27 research outputs found
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 (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
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Stressed and Sleep: The Relationship between Stressors and Sleep Loss in Adolescents Transitioning to High School
Sleep loss is associated with a host of negative physical, psychological, and academic outcomes in adolescents, and past research indicates that stress contributes to sleep loss. Although the transition to high school represents a particularly stressful time for adolescents, no research is currently available on how transition stressors are related to sleep loss. This study sought to examine how transition stressors relate to concurrent and prospective sleep problems in adolescents transitioning to high school. Additionally, it sought to understand the role that gender, family support, and repetitive negative thinking might play in the relationship between stress and sleep. Participants were 511 ninth graders (M age = 14.22, SD = .52). Adolescents completed a short form of the Adolescent Stress Questionnaire, the Perceived Social Support – Family measure, selected items from the Perseverative Thinking Questionnaire – Child Version, and three items about sleep loss at two time points at the beginning and end of their first year of high school (October and May). Girls reported more stressors than boys, and stressors related to peer pressure and teacher interaction appeared to be stable over time. Hierarchical linear regression analyses indicated that all transition stressors were associated with concurrent sleep loss, while peer pressure and school/leisure conflict also related to sleep loss prospectively. Gender moderated these relationships, such that there was a stronger relationship between stressors and sleep loss in boys compared to girls. Less family support and higher levels of repetitive negative thinking were associated with more sleep loss. Repetitive negative thinking appeared to mediate the relationship between certain transition stressors and sleep loss. Stressful transition experiences can negatively impact sleep in adolescents transitioning to high school. Schools should consider family-based intervention programming to improve sleep hygiene. Pediatricians should monitor patients with recent school transitions for sleep problems and provide support for dealing with common transition stressors.</p
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Key Psychosocial Issues for Comprehensive Diabetes Care: Improving Psychosocial Screening and Referral
Psychological concerns are common among patients with diabetes and contribute to difficulties with diabetes management and negative health outcomes. Routine psychosocial screening is an important tool to identify patients with diabetes that would benefit from mental health services, but screening procedures have yet to be widely implemented in diabetes care and are notably absent in adult compared to pediatric diabetes care settings. This three-study project aimed to understand key issues related to the implementation of psychosocial screening and referral procedures within both pediatric and adult diabetes specialty care. Diffusion of Innovations Theory guided the first two studies, which were qualitative in nature and focused on stakeholder (i.e., patients, providers) perspectives regarding the role of mental health within diabetes care, psychosocial screening procedures, and preferences related to psychosocial support for patients. The third study was based in the Theory of Planned Behavior and assessed how parents’ attitudes, beliefs related to stigma and the role of mental health within diabetes care, and perceived behavioral control contributed to their behavioral intentions to seek professional psychological support for their adolescent with diabetes, as well as how various background characteristics influenced these factors.</p
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Ethics Education in COVID-19: Preclinical Medical Students’ Approach to Ventilator Allocation
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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
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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
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Evacuation- and hurricane-related experiences, emotional distress, and their associations with mothers’ health risk behaviors
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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