mixed beneficial and detrimental effects, hence contributing to widespread mistrust of estrogen use. Agents including soy isoflavones are being assessed as viable alternatives to estrogen therapy. In this study, we hypothesized that the neuroprotective effects of genistein, a soy isoflavone are less sensitive to the length of hypogonadism in young adult ovariectomized rats following cerebral ischemia. We expected that long-term hypogonadism will worsen motor and cognitive function, increase post-stroke inflammation with no effect on the neuroprotection of genistein. We compared the effect of treatment with dietary genistein (GEN) on short-term (2 weeks) and long-term hypogonadism (12 weeks) in young adult ovariectomized Sprague-Dawley rats on sensorimotor function, cognition and inflammation after focal ischemia. Dorsal Silastic implant of 17β-estradiol (E2) was used as a control for hormone therapy. Long-term hypogonadism stroked rats performed worse than the short-term hypogonadism stroked rats on the motor and cognitive function tests. GEN did not improve neurological assessment and motor learning after either short-term or long-term hypogonadism. GEN improved cognitive flexibility after short-term hypogonadism but not after the long-term. Both GEN and E2 reduced tissue loss after short-term hypogonadism and reduced GFAP expression at the contralateral side of ischemia after long-term hypogonadism. The length of hypogonadism may differentially influence the neuroprotective effects of both GEN and E2 on the motor and cognitive functions in young adult rats.

Authoritative Parenting Behaviors and Marijuana Use Based on Age Among a National Sample of Hispanic Adolescents

Although numerous prevention efforts have been implemented, marijuana remains the most commonly used illicit substance among Hispanic adolescents nationwide. We sought to determine the influence authoritative parenting behaviors have on lifetime, past year, and past month marijuana use among Hispanic adolescents overall, and then based on age (i.e., 12-13, 14-15, and 16-17 years). We conducted a secondary analysis of the 2012 National Survey on Drug Use and Health (N = 3457). We performed a series of logistic regression analyses. Nearly one-fifth (19.5%) of Hispanic participants reported lifetime marijuana use, 14.5% reported past year use, and 7.5% reported past month use. Results indicated that Hispanic adolescents who are at significantly increased risk for reporting lifetime, past year, and past month marijuana use, were those who reported that their parents seldom or never performed the following behaviors: (1) checked if their homework was done, (2) helped them with their homework, (3) limited the amount of TV they watched, (4) told them they did a good job, and (5) told them they were proud of them. There were no relationships between adolescents' lifetime, past year, or past month marijuana use and whether their parents made their youth do chores or limited their time out on a school night. Regarding age, while results indicated that most authoritative parenting behaviors have a significant effect against marijuana use, the protective effect diminished with age, with the exception of the relationship between adolescents' past month marijuana use and whether their parents checked to see if their homework was done. Substance use prevention programs for this population should start in early adolescence and involve and educate parents on adopting authoritative parenting behaviors.

Role of sex on the relationship between sexual minority status and past 30-day marijuana use among high school students (YRBS, 2015-2019)

BACKGROUND

Sexual minority status (SMS) is a known risk factor for marijuana use among youth in the United States (US). Limited research has examined the differing relationship between SMS and marijuana use across males and females. This study examined the modifying effect of sex on the relationship between sexual minority status (SMS) and past 30-day marijuana use among youth.

METHODS

Data were pooled from the 2015, 2017, and 2019 Youth Risk Behavior Surveillance survey. Participants were 9th through 12th grade students in the US (n = 37,870). An interaction model (SMS*sex) and models stratified by sex tested effect modification. Covariates included race/ethnicity, grade, tobacco use, illicit drug use, and survey year.

RESULTS

The association between SMS and past 30-day marijuana use differed statistically by sex assigned at birth. Among females, SMS was associated with 1.33 greater odds of past 30-day marijuana use. Conversely, among males, SMS was associated with 0.70 lower odds of past 30-day marijuana. Interaction model was statistically significant.

CONCLUSION

SMS is associated with greater odds of being a past 30-day marijuana user among females but lower odds among males. Prevention and education programs aimed at youth should consider these factors during development and implementation. Longitudinal research is needed to further examine the nuances of the relationship observed in this analysis.

Binge drinking among Hispanic older adults: 2015-2019

Previous research has shown that older adults (i.e., individuals 50 years or older) show a high propensity to report unhealthy alcohol habits. Much is to be gleaned regarding these relationships among Hispanic older adults. The purpose of the present study was to examine correlates to binge drinking among a national sample of Hispanic older adults. Pooled data from the 2015-2019 National Survey on Drug Use and Health were analyzed among 4,152 Hispanic individuals. Findings revealed that a sizable percentage (17.9%) of individuals reported binge drinking in the past 30 days. Of the sample, 15.1% of individuals diagnosed with diabetes reported binge drinking and high co-morbid substance use was found. Findings can address critical gaps in Hispanic health care, prevention messaging, and harm reduction.

Sexual Minority Status and Marijuana Initiation during Adulthood: A Longitudinal Study Using Nationally Representative Data

Sexual minorities (i.e. individuals who identify as lesbian, gay, and bisexual) are at increased risk for marijuana use. However, little is known about initiation during adulthood. This study examines: (1) sexual minority status as a risk factor for marijuana initiation, and (2) the modifying effect of sex (labeled at birth) on this relationship. Methods: We analyzed Wave 1 (2013-2014) and Wave 2 (2014-2015) of the Population Assessment of Tobacco and Health, a nationally representative survey. Participants were n = 10,756 adult never marijuana users. A multivariable logistic regression examined the relationship between sexual minority status and initiation of marijuana use at Wave 2. Multivariable logistic regressions, stratified by sex, were used to assess for effect modification. Covariates were sex, age, race/ethnicity, income, currently attending college, and mental health well-being. Results: Approximately 1.1% of adults initiated marijuana use from Wave 1 to Wave 2. Sexual minority status was associated with 1.57 (95% CI: 1.00-2.46) greater odds of marijuana initiation. In stratified analyses, sexual minority status was associated with greater odds of marijuana initiation for females (Adj OR: 1.97; 95% CI: 1.19-3.26) but not males (Adj OR: 0.84: 95% CI: 0.33-2.16). Conclusions: Sexual minority status is a risk factor for marijuana initiation during adulthood. This relationship was only consistent for females, suggesting that sex may be an effect modifier. However, research designed and powered to directly detect this effect is needed. Findings highlight a need for public health interventions that reduce disparities in marijuana use among sexual minorities.

Trends in Suicidal Behaviors Among US Adults 2015-2018

Background: Suicide remains a major public health problem in the United States. The purpose of this study was to examine trends in suicide ideation, planning, and attempts among a national sample of US adults. Method: We used aggregated 2015-2018 data from the National Survey Drug Use and Health Survey. We utilized demographic and substance use questions with each suicide behavior. We assessed weighted absolute and relative changes in a national sample of 7,654 adults. Results: Results revealed that from 2015 to 2018, there was a 16.0% increase in suicide ideation, 18.6% increase in suicide planning, and 11.6% increase in suicide attempts. Significant increases in each behavior were found in African Americans, younger adults, sexual minorities, and individuals who reported past-year drug use. Limitations: Limitations include self-report of suicidal behaviors and desirability of answers. Conclusion: We believe our findings can inform harm reduction efforts and health messages surrounding suicide prevention.

Does marijuana use among African American adolescent males differ based on school factors?

Marijuana use among adolescents is a major public health problem. The purpose of this study was to examine whether past-year marijuana use among African American adolescent males differed based on age and school factors. Data from the 2015-2018 National Survey on Drug Use and Health (NSDUH) were analyzed. A national sample of African American students in grades 7 through 12 (n = 5,738) completed the survey. Results indicated that 14.7% reported using marijuana in the past year. Those at highest risk for past-year marijuana use were those who were male, were 16 to 17 years old, were in 9th through 12th grade, did not like going to school, and thought that most/all students in their grade used marijuana. Prevention professionals should consider the links among school attitudes, perceived social norms, and marijuana use when developing programs and interventions. Efforts are needed that are culturally competent and culturally sensitive to help reduce marijuana use rates among African American male adolescents. Future research is needed to further examine school perceptions and marijuana use among this population.

Trends in LSD use among US adults: 2015-2018

BACKGROUND

The recent use of LSD to treat severe psychological disorders in several clinical applications has proven effective in reducing symptoms and distressing events. Trend analyses are warranted to provide the most current data for clinical and health interventions. The purpose of this study was to examine trends in LSD use among adults in the United States.

METHODS

A secondary analysis of the 2015-2018 National Survey on Drug Use and Health was conducted on 168, 562 adults ages 18 and older.

RESULTS

Past-year LSD use increased 56.4% (P < .0001) from 2015 to 2018. The proportion of LSD users ages 26-34 increased from 19.6% to 31.1% (P < .0001), ages 35-49 increased from 2.73% to 8.82% (P < .0001) and 50 years or older increased from 1.83% to 2.66% (P < .0001). LSD use among bisexual individuals increased from 11.2% to 13.0% (P < .0001). LSD use among individuals with a college degree or more increased from 18.2% to 31.1% (P < .0001). Significant decreases in LSD use were present in individuals who were multi-racial (P < .0001), less than high school education P < .0001), high school education (P < .001), and perceived great risk of drugs (P < .0001).

CONCLUSIONS

LSD use in the US jumped 56.4% from 2015 to 2018. Results from the present study can inform prevention and harm reduction efforts (e.g., co-morbid substance use interventions, health messaging).

Self-esteem, Acculturative Stress, and Marijuana Use Among Hispanic College Students

Previous research has found mixed results regarding the association between acculturation and substance use in Hispanic populations. Additional research is warranted to examine relations among facets of acculturation, particularly acculturative stress, and marijuana use. The purpose of this study was to examine whether self-esteem mediates the relation between acculturative stress and a lifetime history of marijuana use among a sample of Hispanic college students. Hispanic college students ( N = 204; Mean age = 20.3 years) from a large southwestern university participated in an online study and reported on lifetime marijuana use, self-esteem, and acculturative stress. We evaluated the hypothesis that self-esteem would mediate the relation between acculturative stress and the likelihood of reporting a history of marijuana use, utilizing Hayes’ SPSS macro, which provides estimates of boot-strapped confidence intervals for the indirect effect. Results showed that self-esteem did not significantly mediate the relation between acculturative stress and likelihood of marijuana use [ b = .157, 95% CI (−.003, .017)]. Future studies might examine other facets of acculturation in relation to substance use, utilizing a longitudinal approach to better understand these associations.

Psychosocial Determinants to Prenatal Marijuana Use Among a National Sample of Pregnant Females: 2015–2018

Marijuana use continues to be rampant among pregnant females. This study sought to examine recent marijuana use among a national sample of pregnant females. Aggregated data from the 2015–2018 National Survey on Drug Use and Health were utilized. Weighted analyses revealed that 5.19% of females used marijuana in the past 30 days. Those at greatest risk for recent use were African American (adjusted odds ratio [aOR]: 1.91); identified as gay/lesbian (aOR: 11.9) or bisexual (aOR: 3.37); used cigarettes (aOR: 2.74), alcohol (aOR: 5.10), and/or illicit drugs in the past month (aOR: 4.52); and thought marijuana was easy to access (aOR: 7.23). Women at decreased risk were older, Native Hawaiian, in their second trimester, and thought marijuana was a great risk. We believe our findings can inform harm-reduction efforts and inform prevention messages.

Prevalence and Correlates to Lifetime Illicit Substance Use Among a National Sample of Hispanic Transgender Individuals

The Hispanic population is the fastest growing minority population in the United States. A growing body of literature suggests Hispanic individuals are at increased risk for substance use disorders. While much of the literature has focused on Hispanic heterosexual individuals, a paucity of literature has focused on Hispanic transgender individuals. More research is warranted on the prevalence and correlates to substance use among Hispanic sexual minorities, in particular Hispanic transgender individuals. The present study sought to examine correlates to lifetime illicit substance use among a national sample of transgender individuals. A secondary analysis of the 2015 Transgender Survey was conducted among 1,473 Hispanic transgender individuals. Weighted analyses reveal that 29% of Hispanic transgender individuals reported lifetime illicit substance use. Significant predictors included age and prior lifetime substance use. Recommendations for health professionals and policy analysts are included.

The Epidemiology of Recent Alcohol Use Among a National Sample of Middle Eastern College Students

Alcohol use among college students is a national health concern. The epidemiology of alcohol use among Middle Eastern college students remains to be investigated. This study sought to understand the epidemiology of recent alcohol use among Middle Eastern college students. We use data from the 2017 to 2018 Healthy Minds Study to identify predictors of recent alcohol use among 1,763 Middle Eastern students nationwide. Weighted univariate analyses were conducted to determine significant predictors of recent alcohol use. Nearly half (45.5%) of Middle Eastern college students reported using alcohol in the past 2 weeks (recent alcohol use). Those at highest risk for recent alcohol use were in their 4th year of schooling (p < .001), living in a fraternity or sorority house (p < .001), and reported that religion was not a big part of their life (p < .001). Students who lived with their parents were less likely to drink alcohol (p < . 001). Recent alcohol use among Middle Eastern college students is a national public health concern. Interventions are warranted to decrease this growing public health anomaly and to more effectively deal with this current public health crisis.

Hispanic Transgender Individuals: A Forgotten Diaspora

This article addresses gaps and warrants further investigation among Hispanic transgender individuals.

A content analysis of smartphone apps for adolescent smoking cessation

Adolescent cigarette smokers have an increased risk of sustained smoking into adulthood. Smartphone applications (apps) for smoking cessation are a promising treatment resource. However, research on apps for adolescent smoking cessation is limited. This study compared smoking cessation mobile apps targeting an adolescent audience with popular cessation apps for a general audience. Adolescent and general-audience apps were identified by searching the Google Play and Apple App Stores (November 2016). Two coders assessed each app for adherence to clinical practice guidelines for tobacco and adolescent-specific content (2016-2017) and developed a summary score that summed all adherence and adolescent content criteria. Eight adolescent apps were identified and compared with the top 38 general apps (as ranked by Apple and Google). Both general and adolescent apps commonly had adherence content related to developing a quit plan (general: 73.68 per cent; adolescent: 87.50 per cent) and enhancing motivation by describing the rewards of not smoking (general: 76.32 per cent; adolescent: 62.50 per cent). Adolescent-specific content such as peer influence on smoking was common in adolescent apps but not in general apps (general: 5.26 per cent; adolescent: 62.50 per cent). Adolescent apps had a higher general adherence content summary score [t (44) = 2.55, p = .01] and a higher adolescent content summary score [t (7.81) = 2.47, p = .04] than the general apps. On average, adolescent cessation apps included more adherence content and adolescent-specific content than general apps. Future research is needed to determine the extent to which adolescents engage with the adherence content available in these apps.

Neighborhood and community factors related to youth conduct disorder among adolescents

Aim

An estimated 3% to 5% of youth are annually diagnosed with conduct disorder (CD), making it a pressing mental health concern. While many studies have focused on the behavioral aspects of conduct disorder, environmental and neighborhood factors have yet to be explored. The present study examined specific neighborhood and community characteristics associated with youth conduct disorder.

Method

A secondary analysis of the United States’ 2011-2012 National Survey of Children’s Health was conducted. Participants included a total of 34,601 adolescents aged 12-17 (52.3% were male and 47.7% were female).

Results

Results from the final multivariate logistic regression model revealed that neighborhoods without parks or playgrounds, libraries or bookmobiles, litter or garbage on the sidewalks, vandalism, not being on to count on others in neighborhoods, and perceived child safety were all significant risk factors for youth conduct disorder.

Conclusion

Implications of these findings and future strategies for preventing conduct disorder are discussed.

“I Wanna Be Sedated”: A Closer Examination of Psychosocial Factors Associated With Past-Year Tranquilizer Use Among National Sample of Sexual Minority Adults

Sexual minorities are at increased risk of substance use disorders. Gaps in the research exist regarding tranquilizer use among sexual minorities. Identifying risk factors associated with tranquilizer use may assist public health professionals in developing specific interventions for this vulnerable population. The present study examined potential factors associated with past-year tranquilizer use among a national sample of sexual minorities. A secondary data analysis of the 2017 National Survey on Drug Use and Health was conducted. Results revealed that one in five (21.9%) sexual minorities used a tranquilizer within the past year. Associated risk factors included being female, 18 years of age or older, past-year use of illicit drugs, and having lost interest or pleasure in once pleasurable activities. Findings from the present study can assist prevention professionals in further developing and implementing initiatives to mitigate tranquilizer use among sexual minorities.

"You're Ganja Have a Good Time": Investigating the Roots of Blunt Use Among a National Sample of Hispanic Adults

Blunt use is a pressing public health problem in the United States. While most studies have focused on African American youth, there remains a paucity of research examining blunt use among Hispanic individuals. Previous findings, which are quite limited, suggest mixed results, thus warranting further investigation regarding the prevalence of blunt use among Hispanic individuals and factors associated with such use. In accord with Jessor's problem behavior theory, we hypothesized that prior use of illicit substances and certain psychosocial risk factors pose an increased risk for blunt use among Hispanic adults. A secondary analysis examined prior substance use and psychosocial factors of 10,216 Hispanic lifetime blunt users participating in the 2017 National Survey on Drug Use and Health. Findings revealed that one in five (20.5%) Hispanic individuals reported lifetime blunt use. Significant risk factors associated with blunt use were age (18+ years or older), participation in a government assistance program, prior illicit substance use, and changes in appetite or weight. Additional research on other risk factors, prevention mechanisms, and treatment interventions for Hispanic individuals who use blunts is warranted.

School factors and anxiety disorder among Hispanic youth: Results from the 2016 US National Survey on Children’s Health

Anxiety disorders continue to be a major mental health problem among Hispanic youth. A greater understanding of particular risk factors among this at-risk population may assist school health professionals in developing psychosocial interventions designed to mitigate this growing problem. The present study evaluated a variety of school factors related to anxiety among a national sample of Hispanic youth in the US. A secondary analysis of the 2016 National Children’s Health Survey was conducted. A total of 2,138 of Hispanic adolescents aged 12- to 17-years-old participated in the study. A sizeable percentage (10.9%) of Hispanic youth reported anxiety. Results from the final multivariate regression model indicated that bullying others or excluding them, being bullied or excluded by others, not doing all required homework, and school contact to parents about their child’s behavior were all significant risk factors for anxiety among Hispanic adolescents in the US. These risk factors should be considered when planning school health and psychology interventions for Hispanic adolescents in the US.