Afrocentric Cultural Norms, Mental Health Functioning, and the Perception of Intimate Partner Violence Among Young Black Men.

Intimate partner violence (IPV) is a serious public health concern that profoundly impacts the lives of women globally. While IPV cuts across race, socioeconomic status, age groups, and geography, Black women are disproportionately affected. Prior studies report that Black women predominantly couple with Black men and thus, understanding factors associated with IPV perpetration among Black men is essential. Subsequently, the present study explored an important gap in the literature, exploring how collectivism, a core belief ascribed to Afrocentric cultural norms, and factors associated with mental health functioning in emerging adult Black men in the USA is associated with their views of IPV. Data for the study was drawn from a sample of self-identifying Black American males between the ages of 18 and 25 (n=300). Regression analysis demonstrated no significant relationship between age, household income, and education level among participants. Anxiety had a significant relationship with intimate partner beliefs with participants with increased anxiety having more problematic intimate partner beliefs. A model including anxiety, collectivism, and aggressiveness was a significant predictor of problematic intimate partner beliefs. In the final model, collectivism and aggressiveness were statistically significant predictors of perceptions endorsing IPV. Participants who reported higher levels of global aggressive confrontation with others were more likely to endorse IPV. Overall, participants with a sense of value for collectivism over individualism were least likely to endorse IPV. This study provides evidence that cultural norms potentially have a role in Black men's beliefs about IPV. Implications for future research are provided.

Building a community of experts in medication-assisted treatment (MAT) using the Project ECHO© model.

BACKGROUND: Project Extension for Community Healthcare Outcomes (ECHO) utilizes telemedicine to connect a multidisciplinary team of experts with a -network of primary care physicians to enable rapid dissemination of evidence-based -guidelines and practices at scale. In this study, the Project ECHO model disseminated the Arizona Pain and Addiction Curriculum to providers in rural Arizona with the goal to educate providers on medication-assisted treatment (MAT). METHODS: Participants engaged in biweekly, virtual teleECHO sessions, and post-session surveys were used to collect data on provider satisfaction, self-efficacy, knowledge, barriers to change, and changes in practice behavior. RESULTS: Between February 2020 and November 2020, the MAT-ECHO program hosted 20 teleECHO sessions (N = 20) with 255 unique participating providers and delivered 877 learning hours. Analysis of a 6-month post-ECHO survey (N = 13) demonstrated that teleECHO sessions had broad geographic outreach. Participants had an average of 12 years of experience, 38 percent held NP/PA professional degrees, and 54 percent practiced in opioid treatment program settings. Assessment of job satisfaction and well-being revealed overall improved satisfaction among the small cohort of nonwaivered respondents (N = 8), except for meeting patient's needs. MAT-waivered respondents reported no post-session changes. CONCLUSIONS: Data from this study demonstrated that teleECHO sessions were well attended, consisted of a diverse cohort with various degrees, and had broad geographic outreach; hence, the utilization of the teleECHO model has the potential to reach rural providers and subsequently increase the availability and -efficacy of MAT in rural America.

Risk Factors for Experiencing Gender Based Violence Across Racial Groups.

BACKGROUND: College student interpersonal violence victimization is a major public health issue. Sexual assault and intimate partner violence have negative effects on mental and physical health, as well as an individual's ability to perform well academically and fully participate in the college experience. Because an individual's race impacts how they experience the world, it is important to consider racial differences in experiences of interpersonal violence. STUDY QUESTION: This study sought to understand the particular characteristics of Black, White, and Hispanic students that increase their risk of experiencing interpersonal violence victimization. METHOD AND SUBJECTS: Researchers performed a latent class analysis using the Spring 2013 data from the American College Health Association's National College Health Assessment II to determine whether the risk factors for victimization of college students vary based on race. Data was collected from 123,078 college students attending 153 institutions of higher learning. FINDINGS: Results of this latent class analysis showed a 5 class solution where each class had unique risks that increased the potential for interpersonal violence victimization based on the race of the respondent. IMPLICATIONS: Group based differences need to be considered when developing prevention strategies to reduce the risk of victimization on college campuses. Because different risks increase victimization for White, Black, and Hispanic students, it is important to consider how risk reduction strategies may differ for these groups; and ensure that all prevention strategies are culturally informed.

Sexual Assault and Behavioral Health: What Can We Learn From a Probability Sample of Young Sexual Minority Men?

BACKGROUND: Previous research indicates that young sexual minority men (YSMM) are at increased risk of experiencing sexual assault compared to their heterosexual peers. While this increased risk is documented in comparison studies, very little is known about the specific range of sexual assault experiences. The aim of this study was to investigate prevalence of sexual assault experiences and their association with depression and alcohol use for YSMM. METHODS: In 2017 and 2018, 124 YSMM (18-24 year-olds) were recruited to participate in an online study using probability-based sampling methods, in Los Angeles, CA. Participants answered items about lifetime and recent sexual assault experiences (i.e., unwanted touching, oral rape, penetrative rape), characteristics of the coercive behaviors, recent alcohol use, and depression. Analysis of variance (ANOVAs) and multiple linear regressions investigated the relationships between sexual assault experiences and behavioral health. RESULTS: The sample reported a range of lifetime sexual assault experiences: 70% unwanted touching and 28% penetrative rape. Fifty-five percent of the sample reported some type of recent sexual assault, with 17% reporting a recent penetrative rape. ANOVAs of the impact of different forms of sexual assault on behavior health indicated that unwanted touching was associated with higher depression and alcohol use. Further investigation of recent unwanted touching indicated that frequency is associated with depression and binge drinking. Of participants who reported experiences of unwanted touching, 61% reported it occurred while they were intoxicated. DISCUSSION: Findings support previous evidence of high rates of sexual assault among YSMM. Further, the majority of men who reported sexual assault indicated that it occurred while they were intoxicated, suggesting that unwanted touching is occurring while men are drinking alcohol, likely in bars. The culture of gay bars may encourage nonconsensual touching during intoxication and these experiences of sexual assault have consequences (i.e., higher levels of depression and alcohol use).

Influence of social media on how college students perceive healthy relationships and consent.

Objective: Because of the high rates of sexual assault on college campuses, it is important to examine factors that influence perceptions of healthy relationships and consent, including social media. Because college students are heavy users of social media, it is imperative to consider how social media can influence their participation in risky behavior, including the attitudes and norms around sex and relationships. Participants: Undergraduate college students were recruited to participate in a study that sought to understand how college students navigate romantic and sexual relationships. Methods: Participants (N = 392) completed a survey that assessed social media use, and how they perceived healthy relationship behavior and consent. Results: Results showed social media had more of an influence on perceptions of healthy relationships. However, the influence of social media on consent and healthy relationships is inconsistent across platforms; emphasizing the need for further research.

Dyadic Analysis of a Self-report Physical Activity Measure for Adult-Youth Dyads.

Adult physical activity levels influence youth physical activity levels, but the nature of this relationship is still unknown. Most research focusing on this topic has been conducted with accelerometers, which are ideal since self-report physical activity measures can be biased. However, self-report measures for physical activity are useful to include in studies to gather information at low-cost. The purpose of this study was to further develop a self-report adult-youth dyad measure of physical activity. This study was conducted using secondary data analysis of the physical activity measures used in an intervention on behavioral nutrition (iCook 4-H). Participants were a sample of 214 adults (M = 39.0, SD = 8.0 years) and youth (M = 9.4, SD = 0.7 years) pairs. Accelerometer data was collected for a subset of youth (n = 122). There was dependency between the adult-youth physical activity data, and a dyadic confirmatory factor analysis model showed good fit to the data and achieved metric invariance, a measure to determine if the same construct was being measured in both youth and adults. Invariance was confirmed across matched versus unmatched sex pairs and some evidence of invariance with youth accelerometer data. Based on study findings, when using self-report measures of physical activity, researchers should measure both members of the adult-youth dyad to get more accurate measurements. Further validation of these findings is needed using an objective physical activity measure, like accelerometers, with all participants and more diverse samples.

Healthy Romantic Relationships: Attitudes and Perceptions of College Students.

Sexual assault (SA) is a serious issue affecting college students in romantic relationships. Having strong understandings of what constitutes healthy romantic relationships (HRR) can protect students by allowing them to better recognize SA and other problematic behaviors in relationships. However, little research has explored how students conceptualize HRR. Utilizing qualitative thematic analysis, this study analyzed data from individual and focus-group interviews from a sample of 45 students at a southwestern university in the United States. Findings indicated that students understood HRR to be characterized by direct communication, respect, and mutual satisfaction. However, their experiences showed that these ideals were not always achieved. This discrepancy may be explained by the influence of social norms, particularly around sexual behavior and gender role expectations. Implications and recommendations for social workers/counseling professionals are discussed.

A Community-Based Cultural Adaptation Process: Developing a Relevant Cooking Curriculum to Address Food Security for Burundian and Congolese Refugee Families.

Refugee-specific nutrition and cooking curricula addressing dietary acculturation barriers to food security are limited. A cooking curriculum was culturally adapted for Burundian and Congolese refugees to address their unique dietary acculturation experiences. A four-phase curriculum adaptation process (information gathering [literature review, researcher informed, and formative interviews; n = 18], preliminary adaptation design [data incorporation and steering committee; n = 5], pilot testing [n = 10 youth/adult dyads], and refinement) was applied to the existing evidence-based iCook 4-H curriculum using a five-strategy (peripheral, evidential, linguistic, constituent-involving, and sociocultural) cultural adaptation framework. A multiphase, two-cycle coding analytic process was completed within NVivo 12, followed by direct content analysis. Seventeen adaptations were made to the iCook curriculum, derived from varying combinations of four data sources (literature review, researcher informed, priority population, and steering committee), applying all five cultural adaptation strategies. A majority of the curriculum adaptations were derived from two or more data sources (71%) and were categorized within multiple adaptation strategies (88%). This study provided a community-based cultural adaptation process that could be used with various populations to address unique barriers and facilitators to food security. This innovative model addresses cultural needs while simultaneously aiming to improve health habits of refugee communities.

"When a Girl Says No, You Should Be Persistent Until She Says Yes": College Students and Their Beliefs About Consent.

One in five college women report being sexually assaulted with 23% to 45% of men reporting attempting or completing a sexual assault while attending a university. One important concept in preventing sexual assault is consent. It is important to ensure that when students are being asked to wait for consent, they understand what consent is and the potential ways it could manifest in a sexual situation. In total, 25 female and 20 male college students participated in semistructured focus groups or interviews to gain a better understanding of their perspectives of consent and how they ensure that it has been given. Results demonstrate that college students do not have a consistent, coherent, or precise definition of consent. Participants often described consent using vague language and were only able to clearly identify verbal indicators of consent. Much of the discussion of consent centered around an individual's ability or inability to clearly and directly communicate his or her needs. Data also show that how students communicate about consent is influenced by gender expectations. There are multiple complicating factors when determining consent, including alcohol consumption. Participants discussed not understanding how to navigate sexual encounters when one or both parties had been consuming alcohol. Results also showed that there are multiple factors that may lead women to say yes to sex they don't want, and men to not ask for consent. For college students, consent is a complex concept-a concept they may not have a practical and useful definition of. Sexual assault prevention must take steps to provide college students with a definition of consent informed by their experiences and the reality of their sexual encounters.

A Multisession Evaluation of Sexual Assault Prevention Education: The Unique Effects of Program Participation.

One in five college women report being sexually assaulted, while men have the greatest likelihood to commit a sexual assault while attending a university. Because freshmen and sophomore college women are particularly vulnerable to victimization, it is important to provide effective sexual assault prevention education. The current study examines a multisession approach to sexual assault prevention at a southwestern university. This exploratory study assesses scores measuring knowledge of sexual assault, knowledge about healthy sexual relationships, and intent to act to prevent a sexual assault or after one has occurred, after students complete at least one of five sexual assault prevention programs (Community of Care, Consent and Respect, Step Up!, Live Well, or Frisky Business). Results demonstrated that participation in each program had unique effects and the number of programs a student participated in did not significantly affect scores. None of the programs produced significantly higher scores on all three measures. Multiple programs produced significantly higher scores on the knowledge and intervention/resources scales, but none had the same results for the healthy sexual relationships scale. Also, a student's experiences of sexual violence significantly predicted their scores on all three measures. Because each program had different characteristics, the varying results make it difficult to identify the particular factors that led to the best results. Future research must seek to identify the particular combination of factors that produce the best outcomes in terms of changing attitudes and behavior concerning sexual assault and intent to act.

The Gray Area of Defining Sexual Assault: An Exploratory Study of College Students' Perceptions.

College-age women are disproportionately at risk of experiencing sexual assault. Sexual assault causes tremendous psychological distress for survivors. Therefore, it is imperative to understand the perceptions that affect the perpetration of sexual assault. One of those potential factors is how college students conceptualize and define sexual assault. The current qualitative study demonstrated that college students do not have consistent images of sexual assault and often rely on their own perceptions and experiences to define it. Creating and providing a standard of sexual assault based on the reality of college students can provide a foundation for creating effective prevention strategies.

Feasibility and Acceptability of Implementing a Culturally Adapted Cooking Curriculum for Burundian and Congolese Refugee Families.

Pika Pamoja (Cook Together) is an eight-session cooking curriculum for Burundian and Congolese refugee families, culturally adapted from the evidence-based iCook 4-H curriculum to address dietary acculturation barriers to and facilitators of food security. The goal of this study was to determine the feasibility and acceptability of implementing Pika Pamoja. Researchers and a multilingual community aid implemented Pika Pamoja in a pre-post pilot intervention with randomized control (n = 5)/treatment (n = 5) dyads (youth/mother). Feasibility (recruitment/retention, implementation, fidelity testing, and assessment procedures) and acceptability (process and program evaluations) measures were collected. All 10 dyads (control and treatment) were retained throughout the study. All fidelity measures were 91% or above. The final youth assessment instrument included scales for cooking skills (α = 0.93), cooking self-efficacy (α = 0.90), openness to new foods (α = 0.81), and eating (α = 0.68), playing (α = 0.90), and setting healthful goals (α = 0.88) together as a family. The final adult instrument included scales for cooking, eating, and playing together (α = 0.68), kitchen proficiency (α = 0.89), and food security (α = 0.79). Participant feedback was uniformly positive. Based on these results, Pika Pamoja was feasible to implement and was accepted by the priority population. Larger scale studies to measure the effectiveness of Pika Pamoja to increase food security among refugee families are needed.

eB4CAST Approach Improves Science Communication With Stakeholders in a College-Based Health Program.

Communicating scientific results with community partners is often lacking in intervention programs, thus eB4CAST was developed to facilitate impact sharing. This article investigated using the eB4CAST dissemination tool to communicate impact from a campus-based obesity prevention program. Data from Get Fruved RCT university sites collected at baseline were used to generate eB4CAST reports. Experts (n = 13) and RCT sites (n = 15) were asked to provide feedback on eB4CAST reports based on appeal, understanding, and clarity. On all Likert items, participants rated above 7 on each (out of 10). Positive responses from open-ended questions included eB4CAST reports being clear, visually appealing, and aid in program understanding. Overall, eB4CAST was successful in relaying data and information for the Get Fruved program, thus a means for science communication that could be used in interventions. Utilizing infographics to report data and information is a feasible way to disseminate and communicate in a cost-effective, timely manner.

Prediction of preterm pre-eclampsia at midpregnancy using a multivariable screening algorithm.

BACKGROUND: Competing risk models used for midpregnancy prediction of preterm pre-eclampsia have shown detection rates (DR) of 85%, at fixed false-positive rate (FPR) of 10%. The full algorithm used between 19+0 and 24+6  weeks includes maternal factors, mean arterial pressure (MAP), mean uterine artery pulsatility index (UtAPI), serum placental growth factor (PlGF) level in multiples of the median (MoM), and soluble Fms-like tyrosine kinase-1 (sFlt-1) level in MoM. AIMS: To assess performance of the Fetal Medicine Foundation (FMF) algorithm at midpregnancy to screen for preterm (<37 weeks) pre-eclampsia. The outcome measured was preterm pre-eclampsia. MATERIALS AND METHODS: This is a prospective study including singleton pregnancies at 19-22 weeks gestation. Maternal bloods were collected and analysed using three different immunoassay platforms. Maternal characteristics, medical history, MAP, mean UtAPI, serum PlGF MoM and serum sFlt-1 MoM were used for risk assessment. DR and FPR were calculated, and receiver operating characteristic curves produced. RESULTS: Five hundred and twelve patients were included. Incidence of preterm pre-eclampsia was 1.6%. Using predicted risk of pre-eclampsia of one in 60 or more and one in 100 or higher, as given by the FMF predictive algorithm, the combination with the best predictive performance for preterm pre-eclampsia included maternal factors, MAP, UtAPI and PlGF MoM, giving DRs of 100% and 100%, respectively, and FPRs of 9.3 for all platforms and 12.9-13.5, respectively. Addition of sFlt-1 to the algorithm did not appear to improve performance. sFlt-1 MoM and PlGF MoM values obtained on the different platforms performed very similarly. CONCLUSIONS: Second trimester combined screening for preterm pre-eclampsia by maternal history, MAP, mean UtAPI and PlGF MoM using the FMF algorithm performed very well in this patient population.

Development of an Instrument Measuring Perceived Environmental Healthfulness: Behavior Environment Perception Survey (BEPS).

OBJECTIVE: To create a tool to measure college students' perception of the healthfulness of their environment. DESIGN: (1) Item generation, (2) cognitive interview testing and exploratory factor analysis, (3) item refinement/modification, (4) factor structure validation, and (5) criterion validation. SETTING: Ten college campuses. PARTICIPANTS: Time point 1 (n = 120 cognitive interviews; n = 922 factor analysis); time point 2 (n = 2,676), convenience sample of undergraduate students. MAIN OUTCOME MEASURES: Cognitive interviews and survey data were used to assess perceptions about the environment. ANALYSIS: Exploratory factor analysis, structural equation confirmatory factor analysis, correlations, and regressions. RESULTS: Item generation resulted in 93 items. Items were eliminated based on cognitive interviews, exploratory factor analysis of pilot data, and elimination of cross-loading or weak loading items. In confirmatory analyses, a 21-item, 5-factor structure was the best fit for the data (χ2 = 3,286.77, degrees of freedom = 189; comparative fit index = 0.840; root-mean-square error of approximation = 0.078). Environmental factors include physical activity (α = 0.68, 4 items), healthful eating (α = 0.86, 5 items), mental health (α = 0.85, 5 items), barriers to healthful eating (α = 0.70, 4 items), and peer influences (α = 0.73, 3 items). There were significant associations between scales and validation criteria (P < .05). CONCLUSIONS AND IMPLICATIONS: The Behavior Environment Perception Survey is a novel instrument measuring perceptions of the healthfulness of the campus environment. Strengths include a development process involving 10 different universities, strong psychometric properties, and breadth of constructs.

Midpregnancy testing for soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF): An inter-assay comparison of three automated immunoassay platforms.

We performed an inter-assay comparison among three immunoassay platforms for midpregnancy testing of sFlt-1, PlGF and the sFlt-1/PlGF ratio, which are established markers for pre-eclampsia. Maternal blood was collected 19-22 weeks' gestation. Raw data values were converted to multiples of the median (MoM). PlGF and sFlt-1 values among platforms were highly correlated (p < 0.001). There was significant variation in raw data values for PlGF and sFlt-1 among platforms, eliminated following conversion to MoM. When directly comparing raw data values among platforms, platform-specific reference ranges values should be used. MoM values were equivalent among platforms, allowing direct inter-assay result comparison.

Incorporating Technology Into the iCook 4-H Program, a Cooking Intervention for Adults and Children: Randomized Controlled Trial.

BACKGROUND: Families who cook, eat, and play together have been found to have more positive health outcomes. Interventions are needed that effectively increase these health-related behaviors. Technology is often incorporated in health-related interventions but is not always independently assessed. OBJECTIVE: The objective of this study was to describe challenges and facilitators to incorporating technology into the iCook 4-H intervention program. METHODS: Dyads (n=228) composed of children (mean 9.4, SD 0.7 years old) and an adult primary meal preparer (mean 39.0, SD 8 years) were randomly assigned to a control (n=77) or treatment group (n=151). All treatment group dyads participated in 6 in-person sessions designed to increase families cooking, eating, and playing together. We incorporated Web-based between-session technological components related to the curriculum content throughout the intervention. Assessments were completed by both groups at baseline and at 4, 12, and 24 months; they included measured anthropometrics for children, and online surveys about camera and website skill and use for dyads. Session leaders and participants completed open-ended process evaluations after each session about technological components. We computed chi-square analysis for sex differences in technological variables. We tested relationships between video posting frequency and outcomes of interest (cooking frequency, self-efficacy, and skills; dietary intake; and body mass index) with Spearman correlations. Process evaluations and open-ended survey responses were thematically analyzed for beneficial and inhibiting factors, including technological components in the curriculum. RESULTS: Only 78.6% (81/103) of children and 68.3% (71/104) of adults reported always being comfortable accessing the internet postintervention. Boys reported being more comfortable than girls with technological tasks (P<.05). Children who posted more videos had a higher level of cooking skills at 4 months postintervention (r=.189, P=.05). Barriers to website usage reported most frequently by children were lack of accessibility, remembering, interactivity, motivation, time, and lack of parental encouragement. CONCLUSIONS: Incorporating technological supports, such as cameras and websites, into children's programs may help produce improved outcomes. Identifying barriers to and patterns of technology usage need to be considered when developing future child health promotion interventions. TRIAL REGISTRATION: ISRCTN Registry ISRCTN54135351; https://www.isrctn.com/ISRCTN54135351.

Cooking Frequency Associated With Dietary Quality in iCook-4H Youth Participants at Baseline.

BACKGROUND: Increased intakes of ready-made and fast foods paralleled with decreased homemade food consumption have been associated with increased rates of obesity. Researchers have shown associations between cooking self-efficacy (SE) and cooking frequency (CF) with dietary quality and weight status. Some cooking interventions have shown positive associations with dietary outcomes, such as increased fruit and vegetable intake and decreased fast food consumption. There is still much unknown about SE and CF, especially among youth. OBJECTIVE: Determine baseline SE and CF and the associations with dietary quality and body mass index (BMI) of youth enrolled in iCook 4H. METHODS: Youth (n = 228, ages 9-10 years) completed online surveys assessing SE, CF, dietary quality, and demographics. Anthropometrics were collected to calculate BMI-for-age percentiles and weight categories. Descriptive statistics were completed for CF, SE, BMI categories, and demographics. Differences in CF and SE by sex, race, and participation in government assistance programs were determined through independent-sample t tests. Pearson correlations were used to assess the association between dietary quality and CF and SE. Associations between CF and dietary quality were assessed further through 2-way analyses of variance (ANOVAs) that included CF and sex and CF and race as independent variables. Associations between SE and CF and BMI were assessed through ANOVAs. RESULTS: Thirty-seven percent of youth were overweight or obese. Females reported significantly higher CF than males (P = .042). Cooking frequency was positively associated with dietary quality (P < .001), but BMI was not associated with dietary quality. SE was not associated with dietary quality or BMI. CONCLUSION: Based on results, CF was positively associated with dietary quality among youth. More research is needed to assess how different types of cooking relate to diet and BMI. Interventions are needed to determine whether increasing CF leads to better diet outcomes.

Redesign, Field-Testing, and Validation of the Physical Activity Campus Environmental Supports (PACES) Audit.

This paper describes the redesign, field-testing, and convergent validity of a practical tool-Physical Activity Campus Environmental Supports (PACES) audit. Methods. The audit includes two parts: (1) PACES-Programs, which is comprised of questions regarding populations served, fees, programs (recreation/fitness classes and intramurals), proximity, adequacy of facilities, and marketing, and (2) PACES-Facilities, which is comprised of questions regarding built environment (aesthetics, bike racks, stairs, and universal design), recreation equipment, staff, amenities, and access. Each item criterion is specifically scored using a five-point, semantic-differential scale ranging from limited to extensive environmental support. A few questions utilize select all that apply for a summed score. PACES training, interrater reliability, and data collection are all accessible via an online portal. PACES was tested on 76 college campuses. Convergent validity was examined by comparing the PACES-Programs questions to Healthy Campus Initiatives-Programs questions (HCI-Programs) and comparing the PACES-Facilities questions to questions contained in the Physical Activity Resource Assessment (PARA) Instrument. Statistical analyses included Cronbach's alpha, ANOVA, latent profile analysis, and Spearman correlations. Results. The PACES-Programs audit includes 10 items for a potential total of 73 points (α = 0.72) and PACES-Facilities audit includes 15 items for a potential total of 77 points (α = 0.837). Most (77.8%) of the 153 facilities assessed scored in the most healthful range (20-42), which was mainly due to the extensiveness of the aerobic equipment/amenities and the competence/accessibility of staff. Significant differences in PACES-Total and PACES-Programs scores were associated with campus size and PACES-Facilities across regions. For the paired validation assessments, correlations were significant between PACES-Programs and HCI-Programs ((n=41) r=0.498, p < 0.001) and PACES-Facilities and PARA (n=29) for both features (r=0.417, p=0.024) and amenities (r=0.612, p < 0.001), indicating moderate convergent validity. Conclusion. The PACES audit is a valid, reliable tool for assessing the quality of recreation facilities and programs in a variety of college campus environments.

Midpregnancy prediction of pre-eclampsia using serum biomarkers sFlt-1 and PlGF.

OBJECTIVES: Pre-eclampsia remains a significant cause of morbidity and mortality. Placental biomarkers soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) have been investigated previously for their ability to predict pre-eclampsia. We compared the performance of these biomarkers for midpregnancy pre-eclampsia prediction using three different immunoassay platforms. STUDY DESIGN: Prospective study including singleton pregnancies 19-22 weeks' gestation. Maternal bloods were collected at recruitment. Screening performances using receiver operating characteristic (ROC) curves for PlGF and sFlt-1/PlGF ratio raw data and MoM values in isolation were evaluated for three immunoassay platforms using selected cut-off values. MAIN OUTCOME MEASURES: Pre-eclampsia was defined as early-onset (<34 weeks' at delivery) and preterm (<37 weeks' at delivery). RESULTS: For prediction of preterm pre-eclampsia, PlGF MoM and sFlt-1/PlGF ratio MoM performed similarly, with areas under the curve (AUC), detection rates (DR) and false positive rates (FPR) for PlGF MoM and sFlt-1/PlGF ratio MoM being 0.77-0.79 and 0.71-0.74, 62.5% for both and 9.7-14.9 and 10.7-17.7, respectively. For the prediction of early-onset pre-eclampsia, sFlt-1/PlGF ratio raw data and MoM values performed similarly, with AUC, DR and FPR being 0.92-0.97 and 0.93-0.96, 100% for both, and 4.13-16.9 and 9.4-12.2, respectively. CONCLUSIONS: For midpregnancy prediction of preterm pre-eclampsia, PlGF MoM for all three platforms and sFlt-1/PlGF ratio MoM for the two platforms that tested sFlt-1 performed similarly. For midpregnancy prediction of early-onset pre-eclampsia at midpregnancy, sFlt-1/PlGF ratio raw data and MoM values using the early-onset cut-off for the two platforms that tested sFlt-1 gave similar performance from a clinical perspective.