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Nahum-Shani I, Rabbi M, Yap J, Philyaw-Kotov ML, Klasnja P, Bonar EE, Cunningham RM, Murphy SA, Walton MA. Translating strategies for promoting engagement in mobile health: A proof-of-concept microrandomized trial. Health Psychol 2021; 40:974-987. [PMID: 34735165 PMCID: PMC8738098 DOI: 10.1037/hea0001101] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Mobile technologies allow for accessible and cost-effective health monitoring and intervention delivery. Despite these advantages, mobile health (mHealth) engagement is often insufficient. While monetary incentives may increase engagement, they can backfire, dampening intrinsic motivations and undermining intervention scalability. Theories from psychology and behavioral economics suggest useful nonmonetary strategies for promoting engagement; however, examinations of the applicability of these strategies to mHealth engagement are lacking. This proof-of-concept study evaluates the translation of theoretically-grounded engagement strategies into mHealth, by testing their potential utility in promoting daily self-reporting. METHOD A microrandomized trial (MRT) was conducted with adolescents and emerging adults with past-month substance use. Participants were randomized multiple times daily to receive theoretically-grounded strategies, namely reciprocity (the delivery of inspirational quote prior to self-reporting window) and nonmonetary reinforcers (e.g., the delivery of meme/gif following self-reporting completion) to improve proximal engagement in daily mHealth self-reporting. RESULTS Daily self-reporting rates (62.3%; n = 68) were slightly lower than prior literature, albeit with much lower financial incentives. The utility of specific strategies was found to depend on contextual factors pertaining to the individual's receptivity and risk for disengagement. For example, the effect of reciprocity significantly varied depending on whether this strategy was employed (vs. not employed) during the weekend. The nonmonetary reinforcement strategy resulted in different outcomes when operationalized in various ways. CONCLUSIONS While the results support the translation of the reciprocity strategy into this mHealth setting, the translation of nonmonetary reinforcement requires further consideration prior to inclusion in a full scale MRT. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Macapagal K, Li DH, Clifford A, Madkins K, Mustanski B. The CAN-DO-IT Model: a Process for Developing and Refining Online Recruitment in HIV/AIDS and Sexual Health Research. Curr HIV/AIDS Rep 2020; 17:190-202. [PMID: 32444929 PMCID: PMC7380648 DOI: 10.1007/s11904-020-00491-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW HIV/AIDS and sexual health research has increasingly relied on online recruitment in recent years. However, as potential online recruitment avenues (e.g., dating and sexual networking applications, websites, social media) have proliferated, navigating this process has become increasingly complex. This paper presents a practical model to guide researchers through online recruitment irrespective of platform. RECENT FINDINGS The CAN-DO-IT model reflects 7 iterative steps based on work by the authors and other investigators: conceptualize scope of recruitment campaign, acquire necessary expertise, navigate online platforms, develop advertisements, optimize recruitment-to-enrollment workflow, implement advertising campaign, and track performance of campaigns and respond accordingly. Online recruitment can accelerate HIV/AIDS research, yet relatively limited guidance exists to facilitate this process across platforms. The CAN-DO-IT model presents one approach to demystify online recruitment and reduce enrollment barriers.
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Affiliation(s)
- Kathryn Macapagal
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 14-057, Chicago, IL, 60611, USA.
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL, 60611, USA.
| | - Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 14-057, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL, 60611, USA
- Center for Prevention Implementation Methodology for Drug Abuse and HIV, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL, 60611, USA
| | - Antonia Clifford
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 14-057, Chicago, IL, 60611, USA
| | - Krystal Madkins
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 14-057, Chicago, IL, 60611, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 14-057, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL, 60611, USA
- Center for Prevention Implementation Methodology for Drug Abuse and HIV, Feinberg School of Medicine, Northwestern University, 750 N. Lakeshore Drive, Chicago, IL, 60611, USA
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Carr DJ, Adia AC, Wray TB, Celio MA, Pérez AE, Monti PM. Using the Internet to access key populations in ecological momentary assessment research: Comparing adherence, reactivity, and erratic responding across those enrolled remotely versus in-person. Psychol Assess 2020; 32:768-779. [PMID: 32437190 DOI: 10.1037/pas0000847] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ecological momentary assessment (EMA) is a set of longitudinal methods that researchers can use to understand complex processes (e.g., health, behavior, emotion) in "high resolution." Although technology has made EMA data collection easier, concerns remain about the consistency and quality of data collected from participants who are enrolled and followed online. In this study, we used EMA data from a larger study on HIV-risk behavior among men who have sex with men (MSM) to explore whether several indicators of data consistency/quality differed across those who elected to enroll in-person and those enrolled online. One hundred MSM (age 18-54) completed a 30-day EMA study. Forty-five of these participants chose to enroll online. There were no statistically significant differences in response rates for any survey type (e.g., daily diary [DD], experience sampling [ES], event-contingent [EC]) across participants who enrolled in-person versus online. DD and ES survey response rates were consistent across the study and did not differ between groups. EC response rates fell sharply across the study, but this pattern was also consistent across groups. Participants' responses on the DD were generally consistent with a poststudy follow-up Timeline Followback (TLFB) with some underreporting on the TLFB, but this pattern was consistent across both groups. In this sample of well-educated, mostly White MSM recruited from urban areas, EMA data collected from participants followed online was as consistent, reliable, and valid as data collected from participants followed in-person. These findings yield important insights about best practices for EMA studies with cautions regarding generalizability. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Gruszczyńska E, Rzeszutek M. Affective Well-Being, Rumination, and Positive Reappraisal among People Living with HIV: A Measurement-Burst Diary Study. Appl Psychol Health Well Being 2020; 12:587-609. [PMID: 32168436 PMCID: PMC7687166 DOI: 10.1111/aphw.12198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 01/07/2020] [Accepted: 02/18/2020] [Indexed: 11/27/2022]
Abstract
Background Changes of affective well‐being are usually analysed either as longitudinal processes or as daily fluctuations. We used a three‐burst diary study to combine these perspectives. Method The participants were 211 patients with a diagnosis of HIV infection. In three bursts with 6‐month intervals, they completed an online diary for five consecutive days, which gives 15 days of measurements. They evaluate affective well‐being (positive and negative affect), stress associated with a central hassle, and coping (rumination and positive reappraisal). Results Higher daily stress coupled with higher rumination was related to lower well‐being. For positive reappraisal, the picture was more complex. First, its interaction with daily stress had an effect on negative, but not on positive, affect. Second, this effect was significant only at the first burst. Conclusions These results suggest a stable debilitating effect of daily rumination, but a limited and diminishing beneficial effect of daily positive reappraisal among people living with HIV. As such, they do not confirm the view that positive reappraisal sustains affective well‐being during chronic health conditions. This may inform stress management interventions for PLWH, which are now increasingly taking the form of mobile applications, adapted to the daily lives of patients in their natural environment.
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Affiliation(s)
- Ewa Gruszczyńska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
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Examining measurement reactivity in daily diary data on substance use: Results from a randomized experiment. Addict Behav 2020; 102:106198. [PMID: 31775064 DOI: 10.1016/j.addbeh.2019.106198] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 11/22/2022]
Abstract
The debate about whether measurement reactivity exists in daily diary research on substance use is still unsettled due to the issues of study design and statistical methodology. This study proposes a time-varying effect model (TVEM) that characterizes the trajectory of substance use behaviors with nonparametric functions determined by the data rather than imposes presumed parametric functions. It also allows researchers to investigate the effect of measurement reactivity on not only the likelihood of using substances but also the amount of substance use. The TVEM was applied to analyze diary data on alcohol and marijuana use collected from an experiment, which randomized 307 participants in Michigan into daily and weekly assessment schedules during 2014-2016. This study found short-term measurement reactivity on alcohol use, but did not find a significant reactivity effect on marijuana use. The daily group had smaller odds of abstinence from drinking but lower expected drinking quantity in the first week of assessment, which dissipated by the second week. The results indicate that although daily self-monitoring could have short-term reactivity on substance use behaviors that tend to fluctuate across days, such as alcohol use, it does not affect substance use behaviors that are quite consistent, such as marijuana use. Our findings imply that although daily monitoring of drinking may motivate people to reduce the quantity consumed once they start to drink, it may also arouse their desire to start drinking. Yet, both effects tend to last only one week, as participants accommodate to the monitoring by the second week.
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Grov C, Westmoreland D, Rendina HJ, Nash D. Seeing Is Believing? Unique Capabilities of Internet-Only Studies as a Tool for Implementation Research on HIV Prevention for Men Who Have Sex With Men: A Review of Studies and Methodological Considerations. J Acquir Immune Defic Syndr 2019; 82 Suppl 3:S253-S260. [PMID: 31764261 PMCID: PMC6880799 DOI: 10.1097/qai.0000000000002217] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In 2014, Grov et al published a comprehensive review cataloguing both men who have sex with men's (MSM's) sexual behavior transitions in online environments from the 1990s through 2013, as well as researchers' efforts in tandem to use the internet to engage MSM into research, treatment, and prevention. METHODS In this article, we discuss historical events and research having occurred in the half decade since the Grov et al publication. RESULTS Notable transitions include MSM's expanded use of geosocial networking apps, as well as other forms of social media accessed primarily through mobile devices, as well as the addition of biomedical prevention strategies (eg, pre-exposure prophylaxis and undetectable = untransmittable) to the proverbial HIV prevention toolkit. In tandem, researchers have rapidly expanded their employment of internet-mediated methods for the recruitment and engagement of key populations for HIV research, treatment, and prevention. In this article, we discuss methodological considerations for using the internet to conduct HIV prevention research with MSM: (1) sources of recruitment (eg, geosocial apps, Facebook, crowdsourced online panels); (2) design (eg, cross sectional, longitudinal, diaries); (3) incentives (including disincentivizing fraudulent participants and/or spam bots); (4) confidentiality; and (5) representativeness. CONCLUSION We conclude by discussing future directions in HIV prevention research in light of forthcoming technologies such as fifth generation (5G) mobile networks, combined use of self-collected biological data alongside self-report, and the utility of metadata and metaresearch to document, evaluate, and inform best practices.
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Affiliation(s)
- Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
| | - Drew Westmoreland
- CUNY Institute for Implementation Science in Population Health, New York, NY
| | | | - Denis Nash
- CUNY Graduate School of Public Health and Health Policy, New York, NY
- CUNY Institute for Implementation Science in Population Health, New York, NY
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Simons JS, Maisto SA, Palfai TP. Using the Experience Sampling Method to Study Sexual Risk Behavior among Men Who Have Sex With Men (MSM). JOURNAL OF SEX RESEARCH 2019; 56:1147-1154. [PMID: 31553251 DOI: 10.1080/00224499.2019.1663479] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Toward the goal of advancing understanding of rates of HIV transmission among men who have sex with men (MSM) populations, this article provides preliminary data on the use of the experience sampling method (ESM) in a sample of 165 MSM. Participants completed 6 weeks of experience sampling in two 3-week measurement bursts with a 3-week rest interval. Criterion validity of the random and retrospective daily assessments was supported by expected within-person correlations between sexual risk behavior and sexual arousal. Participants reported some sexual activity with a male partner on 18.62% of the days, condomless anal sex (CAS) on 6.52% of days, and not using condoms on 66.56% of days they had anal sex. Over half of the variability in CAS was at the within-person level, which suggests the significance of time varying contextual factors. Finally, CAS reports were relatively stable across the study, suggesting a lack of reactivity to the self-monitoring.
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Affiliation(s)
| | | | - Tibor P Palfai
- Department of Psychological and Brain Sciences, Boston University
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Li DH, Janulis P, Mustanski B. Predictors of correspondence between self-reported substance use and urinalysis screening among a racially diverse cohort of young men who have sex with men and transgender women. Addict Behav 2019; 88:6-14. [PMID: 30099289 PMCID: PMC6291201 DOI: 10.1016/j.addbeh.2018.08.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 08/01/2018] [Accepted: 08/04/2018] [Indexed: 11/28/2022]
Abstract
It is unknown if estimates of illicit drug use among young men who have sex with men and transgender women (YMSM/TW) may be biased due to historical distrust of research or reliable due to more accepting norms for use. Research is needed to examine the validity of drug use self-reports among YMSM/TW. Data came from an ongoing longitudinal study of YMSM/TW aged 16-29 living in Chicago (analytic N = 1029). Baseline urinalysis screens for marijuana, ecstasy, amphetamine, methamphetamine, cocaine, benzodiazepine, and opiate metabolites were compared to self-reported use within different recall periods using measures of concordance. Generalized estimating equations logistic regressions were conducted on three waves of data to identify predictors of disclosing past-6-month use of marijuana and non-marijuana drugs. Past-6-month self-reported use of all non-marijuana substances was <15%. There was excellent agreement between self-reported and drug-tested marijuana use. For other substances, sensitivities within the urinalysis detection window were <0.5 but increased with longer recall periods. Black participants had lower odds of disclosing non-marijuana drug use. Gender minority participants had lower odds of disclosing marijuana use. Participants with a history of arrest had higher odds of disclosing both marijuana and non-marijuana drug use. Wave and year of first research participation were non-significant, suggesting no systematic bias or increasing honesty associated with longer research participation. Programs that rely on self-identification of non-marijuana illicit substance use may be missing a substantial portion of drug-using YMSM/TW. Future epidemiological studies should work to reduce social desirability biases and include biomarker-based drug screenings to increase validity.
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Affiliation(s)
- Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
| | - Patrick Janulis
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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Ventuneac A, John SA, Whitfield THF, Mustanski B, Parsons JT. Preferences for Sexual Health Smartphone App Features Among Gay and Bisexual Men. AIDS Behav 2018; 22:3384-3394. [PMID: 29948335 PMCID: PMC6148366 DOI: 10.1007/s10461-018-2171-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Given the popularity of geosocial networking applications ("apps") among gay, bisexual, and other men who have sex with men (GBMSM), this study sought to examine GBMSM's willingness to use sexual health and behavior tracking features if integrated within apps they are already using to meet sexual partners. Most GBMSM (91%) recruited on a popular app reported interest in one or more sexual health app features, including features to find LGBT-friendly providers (83%), receive lab results (68%), schedule appointment reminders (67%), chat with a healthcare provider (59%), and receive medication reminder alerts (42%). Fewer GBMSM were interested in tracking and receiving feedback on their sexual behavior (35%) and substance use (24%). Our data suggest that integrating sexual health and behavior tracking features for GBMSM who use apps could be promising in engaging them in HIV prevention interventions. Further research is needed on GBMSM's perspectives about potential barriers in using such features.
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Affiliation(s)
- Ana Ventuneac
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven A John
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
| | - Thomas H F Whitfield
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
| | - Brian Mustanski
- Department of Medical Social Sciences and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA.
| | - Jeffrey T Parsons
- The Center for HIV/AIDS Educational Studies & Training (CHEST), New York, NY, USA
- Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY), New York, NY, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA
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Swann G, Newcomb ME, Mustanski B. Validation of the HIV Risk Assessment of Sexual Partnerships (H-RASP): Comparison to a 2-Month Prospective Diary Study. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:121-131. [PMID: 28733826 PMCID: PMC5756508 DOI: 10.1007/s10508-017-1033-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 06/29/2017] [Accepted: 07/02/2017] [Indexed: 05/07/2023]
Abstract
The HIV Risk Assessment of Sexual Partnerships (H-RASP) was developed in order to create a retrospective measure of sexual risk-taking that can account for the differing contexts of sexual partnership(s) within a specified period of time. In order to validate the H-RASP relative to other methods of measuring sexual risk-taking, measurements from the H-RASP were compared to data from a prospective diary study of 95 young men who have sex with men over the same two-month period. We found that the H-RASP was not significantly different at measuring participants' total number of sexual partners and total number of anal sex partners in comparison with the diaries. The two measures were significantly different in measurement of total number of condomless anal sex (CAS) partners and number of CAS acts within partnerships, such that participants on average estimated more CAS partners and acts in the H-RASP. The two measures shared 40.8% of variance on measurement of CAS partners and 44.6% of variance on CAS acts within partnerships. These results suggest that even though the H-RASP is not a perfect replication of prospective diary data, it captures a moderate proportion of the same variance, and, in the case of CAS acts within partnerships, a proportion of the variance that likely would not be measured by retrospective measures that do not ask about behaviors specific to partnerships.
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Affiliation(s)
- Gregory Swann
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA.
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA.
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
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