A new tool to capture dimensions of family dinners in relation to adolescent health and risk-related outcomes: The ‘Family Dinner Index’

There is a strong association between family meals and child and adolescent health. To systematically understand the associations between family meals with a variety of health and risk outcomes, we developed and conducted a validation study of child- and parent-versions of the Family Dinner Index (FDI; FDI-C/FDI-P). We validated the measures with a national sample of 2,090 parent–child dyads. Using factor analysis, we reduced the initial FDIs each to eight items representing communication, enjoyment, and digital distractions; the FDI-C also included meal logistics and the FDI-P, family bonding. Using multivariable log-binomial regression models, we examined the relationships between FDI scores and substance use, violence, weight perception, weight control intention, and health indicators. Children who scored ≥21 on the FDI-C had a significantly lower average prevalence of a ‘negative outcome’ composite, as well as a lower prevalence of each of the individual behaviors. Children of parents who scored ≥24 on the FDI-P had a significantly lower average prevalence of the ‘negative outcome’ composite, as well as a lower prevalence of substance use indicators, negative weight perception and intentions to lose weight, less than daily fruit and vegetable consumption, and not meeting guidelines for physical activity. The FDI measures provide support for face and content validity, as well as concurrent criterion validity and construct validity. Further validation with these measures using a longitudinal design will allow for the establishment of predictive validity. Currently, the FDI measures may help researchers and practitioners identify points of emphasis for tailoring family-based prevention programs accordingly

Anorexia nervosa and the COVID-19 pandemic among young people: a scoping review

Abstract Background The extent to which the recent global COVID-19 Pandemic has impacted young people with restrictive eating disorders [i.e., anorexia nervosa (AN) and atypical anorexia nervosa (AAN)] is unclear. We conducted a scoping review of the literature to identify how the pandemic has impacted this population and to identify gaps in the current literature to inform future research efforts. Main body We searched PubMed, EMBASE, the Web of Science, The Cochrane Library, PsycInfo, ProQuest Dissertations and Theses Global, LitCovid, Google Scholar, and relevant agency websites from 2019 to 2022. We included studies that focused on young people with AN/AAN globally. Of the 916 unduplicated articles screened, 17 articles met the inclusion criteria, reporting on 17 unique studies including 4,379 individuals. Three key findings were identified. First, an increase in hospitalizations related to eating disorders was found during COVID-19 among young people with AN and AAN. Multiple studies cited increased medical instability, even though the overall duration of disease was shorter compared to pre-pandemic levels. Second, changes in eating disorder-related symptomology during the pandemic were reported in this population, as well as poorer overall behavioral and mental health. Suggested reasons behind changes included boredom or minimal distraction from pathological thoughts, increased social isolation, increased social media and online use (e.g., reading blogs or watching YouTube), gym and school closures, changes in routines due to lockdowns and quarantines, and worries over gaining the “Quarantine 15”. Third, there was an increase in the use of telemedicine as a treatment modality for the treatment of AN. Challenges were reported by both clinicians and patients regardless of past experience using telemedicine. When compared to no treatment, telemedicine was recognized as the best option during COVID-19 lockdowns; however some individuals expressed the preference for in-person treatment and planned to return to it once it became available. Conclusion The pandemic significantly impacted young people with restrictive eating disorders as seen by increased hospitalizations and requests for outpatient care. A primary driver of the changes in eating disorder symptomatology may be lockdowns and quarantines. Further research investigating how the series of lockdowns and re-openings impacted individuals with AN/AAN is warranted

Risk factors for missed HIV primary care visits among men who have sex with men

Benefits of anti-retroviral therapy (ART) depend on consistent HIV care attendance. However, appointment non-adherence (i.e. missed appointments) is common even in programs that reduce financial barriers. Demographic, health/treatment, and psychosocial contributors to appointment non-adherence were examined among men who have sex with men (MSM) attending HIV primary care. Participants (n = 503) completed questionnaires, and HIV biomarker data were extracted from medical records. At 12 months, records were reviewed to assess HIV primary care appointment non-adherence. Among MSM, 31.2% missed without cancellation at least one appointment during 12-month study period. Independent predictors (P < 0.05) were: low income (OR = 1.87); African American (OR = 3.00) and Hispanic/Latino (OR = 4.31) relative to non-Hispanic White; depression (OR = 2.01); and low expectancy for appointments to prevent/treat infection (OR = 2.38), whereas private insurance (OR = 0.48) and older age (OR = 0.94) predicted lower risk. Low self-efficacy predicted marginal risk (OR = 2.74, P = 0.10). The following did not independently predict risk for non-adherence: education, relationship status, general health, time since HIV diagnosis, ART history, post-traumatic stress disorder, HIV stigma, or supportive clinic staff. Appointment non-adherence is prevalent, particularly among younger and racial/ethnic minority MSM. Socioeconomic barriers, depression and low appointment expectancy and self-efficacy may be targets to increase care engagement

Patterns of Substance Use Among a Large Urban Cohort of HIV-Infected Men Who Have Sex With Men in Primary Care

The present study sought to identify characteristics of HIV-infected MSM that are associated with the use of specific substances and substance abuse in general. Participants were 503 HIV-infected MSM who were receiving primary care. A self-assessment and medical records were used to obtain information about past 3-month alcohol and drug use and abuse, and demographics, HIV-disease stage and treatment, sexual risk, and mental health. Associations of these four domains with substance use and abuse outcomes were examined using hierarchical block-stepwise multivariable logistic regression. Substance use and abuse in the sample was high. Transmission risk behavior was significantly associated with over half of the outcomes. The associations of demographic and HIV-disease stage and treatment variables varied by substance, and mental health problems contributed differentially to almost every outcome. These findings should be considered for designing, implementing, and evaluating substance use programming for HIV-infected MSM

Demonstration and evaluation of a peer-delivered, individually-tailored, HIV prevention intervention for HIV-infected MSM in their primary care setting

Employing HIV-infected peer counselors in secondary prevention interventions for MSM is appealing for scalable interventions. One-hundred-seventy-six HIV-infected MSM at their primary care facility participated in a secondary HIV-prevention study delivered by HIV-infected MSM peers. Of those who entered the intervention and completed the initial intake, 62% completed all four of the intervention sessions, and 93% completed at least one. While there was no overall change in transmission risk behavior (TRB) for the whole sample, among those who reported HIV TRB at baseline (n = 29), there were significant reductions in TRB over the next year. Themes that emerged in qualitative exit interviews conducted with a subset of participants centered on peer counselor quality, intervention implications, and intervention experience. This demonstration project provides initial evidence for the ability to recruit HIV-infected MSM in care into a peer-based intervention study, and shows how a peer-based intervention can be delivered in the context of HIV care

Testing a social-cognitive model of HIV transmission risk behaviors in HIV-infected MSM with and without depression

Social-cognitive models have been used to explain health risk behaviors in numerous populations, including people with HIV. However, these models generally do not account for the influence of clinically significant psychological problems such as major depression. This study examined whether a social-cognitive model would explain recent sexual transmission risk behavior among sexually active HIV-infected men who have sex with men (MSM) who meet or do not meet screening criteria for major depression. Participants (n = 403) completed self-report assessments of negative expectancy, social models, and self-efficacy (SE) related to condom use, as well as recent STRB and a screening measure for major depression. Multiple group modeling was used to examine whether condom use SE explained associations of negative expectancy and social models for condom use with recent STRB among participants who screened positive (n = 47) or negative (n = 356) for major depression. The multiple group model fit the data well (chi2(36) = 30.55, p = .73; CFI = 1.00; RMSEA<.01; SRMR = .05). Among MSM who screened negative for depression, lower condom use SE explained indirect paths from negative expectancy about condom use and poorer social models for condom use to greater STRB. Among MSM who screened positive for depression, only negative expectancy was associated with greater STRB. Models of STRB may not generalize to HIV-infected individuals with clinical depression. Risk reduction interventions based on these models should account for comorbid mental health conditions to maximize effectiveness

Evaluation of the Massachusetts Smoke-free Workplace Law

STUDY OBJECTIVES This report describes an evaluation of the Massachusetts Smoke-Free Workplace Law. The main objectives were to: (1) assess the change in indoor air quality that occurred in a sample of hospitality venues pre and post the law; (2) determine compliance with the law after implementation; and (3) evaluate economic changes pre and post the law, including patronage, sales revenue, and employment rates

Opioid prescriber screening practices to detect risk for developing opioid use disorder: Qualitative perspectives from providers during the fourth wave of the opioid crisis

Little is known about how clinical providers assess risk for opioid use disorder (OUD), especially when considering prescriptions for opioid-naïve patients with acute pain. While formal screening tools exist, they are not widely used, and may not be sensitive enough to identify low-risk individuals who are susceptible to developing an OUD. Therefore, we sought to understand opioid prescribers' perspectives on their screening practices. We conducted qualitative interviews with 32 opioid prescribers across Massachusetts (11/2020–08/2021); approximately half (47%) used screening tools to identify risk for developing an OUD. We inquired about providers' risk-related screening practices before prescribing opioids, management of high-risk patients, and perspectives on barriers and facilitators to effective screening. We used a deductive content analytic approach, examining the results through a stratified lens based on use of screening methods. General prescribing and risk assessment practices did not vary by strata; however, perspectives on screening were different, as were challenges and barriers that providers identified. Recommendations from those who utilized screeners focused on standardizing and streamlining screening processes; those who did not screen suggested making risk assessments clear to avoid interpretation issues and limiting biases toward certain population groups. Findings are framed in the context of the Normalization Process Theory, addressing a lack of coherence in providers’ understanding of screeners and lack of cognitive participation and collective action across their practices surrounding OUD screening. Future research with providers should focus on strategies to integrate effective procedures around OUD prevention into their practices and methods to evaluate their impact