Preliminary Efficacy of a Multi-Behavioral Zoom-Based Peer Health Coaching Intervention in Young Adults: A Stepped Wedge Randomized Controlled Trial.

The purpose of this study was to test the preliminary efficacy of a Zoom-based peer coaching intervention on health and risk behaviors in young adults. A convenience sample of young adults was recruited from one U.S. university (N = 89; 73.0 percent female). Participants were randomized to one of two coaching session sequences within the framework of a stepped wedge randomized controlled trial. One experimental sequence received a control condition and a single coaching session, and the second sequence received two sessions. The intervention was a 1-hour program delivered by peer health coaches in a one-on-one setting on Zoom. The program consisted of a behavior image screen, a consultation, and goal planning. Behavioral assessments were completed after each condition. Mixed-effects models were employed to test for behavior differences after coaching sessions compared with the control condition (no coaching session) adjusting for baseline scores. Participants reported significantly higher levels of vigorous physical activity (b = 750 metabolic equivalent of task minutes, p < 0.001), a lower frequency of e-cigarette use (b = -2.1 days; p < 0.001), and a lower risk of e-cigarette susceptibility after two sessions (relative risk = 0.04, p = 0.05), and higher odds of using stress reduction techniques after one session (odds ratio = 1.4, p = 0.04). A nonsignificant trend was observed for longer weekday sleep (b = 0.4 h/night, p = 0.11) after two coaching sessions. The Zoom-based peer health coaching intervention may be an efficient way to improve vigorous physical activity, lower e-cigarette use and susceptibility, and facilitate the use of stress reduction techniques in young adults. The results observed from this preliminary study warrants further investigation using powered effectiveness trials.

Bidirectional associations of physical activity, sleep, and self-reported mental health in young adults participating in an online wellness intervention during the COVID-19 pandemic.

Purpose: The purpose of this study was to examine the bidirectional associations of physical activity (PA), sleep, and mental health in young adults participating in an online wellness intervention from October 2021 to April 2022. Methods: Participants were a sample of undergraduate students from one US university (N = 89; 28.0% freshman; 73.0% female). The intervention was a 1-h health coaching session that was delivered either once or twice by peer health coaches on Zoom during COVID-19. The number of coaching sessions was determined by random allocation of participants to experimental groups. Lifestyle and mental health assessments were collected at two separate assessment timepoints after each session. PA was assessed using the International Physical Activity Questionnaire-Short Form. Weekday and weekend sleep were assessed by two one-item questionnaires and mental health was calculated from five items. Cross-lagged panel models (CLPMs) examined the crude bidirectional associations of PA, sleep, and mental health across four-time waves (i.e., T1 through T4). To control for individual unit effects and time-invariant covariates, linear dynamic panel-data estimation using maximum likelihood and structural equation modeling (ML-SEM) was also employed. Results: ML-SEMs showed that mental health predicted future weekday sleep (ß = 0.46, p < 0.001) and weekend sleep predicted future mental health (ß = 0.11, p = 0.028). Although CLPMs showed significant associations between T2 PA and T3 mental health (ß = 0.27, p = 0.002), no associations were observed when unit effects and time-invariant covariates were accounted for. Conclusion: Self-reported mental health was a positive predictor of weekday sleep and weekend sleep positively predicted mental health during the online wellness intervention.

Reasons for Pack Size Purchase among US Adults Who Purchase Cigars.

With municipalities across the US establishing minimum cigar pack size regulations, it is critical to understand what drives pack size preference. The purpose of this exploratory study was to identify reasons for cigar pack size purchase. We used Amazon's Mechanical Turk to survey adults who had purchased cigars and reported past 30 day use. Participants responded to an open-ended item asking their reasons for purchasing their usual pack size. Responses were double-coded and categorized. Of 152 respondents, 61 used traditional cigars, 85 used cigarillos, and 36 used filtered cigars. Across all cigar types, most participants (73.7%) purchased boxes rather than singles; 5-9-packs were the most popular pack size category (19.7%), followed by 20+-packs (18.4%). We identified 16 reasons for pack size purchase across seven categories: price, consumption, social aspect, convenience, product characteristics, availability, and general preferences. Reasons varied according to whether the consumer purchased larger or smaller pack sizes. In this exploratory study to identify reasons for cigar pack size purchases, findings were consistent with those identified through tobacco industry documents and in the cigarette literature. Future research should examine the prevalence of these reasons, including as a function of demographic and use characteristics, to help inform the understanding of potential minimum cigar pack regulations.

Does warning language impact perceptions? Results from an exploratory experiment comparing English, Spanish, and Dual language E-Cigarette warnings among Spanish speakers in the US.

Tobacco warnings written in English may not be as effective among Spanish speakers. We explored whether warning perceptions differ based on exposure to English, Spanish, or dual language warnings. From November 2, 2020 - December 29, 2020, we conducted an online experiment with a convenience sample of 776 Spanish-speaking adults in the US, randomizing each to one of three warning conditions: English only, Spanish only, or dual (both English and Spanish). Multivariable linear and logistic regressions examined associations between warning exposure and perceptions. Of 776 participants, 291 preferred to read in Spanish, 55.5% were male, 62.5% were Hispanic, and 48.1% reported past 30-day e-cigarette use. Negative affect (ß = 1.79, p = 0.007), perceived message effectiveness (ß = 0.84, p = 0.007), and psychological reactance (ß = 1.55, p < 0.001) were greater among participants exposed to the dual language warnings compared to those exposed to the English warnings. Results of this exploratory study suggest that e-cigarette warning statements presented in both English and Spanish may result in stronger reactions among Spanish speakers. With increasing prevalence of Spanish speakers in the US, future work should continue to examine this topic.