LGBTQIA+ Individuals' Experiences with Intimate Partner Violence and Perceptions of Victim Services.

This study explored lived experiences of LGBTQIA+ survivors of intimate partner violence (IPV). Seven participants completed a one-on-one, in-depth interview to share their experiences of IPV and any internal or external factors that influenced whether they sought support services or reported victimization. Thematic analysis revealed four overarching themes: (a) health complications, (b) coping mechanisms, (c) barriers to seeking professional help, and (d) suggestions for professionals. Results contribute insight into internal and external barriers LGBTQIA+ IPV survivors face when accessing support services and outline practical approaches for professionals providing support to LGBTQIA+ IPV survivors.

Impact of COVID-19 stress on food insecurity and fruit and vegetable consumption among college students.

Objective: This cross-sectional study utilized structural equation modeling to examine effects of COVID-19 stress on food insecurity and fruit and vegetable consumption mediated through personal agency and behavioral intention. Participants: Students (n = 749) enrolled at one federally designated Hispanic-serving public university during the fall 2020 semester. Methods: A 34-item survey was developed and administered. Results: COVID-19 stress had a statistically significant impact on food insecurity (B = .341; p < .001) and an inverse impact on personal agency to consume fruit and vegetables (B = -.283; p < .001). Personal agency (B = .389; p < .001) and behavioral intention to consume fruit and vegetables were directly associated while food insecurity inversely impacted behavioral intention (B = -.076; p = .034). Conclusions: Pandemic-related stress impacts nutrition behaviors among the student population already at risk of poor fruit and vegetable intake. During periods of high pandemic-related stress, college students need adequate access to fruits and vegetables and health promotion programs emphasizing stress management and healthy dietary behaviors.

Sexual Dating Violence, School-Based Violence, and Risky Behaviors Among U.S. High School Students.

Sexual dating violence is associated with several risky health behaviors among adolescents. This study explored the associations between school-based violence, risky health behaviors, and sexual dating violence victimization among U.S. high school students using the 2017 Youth Behavior Risk Survey data. Results indicate a statistically significant correlation (p < .05) between sexual dating violence, sex, sexual identity, and various risky behaviors including bullying, electronic bullying, alcohol use, and physical fighting. These additional behavioral risks experienced by sexual dating violence victims should be further researched to determine impact on overall quality of life and to help guide health education intervention development.

If We Build It, Will They Come? Challenges of Adapting and Implementing a Smoking Cessation Program for the LGBTQ Community in Southcentral Texas.

Studies indicate that tobacco use among lesbian, gay, bisexual, transgender, or queer (LGBTQ) community members is consistently higher than the general population. The Last Drag is a tobacco cessation program developed and implemented in 1991 in San Francisco, California, that has shown promise in assisting LGBTQ members with tobacco cessation. This article describes the practical challenges of adapting The Last Drag to be implemented in a southcentral Texas community. Primary challenges included short time line to expected implementation, issues with culturally insensitive language, and barriers to participant recruitment. Acknowledging and overcoming these challenges can assist public health educators who are addressing tobacco cessation in LGBTQ populations.

The FLASHE Study: Racial and Sex Disparities in Adolescent and Parent Modifiable Cancer Risk Behavior.

Objectives: Understanding modifiable risk factors related to cancer among adolescents and their parents may help identify at-risk populations and intervention aims for reducing cancer risk among families. Methods: Participants were 1336 adolescent-parent dyads who participated in the 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) conducted by the National Cancer Institute. Using independent samples t-test and one-way ANOVA, we assessed differences in mean behavioral scores by sex and race/ethnicity, respectively. Results: For this nationwide sample, non-Hispanic black adolescents and parents were significantly (p < .05) more likely to participate in multiple dietary and sedentary behaviors than their Hispanic and non-black counterparts. Male adolescents reported significantly higher consumption of sugar-sweetened beverages and processed and red meats than their female peers (p < .02 for all). We also found a strong positive association between adolescents' and their parents' dietary and sedentary behaviors (p < .001 for all). Conclusions: Sex and racial differences in cancer-related health behaviors among adolescents and their parents suggest current guidelines for cancer may benefit from inclusion of younger populations and families. Effective health interventions targeting adolescent-parent dyads may help reduce cancer risk among multiple populations simultaneously.

Intrapersonal Factors of Male and Female Adolescent Fruit and Vegetable Intake.

OBJECTIVES: In this study, we examined the role of socio-demographic (race/ethnicity, sex, grade, nativity, literacy, body mass index) and individual-level (normative beliefs, knowledge, perceived barriers, food preference, self-efficacy) factors on US adolescent fruit and vegetable consumption. METHODS: We conducted hierarchical multiple regression analysis to determine the influence of factors on adolescent fruit and vegetable consumption in a nationally represen- tative sample of 795 adolescents from the National Cancer Institute's 2014 Family Life, Activity, Sun, Health, and Eating (FLASHE) study. RESULTS: Socio-demographic variables explained little variance (1.7%) whereas individual-level factors explained approximately 29% of the variance in adolescent fruit and vegetable consumption. Statistically significant (p < .001) predictors of adolescent fruit and vegetable consumption were food preference (ß = .253), self-efficacy (ß = .184), perceived barriers (ß = -.139), and normative beliefs (ß = .134). After controlling for sex, food preference and normative beliefs were stronger predictors of male, and perceived barriers was a stronger predictor of female, adolescent fruit and vegetable consumption. CONCLUSIONS: Understanding the predictive strength and sex-specific differences of intrapersonal variables on male and female adolescent fruit and vegetable consumption informs health promotion efforts to increase intake to recommended amounts.

High-Risk Driving Behaviors Among 12th Grade Students: Differences Between Alcohol-Only and Alcohol Mixed With Energy Drink Users.

BACKGROUND: About 30% of high school students use energy drinks. Alcohol mixed with energy drinks (AmED) has been associated with higher rates of risky driving among college students. OBJECTIVES: The purpose of this study was to: (a) examine AmED-use in a sample of high school students and (b) to specifically investigate differences in risky driving behaviors between 12th grade students who engaged in AmED-use and those who consumed alcohol only. METHODS: Differences in risky driving behaviors were investigated by utilizing secondary data analyses of nationally representative data from the Monitoring the Future Study (N = 1305). RESULTS: 12th grade AmED users were significantly more likely to be in a motor vehicle accident (p <.001) and receive a ticket for a traffic violation (p <.05). Additionally, 12th grade AmED users were significantly less likely to wear a seatbelt as a driver or passenger (p <.001). Conclusions/Importance: Although this study does not link risky driving behaviors to specific drinking events, it does indicate a relationship between AmED-use and high-risk driving. Because traffic accidents are the highest cause of mortality among U.S. teenagers, drug education efforts to reduce high-risk driving behaviors should include information on the decision-making and synergistic effects of energy drinks when mixed with alcohol.

Urban and Rural Adolescents' Points-of-Access for Alcohol and Tobacco.

The purpose of this study was to examine alcohol and tobacco access points among a sample of rural and urban youth. Through collaboration with four regional school districts, a local drug prevention coalition administered a survey to a sample of 445 youth representing 30 different communities in a central U.S. region. The survey items included demographics, 30-day use measures, and questions about points-of-access for alcohol and tobacco. Results showed no differences among points-of-access between urban and rural youth. Ability to obtain alcohol from family, peers, other non-peer youth, and other non-family adults (P < 0.05) were each statistically significant predictors of 30-day alcohol use. Ability to obtain tobacco from family, peers, other non-peer youth, other non-family adults, and self-purchase (P < 0.05) were statistically significant predictors of 30-day tobacco use. Access through peers was the strongest predictor for both 30-day alcohol and tobacco use. Determining the primary social points-of-access youth use to obtain alcohol and tobacco can assist in the development of appropriate community-level prevention strategies and policies.

Adolescent Nonmedical Use of Opioids and Alcohol Mixed with Energy Drinks.

Objective In this study, we examined the relationship between alcohol mixed with energy drink use (AmED) and nonmedical prescription opioid use among 12th graders, using data from the 2015 Monitoring the Future Study. Methods Wilcoxon-Mann-Whitney and logistic regression analyses were used to determine differences in nonmedical prescription opioid use by students who used alcohol-only (AO) versus AmED and to identify covariates of nonmedical prescription opioid use. Results Greater frequency of AmED use was associated with greater frequency of nonmedical Oxycontin (r = 0.391, p < .001) and Vicodin (r = 0.379, p < .001) use with moderate effect sizes. Results revealed statistically significant differences in frequency of nonmedical Oxycontin (p < .001, Cohen's d = 0.29) and Vicodin (p < .001, Cohen's d = 0.30) use between AO and AmED use. Likelihood of nonmedical prescription opioid use increased by a factor of 2 for each time AmED was consumed in the past 12 months. Conclusion Our results highlight the need to improve understanding of the relationship between nonmedical prescription opioid, energy drink and AmED use. AmED use appears to be associated with increased nonmedical prescription opioid use.

Adolescent Energy Drink Use Related to Intake of Fried and High-sugar Foods.

OBJECTIVE: We assessed the relationship between energy drinks, fried food, and high-sugar food consumption. METHODS: Secondary analyses including Mann-Whitney U, Cohen's d and effect sizes were used to examine 7-day intakes of energy drinks, fried foods, and high-sugar foods among teenagers (N = 1570) who participated in the 2014 FLASHE Study. RESULTS: Energy drink consumption during the past 7 days was reported by 14.4% (N = 226) of participants. Those who reported consumption of energy drinks in the past 7 days were more likely to eat various fried and high-sugar foods than those who did not report past 7-day energy drink consumption. These foods include candy (p < .001), cake (p = .011), desserts (p < .001), sugary cereal (p < .001), fried potatoes (p < .001), fried chicken (p < .001), and chips (p < .001). CONCLUSIONS: Energy drink consumption among adolescents may be linked to other high-risk nutrition intake behaviors, specifically increased consumption of fried and high-sugar foods. This study adds to the growing number of recent studies highlighting the multiple behavioral risks associated with early energy drink use. Health promotion and nutrition education efforts should focus on delaying early consumption of energy drinks among adolescents.

Energy Drink Use Linked to High-sugar Beverage Intake and BMI among Teens.

OBJECTIVE: We assessed the relationship of energy drink, high-sugar, and low-sugar beverage consumption. METHODS: Mann-Whitney U, Cohen's d and effect sizes were used to examine data from 1737 adolescents in the United States who participated in the 2014 FLASHE Study. Secondary analysis examined consumption of energy drinks, high- and low-sugar beverages, and adolescents' BMIs. RESULTS: Among adolescents, 13.7% (N = 239) reported past 7-day energy drink consumption. Participants who did not consume energy drinks in the past 7 days were more likely to consume low-sugar beverages of water (p < .001) and milk (p = .046). Consumption of energy drinks was positively related to sweetened fruit drinks (p < .001), pure fruit juice (p = .008), soda (p < .001), and sports drinks (p < .001). Energy drink consumers also reported higher mean BMI (p = .004). CONCLUSIONS: Adolescents who consume energy drinks during the past 7 days are more likely to also consume other high-sugar beverages. Whereas those who report no past 7-day use of energy drinks consume higher rates of low- or no-sugar beverages. Health education and prevention efforts to reduce adolescent energy drink consumption may lead to reductions in other high-sugar beverage intake and have a positive impact on obesity rates among adolescents.

Impact of alcohol and alcohol mixed with energy drinks on non-medical prescription stimulant use in a nationally representative sample of 12th-grade students.

BACKGROUND AND OBJECTIVES: Approximately 30% of high school students use energy drinks. Alcohol use and alcohol mixed with energy drink use (AmED) is associated with risky behavior, including non-medical prescription stimulant use. We assessed alcohol-only, AmED and non-medical prescription stimulant use among 12th grade students in the U.S. using a nationally representative secondary data from the 2012 Monitoring the Future Study. METHODS: Wilcoxon-Mann-Whitney tests and logistic regression analyses were used to determine differences in non-medical prescription stimulant use by students who used alcohol-only versus AmED and to identify covariates of non-medical prescription stimulant use. Pearson-product moment coefficients were used to determine strength of variable relationships. RESULTS: Significant differences were found in frequency of Ritalin (p < .001, Cohen's d = .23) and Adderall (p < .001, Cohen's d = .32) use between alcohol-only students and AmED students. Greater frequency of AmED use was also associated with greater frequency of Ritalin use (r = .293, p < .001) and Adderall use (r = .353, p < .001). Males (b = .138, OR = 1.148) were more likely to use prescription stimulants non-medically than females. DISCUSSION AND CONCLUSIONS: This study highlights the need to better understand influences on non-medical prescription stimulant, energy drink and AmED use, as the combined effects of stimulants contained in energy drinks and the depressant effects of alcohol appear to be associated with increased non-medical prescription stimulant use. SCIENTIFIC SIGNIFICANCE: Research on the influential factors related to energy drinks, alcohol, and non-medical prescription stimulants will help practitioners to more appropriately design prevention and intervention strategies addressing these high-risk behaviors. (Am J Addict 2016;25:378-384).

Attitudes about partner communication regarding contraceptive use among hispanic male college students.

OBJECTIVE: The purpose of this exploratory study was to examine cultural factors that influence Hispanic male college students' intention to communicate with partners about contraception use. PARTICIPANTS: A sample of 239 self-identified Hispanic participants enrolled in at least 1 college course participated in this study in the spring 2014 semester. METHODS: Students completed a 47-item paper survey. Data were analyzed with multiple regression and descriptive methods. RESULTS: Participants with more siblings were more likely to intend to communicate with partners about contraception use than those with fewer siblings. Participants who received contraceptive information exclusively from fathers exhibited a more favorable attitude toward partner communication. Mother's education level was positively correlated with participants' contraceptive knowledge. CONCLUSIONS: These results emphasize the importance of support from family members to this sample's intentions to communicate with partners about contraceptive use. Parental involvement and male responsibility, in regards to contraceptive use, should be integrated into Hispanic-focused sexual health improvement efforts.

Depressive symptomology management and falls among middle aged and older adults.

OBJECTIVES: This study aims to examine the relationship between middle-aged and older adults' depressive symptomology and anti-depressant use and the frequency of falls within the previous 12 months, controlling for sociodemographic variables, health indicators, and health behaviors. METHOD: From the 2010 National Social Life, Health, and Aging Project, 2338 cases were examined. Falls were categorized into a binary variable, comparing zero falls with one or more falls. An unadjusted model was run to examine the relationship between independent and dependent variables. Potential covariates were added into the model, and backward elimination was used among independent variables with a univariate P < 0.05 to identify the covariates with the strongest association with falls. This final adjusted binary logistic regression model was then used to examine the relationship between falls and the independent variables. RESULTS: In the adjusted model, anti-depressant use was positively associated with falls (P = 0.001), as was being female (P < 0.001), having diabetes (P = 0.018), and having increased limitations in daily activities (P < 0.001). The relationship between depressive symptomology and anti-depressant prescription was also significantly associated with falls (P = 0.006). CONCLUSION: While findings confirm that a relationship between depressive symptomology and anti-depressant use are associated with falls among middle-aged and older adults, additional studies are needed that simultaneously examine the influence of these two risk factors.

Combined Use of Alcohol and Energy Drinks Increases Participation in High-Risk Drinking and Driving Behaviors Among College Students.

OBJECTIVE: A recent study suggested that college students who combined alcohol and energy drinks were more likely than students who consumed only alcohol to drive when their blood alcohol concentration (BAC) was higher than the .08% limit and to choose to drive despite knowing they had too much alcohol to drive safely. This study sought to replicate those findings with a larger sample while also exploring additional variables related to impaired driving. METHOD: College students (N = 549) completed an anonymous online survey to assess differences in drinking and driving-related behaviors between alcohol-only users (n = 281) and combined alcohol-energy drink users (n = 268). RESULTS: Combined users were more likely than alcohol-only users to choose to (a) drive when they perceived they were over the .08% BAC limit (35.0% vs. 18.1%, p < .001), (b) drive despite knowing they had too much alcohol to drive safely (36.3% vs. 17.0%, p < .001), and (c) be a passenger when they knew the driver had too much alcohol to drive safely (44.1% vs. 23.6%, p < .001). Combined users were significantly more likely (p < .001) to report indicators of high-risk alcohol use, such as larger number of drinks consumed, number of days drinking, number of days drunk, number of heavy episodic drinking episodes, greatest number of drinks on one occasion, and average hours of consumption. CONCLUSIONS: Combined use of alcohol and energy drinks may place drinkers at greater risk when compared with those who consume only alcohol. College students in this sample who combined alcohol and energy drinks were more likely to participate in high-risk driving behaviors than those who consumed only alcohol.

Increased Energy Drink Use as a Predictor of Illicit Prescription Stimulant Use.

BACKGROUND: The purpose of this study was to examine energy drink usage patterns and to investigate the relationship between energy drink use and illicit use of prescription stimulants among college students. METHODS: A sample of 605 undergraduate and graduate students (mean age±SD: 21.96±4.216) from a large midwestern university voluntarily participated in the study. RESULTS: Of the participants, 48.9% (n=296) reported using energy drinks in the past 30 days, whereas 25.3% (n=153) reported using prescription stimulant drugs in the past 30 days. Among prescription stimulant users without a valid medical prescription, Mann-Whitney U tests and logistic regression analysis revealed that the frequency of energy drink consumption was a significant predictor of illicit prescription stimulant use, with the odds for use increasing by 14% with each additional day of energy drink use (odds ratio for using=1.143, P≤.001). Analyses revealed statistically significant differences (P<.05) between prescription stimulant users and nonusers for all energy drink use variables, with the strongest predictors of prescription stimulant use being the number of days using energy drinks in the past 30 days and number of energy drink binges in the past 30 days. CONCLUSIONS: Results indicate that the frequency of energy drink use was a significant predictor of the illicit use of prescription stimulants.

Understanding athletic trainers' beliefs toward a multifacted sport-related concussion approach: application of the theory of planned behavior.

CONTEXT: Practice guidelines recommend a multifaceted approach for managing concussions, but a relatively small percentage of athletic trainers (ATs) follow these recommendations. Understanding ATs' beliefs toward the recommended concussion practice guidelines is the first step in identifying interventions that could increase compliance. The theory of planned behavior (TPB) allows us to measure ATs' beliefs toward the recommended concussion practice guidelines. OBJECTIVE: To examine the influence of ATs' beliefs toward the current recommended concussion guidelines on concussion-management practice through an application of the TPB. DESIGN: Cross-sectional study. SETTING: A Web link with a survey was e-mailed to 1000 randomly selected members of the National Athletic Trainers' Association (NATA). PATIENTS OR OTHER PARTICIPANTS: A total of 221 certified ATs working in secondary school/clinic, high school, and college/university settings. MAIN OUTCOME MEASURE(S): A 66-item survey reflecting the current recommended concussion guidelines of the NATA and International Conference on Concussion in Sport was created to measure beliefs using the TPB constructs attitude toward the behavior (BA), subjective norms (SN), perceived behavioral control (PBC), and behavioral intention (BI) of ATs. We used a linear multiple regression to determine if the TPB constructs BA, SN, and PBC predicted BI and if PBC and BI predicted behavior according to the TPB model. RESULTS: We found that BA, SN, and PBC predicted BI (R = 0.683, R(2) = 0.466, F3,202 = 58.78, P < .001). The BA (t202 = 5.53, P < .001) and PBC (t202 = 9.64, P < .001) contributed to the model, whereas SN (t202 = -0.84, P = .402) did not. The PBC and BI predicted behavior (R = 0.661, R(2) = 0.437, F2,203 = 78.902, P < .001). CONCLUSIONS: In this sample, the TPB constructs predicted BI and behavior of ATs' compliance with recommended concussion-management guidelines. The BA and PBC were the most influential constructs, indicating that those with positive attitudes toward concussion-management recommendations are more likely to implement them, and ATs are less likely to implement them when they do not believe they have the power to do so. We theorize that interventions targeting ATs' attitudes and control perceptions will lead to improved compliance.

Consumption of sport-related dietary supplements among NCAA Division 1 female student athletes.

OBJECTIVES: To determine factors that influence sport-related dietary supplement consumption among NCAA Division 1 female student athletes and to estimate the plausibility of the theory of planned behavior (TPB) for predicting the use of sport-related dietary supplements among NCAA Division 1 female student athletes. METHOD: Self-report data were collected by questionnaire from 207 NCAA Division 1 female student athletes. Parameter estimates of 3 TPB-based models were calculated using Mplus software. RESULTS: The TPB-based models explained 64-66% and 18% of variance in behavioral intention and behavior, respectively, with subjective norm being the strongest predictor of dietary supplement consumption intention. CONCLUSIONS: Results support plausibility for the TPB to predict sport-related dietary supplement consumption among NCAA Division 1 female student athletes.