Recruiting Diverse Smokers: Enrollment Yields and Cost

To help tobacco control research better include vulnerable populations, we sought to identify effective ways to recruit diverse smokers. In 2014–2015, we recruited 2149 adult cigarette smokers in California and North Carolina, United States, to participate in a randomized trial of pictorial cigarette pack warnings. The most effective means of recruiting smokers were the classified advertising website Craigslist (28% of participants), word of mouth (23%), Facebook (16%), and flyers or postcards (14%). Low-income and African American smokers were more likely to respond to interpersonal contact (including staff in-person recruitment and word of mouth) than were high-income and non-African American smokers (all p < 0.05). Hispanic and gay, lesbian, and bisexual smokers were more likely to be recruited by Craigslist than non-Hispanic and straight smokers (both p < 0.05). Of the recruitment methods requiring cost, the cheapest was Craigslist ($3–7 per smoker). The most expensive methods were newspaper ads in California ($375 per smoker) and staff in-person recruiting in North Carolina ($180 per smoker). Successfully recruiting diverse smokers requires using multiple methods including interpersonal, online, and other media. Craigslist and word of mouth are especially useful and low-cost ways to recruit diverse smokers

“That’s probably what my mama’s lungs look like”: how adolescent children react to pictorial warnings on their parents’ cigarette packs

Abstract Background Pictorial cigarette pack warnings discourage smoking, but most evidence comes from studies of adults. Our qualitative study explored adolescents’ reactions to pictorial warnings on their parents’ cigarette packs. Methods We interviewed 24 adolescents whose parents received pictorial warnings on their cigarette packs as part of a randomized clinical trial. We conducted a thematic content analysis of the interview transcripts. Results Pictorial cigarette pack warnings led adolescents to imagine the depicted health effects happening to their parents, which elicited negative emotions. The warnings inspired adolescents to initiate conversations with their parents and others about quitting smoking. Adolescents believed the warnings would help smokers quit and prevent youth from starting smoking. Some current smokers said the warnings made them consider quitting. Conclusions Conversations about the pictorial warnings may amplify their effectiveness for smokers, their adolescent children, and friends of the adolescent children. Cigarette pack warnings may reach a broad audience that includes adolescent children of smokers

Medical Student Choices Regarding Ventilator Allocation for People With Disabilities

In the COVID-19 pandemic, concerns exist that ventilator triage policies may lead to discrimination against people with disabilities. This study evaluates whether preclinical medical students demonstrate bias towards people with disabilities during an educational ventilatorallocation exercise. Written student responses to a triage simulation activity were analyzed to describe ventilator priority rankings and to identify themes regarding disability. Disability status was not cited as a reason to withhold a ventilator. Key themes observed in ventilator triage decisions included life expectancy, comorbidities, and social worth. Although disability discrimination has historically been perpetuated by health care professionals, it is encouraging that preclinical medical students did not demonstrate explicit bias against people with disabilities in ventilator triage scenarios

Climate change and extreme weather disasters: evacuation stress is associated with youths’ somatic complaints

ObjectiveClimate-change has brought about more frequent extreme-weather events (e.g., hurricanes, floods, and wildfires) that may require families to evacuate, without knowing precisely where and when the potential disaster will strike. Recent research indicates that evacuation is stressful for families and is associated with psychological distress. Yet, little is known about the potential impact of evacuation stressors on child health. After Hurricane Irma, which led to a mass evacuation in Florida, we examined whether evacuation stressors and hurricane exposure were uniquely associated with youth somatic complaints, and whether youth psychological distress (i.e., symptoms of posttraumatic stress, anxiety, and depression) served as a potential mediating pathway between evacuation stressors, hurricane experiences, and somatic complaints.MethodThree months after Irma, 226 mothers of youth aged 7–17 years (N=226; M age = 9.76 years; 52% boys; 31% Hispanic) living in the five southernmost Florida counties reported on evacuation stressors, hurricane-related life threat and loss/disruption, and their child’s psychological distress and somatic complaints using standardized measures.ResultsStructural equation modeling revealed a good model fit (χ2 = 32.24, p = 0.003, CFI = 0.96, RMSEA = 0.08, SRMR = 0.04). Even controlling for life-threatening hurricane experiences (β = 0.26) and hurricane loss and disruption (β = 0.26), greater evacuation stressors were associated with greater symptoms of youth psychological distress (β = 0.34; p’s < 0.001), and greater psychological distress was associated with more somatic complaints (β = 0.67; p < 0.001). Indirect effects revealed that evacuation stressors (p < 0.001), actual life-threatening events (p < 0.01), and loss and disruption (p < 0.01) were all uniquely and indirectly associated with youths’ somatic complaints via youth psychological distress.DiscussionFindings suggest that even coping with the threat of a disaster may be sufficient to prompt psychological and physical health symptoms in youth. Due in part to climate change, threats of disaster occur much more often than actual disaster exposure, especially for areas that are prone to hurricanes or wildfires. Preparing youth and families residing in vulnerable areas for potential disaster evacuation or sheltering-in-place appears critical. Encouraging families to develop Disaster Plans and teaching stress management skills may reduce both youth distress and somatic health problems

Stressors, Repetitive Negative Thinking, and Insomnia Symptoms in Adolescents Beginning High School

Although the first year of high school may represent a particularly stressful time for adolescents, no research addresses how stressors are related to insomnia symptoms during this time. Thus, we examined how stress relates to concurrent and prospective insomnia symptoms in adolescents beginning high school (Aim 1). Additionally, we assessed repetitive negative thinking (RNT) as a mediator (Aim 2). We also evaluated whether the pattern of associations differed for boys and girls (Aim 3). Adolescents (N = 502; M age = 14.22 years; 58.2% girls; 91.2% Hispanic/Latinx) completed questionnaires about stressors related to beginning high school (e.g., school performance, peer pressure), family support, RNT, and insomnia symptoms at the beginning and end of their first year of high school. Multiple group structural equation models assessed relationships between these variables and evaluated differences between boys and girls. School/leisure conflict and low family support were directly associated with insomnia symptoms at both times, and RNT mediated these relationships in both boys and girls. In girls, peer pressure and low family support were indirectly associated with Time 1 and Time 2 insomnia symptoms via RNT. In boys, school performance was indirectly associated with Time 1 and Time 2 insomnia symptoms via RNT. Stressful experiences at the beginning of high school negatively affect sleep in adolescents both in the short and long term. Pediatric psychologists should educate adolescents and their parents about the risk of sleep problems during this time period and provide strategies for stress management and for proper sleep hygiene

“My Kids Are My Priority”: Mothers’ Decisions to Evacuate for Hurricane Irma and Evacuation Intentions for Future Hurricanes

Although families with children are particularly vulnerable in hurricanes, little is known about factors affecting families’ evacuation decisions. Following Hurricane Irma, we evaluated multiple factors potentially influencing mothers’ evacuation decisions and evacuation intentions for future hurricanes. Mothers of children under 18 years (N=536) completed an online survey assessing sociodemographic, hurricane-related, family, and psychological factors, as well as intentions regarding future evacuation. Logistic regression analyses identified factors associated with increased evacuation likelihood. Mothers’ reported reasons for evacuating highlighted family and psychological factors as most critical in decision-making. Mothers who evacuated for Irma or experienced more Irma-related loss/disruption reported significantly greater intention to evacuate for future hurricanes than mothers who did not. Mothers prioritize the safety and comfort of their children and keeping their family together when deciding whether to evacuate. Developing a Family Disaster Plan may facilitate evacuation decisions

Considerations for Assessment Training Competencies in Health Service Psychology Programs in the Age of COVID-19

Health service psychologists have made a rapid transition to delivering telepsychology services during the COVID-19 pandemic. The provision of remote assessment services, or teleassessment, however, has lagged behind given the limited evidence base. This delay has been uniquely challenging for university training clinics, which are equally responsible for developing trainee assessment competencies and providing high-quality assessments to clients. Training clinics have been tasked with implementing programmatic adaptation to meet this need with limited guidance. We address this gap by describing the considerations university training clinics must make under physical distancing policies, including protections for the health of trainees and clients, ensuring standardized administration of assessments, providing developmentally appropriate training opportunities, and guaranteeing transparency in the consent and feedback processes. We recommend solutions to reconcile these inherent challenges and highlight training opportunities as they relate to the development of profession-wide competencies and ethical principles. These recommendations demonstrate that by integrating flexibility into program curriculums, training clinics can continue to adhere to accreditation standards while developing trainee competencies in assessment during the COVID-19 pandemic

The stress before the storm: Psychological correlates of hurricane-related evacuation stressors on mothers and children

Natural disasters, such as hurricanes, can contribute to the development of posttraumatic stress symptoms (PTSS), anxiety, and depression. Furthermore, mothers and children are especially vulnerable postdisasters. Despite the rise in the frequency of climate-related disasters and also the threat of disasters (e.g., storms that threaten but do not make landfall), little is known about how predisaster experiences are associated with mothers' and children's postdisaster psychological functioning. This study examined evacuation-related stressors as predictors of mothers' and youths' psychological functioning 3 months after Hurricane Irma. Mothers ( = 535; 33% ethnic/racial minorities) from South Florida counties most affected by Hurricane Irma completed an online survey that assessed evacuation-related stressors (both pre- and posthurricane), hurricane exposure (i.e., life threat, loss/disruption), and posthurricane social support and mental health symptomatology (i.e., PTSS, anxiety, depression). Mothers of children aged 7-17 years ( = 226) also reported on their child's psychological functioning. Using a risk and resilience model, evacuation stressors significantly predicted mothers' and youths' PTSS and symptoms of anxiety and depression, even after accounting for demographic factors, hurricane exposure, and availability of social support. Mothers of older children also reported significantly higher levels of PTSS, anxiety, and depression than mothers who only had young children (aged 6 or younger) at home. Evacuation experiences represent significant stressors that may put mothers and children at risk for PTSS and psychological distress. Resilience-building efforts should include efforts to better prepare families for prestorm evacuations, thereby reducing risk in mothers and youth and ultimately contributing to better psychosocial functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved)