Comparison of Online Survey Recruitment Platforms for Hard-to-Reach Pregnant Smoking Populations: Feasibility Study

BODY-Q Normative Scores: Psychometric Validation of the BODY-Q in the General Population in Europe and North America

Background

BODY-Q is a rigorously developed patient-reported outcome measure designed to measure outcomes of weight loss and body contouring patients. To allow interpretation and comparison of BODY-Q scores across studies, normative BODY-Q values were generated from the general population. The aim of this study was to examine the psychometric properties of BODY-Q in the normative population.

Methods

Data were collected using two crowdsourcing platforms (Prolific and Amazon Mechanical Turk) in 12 European and North American countries. Rasch measurement theory (RMT) was used to examine reliability and validity of BODY-Q scales.

Results

RMT analysis supported the psychometric properties of BODY-Q in the normative sample with ordered thresholds in all items and nonsignificant chi-square values for 167 of 176 items. Reliability was high with person separation index of greater than or equal to 0.70 in 20 of 22 scales and Cronbach alpha values of greater than or equal to 0.90 in 17 of 22 scales. Mean scale scores measuring appearance, health-related quality of life, and eating-related concerns scales varied as predicted across subgroups with higher scores reported by participants who were more satisfied with their weight. Analysis to explore differential item functioning by sample (normative versus field-test) flagged some potential issues, but subsequent comparison of adjusted and unadjusted person estimates provided evidence that the scoring algorithm worked equivalently for the normative sample as in the field-test samples.

Conclusions

The BODY-Q scales showed acceptable reliability and validity in the normative sample. The normative values can be used as reference in research and clinical practice in combination with local estimates for parallel analysis and comparison.

Multidimensional social support and parenting among Black fathers: A profile-oriented approach

Though studies have examined the role of social support in the lives of Black men, less is known about the role and function of multi-domain social support as they navigate fatherhood. This investigation utilizes a profile-oriented approach to identify patterns of general and parenting-specific social support (i.e., family; peers; community) among a sample of 759 Black American fathers. Additionally, this study examines how identified support profiles are associated with Black fathers' parenting outcomes (i.e., stress, satisfaction, self-efficacy, and involvement). Latent class analyses identified 10 distinct social support profiles among Black fathers. Results also indicated that there was some profile variation in levels parenting outcomes. Findings suggest variation in the availability and utilization of general and parenting support among Black fathers.

Data quality in online human-subjects research: Comparisons between MTurk, Prolific, CloudResearch, Qualtrics, and SONA

With the proliferation of online data collection in human-subjects research, concerns have been raised over the presence of inattentive survey participants and non-human respondents (bots). We compared the quality of the data collected through five commonly used platforms. Data quality was indicated by the percentage of participants who meaningfully respond to the researcher's question (high quality) versus those who only contribute noise (low quality). We found that compared to MTurk, Qualtrics, or an undergraduate student sample (i.e., SONA), participants on Prolific and CloudResearch were more likely to pass various attention checks, provide meaningful answers, follow instructions, remember previously presented information, have a unique IP address and geolocation, and work slowly enough to be able to read all the items. We divided the samples into high- and low-quality respondents and computed the cost we paid per high-quality respondent. Prolific ($1.90) and CloudResearch ($2.00) were cheaper than MTurk ($4.36) and Qualtrics ($8.17). SONA cost $0.00, yet took the longest to collect the data.

Ecological Momentary Assessment of Heavy Episodic Drinking in the Early Postpartum Period: A Feasibility Study

Background

Postpartum mothers are at heightened risk for heavy episodic drinking (HED). Research with this population is critical to developing acceptable and effective tailored interventions, but new mothers who use alcohol are often reluctant to engage in research due to stigma and fear of child removal. This study examined feasibility of recruitment and ecological momentary assessment (EMA) in early postpartum mothers with histories of HED.

Methods

Participants were recruited via Facebook and Reddit and completed 14 days of EMA surveys. Baseline characteristics, recruitment feasibility, and EMA feasibility and acceptability were examined. Participants attended focus groups to further inform quantitative data.

Results

Reddit yielded a larger proportion of eligible individuals than Facebook, and 86% of the final enroled sample was recruited via Reddit. The average compliance rate of 75% is in line with other studies of similar populations. Half the sample reported alcohol use, and 78% reported the urge to drink at least once, supporting feasibility of EMA for collecting alcohol use data. Participants reported low burden and high acceptability of the study on both quantitative and qualitative measures. Baseline low maternal self-efficacy was associated with greater EMA compliance, and first-time mothers reported lower EMA burden compared to veteran mothers. College graduates, and participants with lower drinking refusal self-efficacy and greater alcohol severity were more likely to report alcohol use on EMA.

Conclusions

Future studies should consider Reddit as a recruitment strategy. Findings generally support feasibility and acceptability of EMA to assess HED in postpartum mothers.

Does Exposure to Pediatrician or Parent Blog Content Influence Infant Safe Sleep Practices?

OBJECTIVE

To examine whether exposure to safe sleep recommendations using a blog format changed infant sleep practices.

METHODS

We conducted a pilot randomized controlled trial via Qualtrics, a web-based platform, with a national sample of parents of children < 1 year old. Survey questions about infant sleep practices included: bed-sharing, location, position and objects present. Safe sleep was defined as not bed-sharing, in a crib, bassinet or playard, back positioning, and no other objects present except pacifiers. Participants were randomized to read one of the following: (1) pediatrician blog post, (2) parent blog post, or (3) no blog post. The blog posts contained the same content about infant sleep but varied by identified authorship. All participants received links to online content about safe sleep. Participants received a follow-up survey 2-4 weeks later with the same questions about infant sleep practices. We compared responses in pre- and post-surveys by type of blog post exposure using multivariable logistic regression models.

RESULTS

The average infant age (n = 1500) was 6.6 months (Standard Deviation 3.3). Most participants (74%) were female; 77% were married; 65% identified as white Non-Hispanic, 12% were black and 17% were Hispanic. 47% (n = 711) completed both surveys. We identified no differences in the odds of any of the four safe sleep practices after exposure to safe sleep recommendations in blog post format.

CONCLUSION

Although in-person advice has been associated with improved safe sleep practices, we did not identify changes in infant sleep practices after exposure to safe sleep advice using blog posts.

Internet-Based Mental Health Survey Research: Navigating Internet Bots on Reddit

This study was a multistage process of recruiting participants through Reddit with the intent of increasing data integrity when facing an infiltration of Internet bots. Approaches to increase data integrity centered around preventing the occurrence of Internet bots from the onset and increasing the ability to identify Internet bot responses. We attempted to detect bots in a study focused on understanding social factors related to autism and suicide risk. Four recruitment rounds occurred through Reddit on mental health-related subreddits, with one post made on each subreddit per recruitment round. We found high presence of bots in the initial rounds-indeed, using location data, one third of the total responses (33.4 percent; 118/353) came from just eight locations (i.e., 4.7 percent of all locations). The proportion of detected bots was significantly different across the rounds of recruitment (χ² = 150.22, df = 3, p < 0.001). In round 4, language advertising compensation was removed from recruitment posts. This round had significantly lower proportions of detected bots compared with round 1 (χ² = 33.01, df = 1, p < 0.001), round 2 (χ² = 129.14, df = 1, p < 0.001), and round 3 (χ² = 46.6, df = 1, p < 0.001). Through a multistage recruitment process, we were able to increase the integrity of our collected data, as determined by a low percentage of fraudulent responses. Only once we removed advertisement of compensation in recruitment posts, did we see a significant decrease in the quantity and percentage of Internet bot responses. This multistage recruitment study provides valuable information regarding how to adapt when an online survey study is infiltrated with Internet bots.

Lifestyle and Health-Related Quality of Life Relationships Concerning Metabolic Disease Phenotypes on the Nutrimdea Online Cohort

Obesity, diabetes and cardiovascular events are non-communicable diseases (NCDs) directly related to lifestyle and life quality. Rises on NCDs rates are leading to increases in early deaths concerning metabolic morbidities. Health-related quality of life (HRQoL) has been described as a subjective perception about the influence of health and personal features on human well-being. This study aimed to characterize phenotypic and lifestyle roles on the occurrence of metabolic diseases and determine the potential mutual interactions and with HRQoL. Data from an online adult population (NUTRiMDEA study, n = 17,332) were used to estimate an adapted Obesogenic Score (ObS), while logistic regression analyses were fitted in order to examine relevant factors related to the prevalence of different metabolic diseases including HRQoL. Sex and age showed significant differences depending on lifestyle and metabolic health (p < 0.05). Adherence to the Mediterranean diet and physical activity showed a mutual interaction concerning ObS (p < 0.001), as well with metabolic health (p = 0.044). Furthermore, metabolic diseases showed own features related to sociodemographic and lifestyle characteristics in this population. Metabolic syndrome components may be differently influenced by diverse lifestyle or socioeconomic factors which in turn affect the perceived HRQoL. These outcomes should be taken into account individually for a precision medicine and public health purposes.

Adverse effects and potential benefits among selective androgen receptor modulators users: a cross-sectional survey

Selective androgen receptor modulators (SARMs) are a class of androgen receptor ligands that bind androgen receptors and display tissue selective activation of androgenic signaling. SARMs have selective anabolic effects on muscle and bone, and were originally synthesized for treatment of muscle wasting conditions, osteoporosis, breast cancer. To date, no SARM has been clinically approved and little is known about the beneficial effects and other adverse effects on users. We examined the adverse effects and potential benefits of SARMs amongst users. We performed an internet survey assessing the demographics of users via a 32-question survey. Using reddit as a platform, we distributed the survey through various subreddits that included potential SARMs users. Out of the 520 responses, 343 participants admitted having used SARMs. Most were males (98.5%), between the ages of 18-29 (72.3%). More than 90% of users acquired SARMs via the internet and did not consult with a physician. More than half of SARMs users experienced side effects including mood swings, decreased testicular size, and acne. More than 90% of men reported increased muscle mass and were satisfied with their SARMs usage. Despite having seemingly positive effects, more than 50% of SARMs users report significant adverse effects. Chi square was the main method of statistical analysis. Future studies should focus on comprehensive reproductive evaluation of men using SARMs.

Online Patient Recommender Systems for Preventive Care: Propositions to Advance Research (Preprint)

BACKGROUND

Preventive care helps patients identify and address medical issues early when they are easy to treat. The internet offers vast information about preventive measures, but the sheer volume of data can be overwhelming for individuals to process. To help individuals navigate this information, recommender systems filter and recommend relevant information to specific users. Despite their popularity in other fields, such as e-commerce, recommender systems have yet to be extensively studied as tools to support the implementation of prevention strategies in health care. This underexplored area presents an opportunity for recommender systems to serve as a complementary tool for medical professionals to enhance patient-centered decision-making and for patients to access health information. Thus, these systems can potentially improve the delivery of preventive care.

OBJECTIVE

This study proposes practical, evidence-based propositions. It aims to identify the key factors influencing patients' use of recommender systems and outlines a study design, methods for creating a survey, and techniques for conducting an analysis.

METHODS

This study proposes a 6-stage approach to examine user perceptions of the factors that may influence the use of recommender systems for preventive care. First, we formulate 6 research propositions that can be developed later into hypotheses for empirical testing. Second, we will create a survey instrument by collecting items from extant literature and then verify their relevance using expert analysis. This stage will continue with content and face validity testing to ensure the robustness of the selected items. Using Qualtrics (Qualtrics), the survey can be customized and prepared for deployment on Amazon Mechanical Turk. Third, we will obtain institutional review board approval because this is a human subject study. In the fourth stage, we propose using the survey to collect data from approximately 600 participants on Amazon Mechanical Turk and then using R to analyze the research model. This platform will serve as a recruitment tool and the method of obtaining informed consent. In our fifth stage, we will perform principal component analysis, Harman Single Factor test, exploratory factor analysis, and correlational analysis; examine the reliability and convergent validity of individual items; test if multicollinearity exists; and complete a confirmatory factor analysis.

RESULTS

Data collection and analysis will begin after institutional review board approval is obtained.

CONCLUSIONS

In pursuit of better health outcomes, low costs, and improved patient and provider experiences, the integration of recommender systems with health care services can extend the reach and scale of preventive care. Examining recommender systems for preventive care can be vital in achieving the quadruple aims by advancing the steps toward precision medicine and applying best practices.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/43316.

General population normative scores for interpreting the BODY-Q

The BODY-Q is a patient-reported outcome measure used to assess outcomes in patients undergoing weight loss and/or body contouring surgery (BC) following massive weight loss. Normative values for the BODY-Q are needed to improve data interpretation and enable comparison. Thus, the aim of this study was to determine normative values for the BODY-Q. Participants were recruited internationally through two crowdsourcing platforms. The participants were invited to complete the BODY-Q scales through an URL link provided within the crowdsourcing platforms. General linear analyses were performed to compare normative means between countries and continents adjusted for relevant covariates. Normative reference values were stratified by age, body mass index (BMI), and gender. The BODY-Q was completed by 4051 (2052 North American and 1999 European) participants. The mean age was 36 years (±14.7 SD) and ranged from 17 to 76 years, the mean BMI was 26.4 (±6.7 SD) kg/m² , and the sample consisted of 1996 (49.3%) females and 2023 (49.9%) males. Younger age and higher BMI were negatively associated with all BODY-Q scales (p < .001). This study provides normative values for the BODY-Q scales to aid in the interpretation of BODY-Q scores in research and clinical practise. These values enable us to understand the impact of weight loss and BC on patients' lives.

Black women's experiences of gendered racial sexual objectification, body image, and depressive symptoms

Black women navigate unique sexual objectification experiences and concerns about their bodies as a consequence of the race- and gender-based marginalization that they face. However, less is known about the influence of gendered racial sexual objectification experiences on Black women's mental health (i.e., depressive symptoms) or the contributions of key body image indicators (i.e., body surveillance and current-ideal body image discrepancy) that reflect Black women's engagement in monitoring and managing their bodies. We surveyed 1595 Black women to test our hypotheses that experiences of gendered racial sexual objectification (i.e., frequency and stress appraisal) would be positively associated with depressive symptoms and that body surveillance and current-ideal body image discrepancy would moderate this association. Analyses showed that more frequent experiences of gendered racial sexual objectification and higher stress appraisal of these experiences were significantly associated with more depressive symptoms. Furthermore, body surveillance and current-ideal body image discrepancy moderated the relation between gendered racial sexual objectification and depressive symptoms. Findings highlight how Black women's objectification and increased engagement in body monitoring and management practices are associated with their experiences of depressive symptoms, and thus, may negatively influence their mental health.

Mindfulness and Depersonalization: a Nuanced Relationship

Objectives

Methods

Results

Conclusions

Supplementary Information

Perceptions of the impact of COVID-19 on healthcare communication in a nationally representative cross-sectional survey of family caregivers

OBJECTIVE

To understand the perceptions of the impact of the COVID-19 pandemic on healthcare communication with family caregivers.

DESIGN

Nationally representative survey.

SETTING

USA (national).

PARTICIPANTS

340 family caregivers, demographically representative of the US population by race/ethnicity.

PRIMARY OUTCOME MEASURES

Communication outcomes (feeling involved by the provider, feeling involved by the care recipient, feeling more encouraged to be involved in care, feeling contributory to discussions, feeling questions are being answered), behavioural/wellness outcomes (feeling anxious, feeling isolated, feeling it is easier to attend the clinic visit), and desire to continue using telemedicine.

RESULTS

Having less than a college degree was associated with decreased odds of feeling involved by the provider (OR 0.46; 95% CI 0.26 to 0.83; p=0.01), feeling involved by the care recipient (OR 0.44; 95% CI 0.24 to 0.79; p=0.01), feeling more encouraged to be involved in care (OR 0.49; 95% CI 0.27 to 0.86; p=0.01), feeling like they contribute to discussions (OR 0.45; 95% CI 0.25 to 0.82; p=0.01) and feeling like their questions are being answered (OR 0.33; 95% CI 0.18 to 0.60; p<0.001).

CONCLUSION

In our sample, the shift to telemedicine during COVID-19 was well received but caregivers of low educational attainment reported poorer health communication, and a greater proportion of black/African American and Hispanic caregivers reported a desire to return to in-person visits. There is an opportunity to improve health systems and increase equity as telemedicine becomes more widespread.

The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study

As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.

U.S. Adult Perspectives on Facial Images, DNA, and Other Biometrics

Applications of biometrics in various societal contexts have been increasing in the United States, and policy debates about potential restrictions and expansions for specific biometrics (such as facial recognition and DNA identification) have been intensifying. Empirical data about public perspectives on different types of biometrics can inform these debates. We surveyed 4048 adults to explore perspectives regarding experience and comfort with six types of biometrics; comfort providing biometrics in distinct scenarios; trust in social actors to use two types of biometrics (facial images and DNA) responsibly; acceptability of facial images in eight scenarios; and perceived effectiveness of facial images for five tasks. Respondents were generally comfortable with biometrics. Trust in social actors to use biometrics responsibly appeared to be context specific rather than dependent on biometric type. Contrary to expectations given mounting attention to dataveillance concerns, we did not find sociodemographic factors to influence perspectives on biometrics in obvious ways. These findings underscore a need for qualitative approaches to understand the contextual factors that trigger strong opinions of comfort with and acceptability of biometrics in different settings, by different actors, and for different purposes and to identify the informational needs relevant to the development of appropriate policies and oversight.

Disparities in Patient-Centered Communication via Telemedicine

Purpose: This study investigated disparities in the uptake of telemedicine and the degree of patient-centeredness of telemedicine consultations among vulnerable patient populations. The focus includes rural adults and adults living with psychological distress and a high risk for chronic obstructive pulmonary disease (COPD). Materials and Methods: In August 2020, a random sample of 932 U.S. adults ≥35 years old with a history of smoking tobacco completed an online survey. Chi-squared analyses were conducted to compare the sociodemographics of participants who did and did not use telemedicine. A series of analysis of variance tests were conducted to examine whether satisfaction with patient-centeredness of telemedicine consultations (i.e., open-endedness, expressed empathy, provider's ability, 5-point Likert scale) differs by rural/urban residence, psychological distress, and COPD risk. Results: About 25% of the sample (n = 240) reported having used telemedicine. Telemedicine use was associated with younger age, Hispanic ethnicity, and moderate-to-high psychological distress, but not rurality. Participants reported high general satisfaction with the patient-centeredness of telemedicine consultations (M = 4.42 ± 0.73). However, high psychological distress and identifying as a current smoker were associated with less satisfaction across all domains. High COPD risk was uniquely associated with less satisfaction in how providers express empathy remotely. Conclusion: Individuals with moderate-to-high psychological distress and a high risk for COPD experience challenges accessing high-quality, patient-centered care via telemedicine. As telemedicine becomes ubiquitous in health care, innovative solutions are needed to overcome barriers that prevent providers from delivering patient-centered care and patients from feeling satisfied with their remote consultations.

A quantitative and qualitative examination of the impacts of the COVID-19 pandemic on U.S. veterans with self-reported anxiety and alcohol use disorder

INTRODUCTION

The COVID-19 pandemic generated concerns about rising stress and alcohol use, especially in U.S. veterans who experience high rates of anxiety disorders (ADs), alcohol use disorder (AUD), and dual AD+AUD diagnoses. This study investigated differences among these diagnostic groups in a veteran population related to their concern about COVID-19, impacts of COVID-19 on quality of life, and self-reported changes to urge to drink and drinking frequency.

METHODS

A nationally administered online survey was given to a sample of U.S. veterans reporting substance use issues during the pandemic. Differences in the level of concern about COVID-19, impacts of COVID-19 on quality of life, and drinking behaviors were examined in those self-reporting AD (n = 98), AUD (n = 46), or AD+AUD (n = 67). Consensual qualitative research was used to analyze an open-ended question about COVID-19's impact on substance use, health, and quality of life.

RESULTS

Veterans with AD+AUD experienced significant increases in urge to drink and alcohol consumption compared to veterans with AD only. Greater urge and frequency of drinking were associated with greater negative impacts of COVID-19 on quality of life. There were no differences among groups in global negative impact on quality of life or level of COVID-19 concern. However, respondents described specific COVID-19 worries, with qualitative findings revealing that those with AD+AUD reported a disproportionate psychosocial burden due to the pandemic.

DISCUSSION

Special attention in screening and treatment should be given to those with a dual AD+AUD diagnosis who may be experiencing both an increase in alcohol use and psychosocial burden as stress increases due to the pandemic.

HRQoL and nutritional well-being dissimilarities between two different online collection methods: Value for digital health implementation

Background

Online health data collection has gained a reputation over the last years to record and process information about health issues for implementing digital health.

Objective

The research aim was to appraise two online methods (open and rewarded) to collect information about HRQoL and nutritional well-being and to compare the results between both surveyed populations.

Methods

This cross-sectional study is framed on the NUTRiMDEA project. Online data through two different web-based methods (open survey and rewarded survey) were retrieved to assemble data related to sociodemographic, lifestyle (diet, physical activity and sleep patterns) and general health aspects, as well as HRQoL by an evidence-based form such as the SF-12 questionnaire, the IPAQ survey, and MEDAS-14, participants were adults (>18 years old).

Results

Overall, 17,332 participants responded to the open survey (OS, n = 11,883) or the rewarded survey (RS, n = 5449). About 65.1% of the participants were female, while the mean age was in the range of 40–70 years. There were significant differences ( p < 0.05) between surveyed populations in sociodemographic, lifestyle (diet and physical activity), health and HRQoL data.

Conclusions

This investigation implemented an evidence-based online questionnaire that collected demographic, lifestyle factors, phenotypic and health-related aspects as well as compared differential outcomes in HRQoL and nutritional/lifestyle well-being depending on the online mode data collection. Findings demonstrated dissimilarities in most aspects of health, HRQoL, dietary intake and physical activity records between both populations. Overall, OS sample was characterized as a healthier population with superior lifestyle habits than RS participants.

Characterizing prescription stimulant nonmedical use (NMU) among adults recruited from Reddit

•

Adults reporting past 5-year non-oral prescription stimulant NMU were studied.

•

Non-oral NMU preferences were snorting (59%) injecting (4%) or smoking (1%).

•

Polysubstance use was reported by 79.1% of the sample.

•

Route of administration and motivation for prescription stimulant NMU were related.

•

Prescription stimulant oral and intranasal NMU was to enhance performance.

•

Prescription stimulant intravenous and smoking NMU was to get high.

Objective

Increased prescription stimulant nonmedical use (NMU) is part of a growing polysubstance use landscape. The purpose of the present study was to characterize prescription stimulant NMU among adults reporting past 5-year non-oral prescription stimulant NMU.

Methods

Adults who reported non-oral prescription stimulant NMU within the last 5 years were recruited by banner ads placed on the Reddit website between February and September 2019. Types of prescription stimulants used, routes of administration, preferred routes of administration, motivations for prescription stimulant NMU, concurrent substances used simultaneously during prescription stimulant NMU, illicit substances used and factors impacting prescription stimulant NMU were queried.

Results

Respondents (n = 225) were male (86.2%), non-Hispanic (92.4%), white (78.2%), between 18 and 24 (48.0%) or 25–34 (43.1%) years with some amount of college education (81.3%). Most reported lifetime intranasal (93.8%) or oral use (85.2%). Prescription stimulants were diverted: 64.5% reported the prescription stimulants were given to them by a family or a friend and 10.5% reported that they had stolen these medications from a family or friend. Preferred route of administration was oral use (70.2%). Motivations to use were stratified by route of administration: intranasal (55.6%) or oral (63.0%) use was primarily endorsed as an attempt to enhance performance at work or at school; use by injection (57.1%) or smoking (62.5%) was primarily endorsed to get high. Most of the sample reported concurrent drug use (79.1%) including tobacco (57.3%), marijuana (52.0%), caffeine (47.6%) or alcohol (41.8%), among others. When excluding licit substances, 30.7% reported using 1 illicit substance concurrently with prescription stimulants and 25.3% reported using 2 or more illicit substances concurrently with prescription stimulants. Whether participants would undertake prescription stimulant NMU was determined by their work/school schedules or the location of the NMU (48.9%) whereas the route of administration employed was primarily influenced by the desired feeling or effect (56.9%).

Conclusions

Adults reporting lifetime non-oral prescription stimulant NMU engage in substantial risky behaviors that in addition to alternate routes of administration include polysubstance use, diversion and concurrent substance use.

Panic Buying: Modeling What Drives it and How it Deteriorates Emotional Well-being

This study develops a panic buying model that explains its driving forces and adverse consequences. The data were collected from 415 U.S. nationwide consumers during the outbreak of the current pandemic and analyzed through structural equation modeling. Results indicated that although social learning through traditional media did not significantly affect consumers' fearfulness toward product shortage or panic buying, social learning through social media exerts significant effects on both. The results also provide empirical evidence that consumers' panic buying can trigger them to experience more negative emotions, which proves why such abnormal buying behaviors are an essential matter to be addressed.

Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction?

Introduction

Several studies have investigated the association between erectile dysfunction (ED), its treatment, and female sexual dysfunction, but the impact of males blaming their female partners for their ED remains unknown.

Aims

To investigate whether women who are blamed by their male partners for their ED experience worse overall sexual function and satisfaction.

Methods

We performed a global, cross-sectional web-based survey to investigate female perceptions of ED. We distributed the 30-item survey via email, Reddit, Amazon Mechanical Turk, and Facebook. Women 18 years of age or older were eligible to participate and answered questions based on a 5-point Likert scale. Women were grouped by ages 18-29, 30-39, and 40 and older.

Main Outcome Measures

The survey collected data that included general demographics and questions regarding experiencing male blame for ED and its relationship with each subject's sexual health and wellness.

Results

A total of 13,617 females participated in the survey. Of the women surveyed, 79% have experienced their partner losing their erection during sexual activity and approximately 1 out of 7 women (14.7%) had experienced being blamed by their partner for loss of their erection. Women who were blamed for their partner's ED were more likely to end the sexual encounter, were less sexually satisfied, and were more likely to end relationships due to their partner's ED.

Conclusion

Approximately 1 out of 7 women have experienced male blame for their partner's ED which is associated with negative impacts on female mental health, sexual satisfaction and the success of the overall partnership. Because of its widespread impact on female wellness, male blame should be considered during evaluation of female sexual history and men must be educated on the significant impact their reactions during intimacy have on their female partners and their relationships as a whole. Dubin JM, Wyant WA, Balaji NC, et al. Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction?. Sex Med 2021;9:100352.

Perceptions of Psychological Intimate Partner Violence: The Influence of Sexual Minority Stigma and Childhood Exposure to Domestic Violence among Bisexual and Lesbian Women

Sexual minority women (SMW; bisexual, lesbian) experience psychological intimate partner violence (IPV) disproportionately more than physical forms and have higher lifetime victimization rates than heterosexual women. This study presents an examination of perceptions of psychological IPV, sexual minority stigma, and childhood exposure to domestic violence among a sample of 183 SMW residing within the U.S. With an emphasis on group differences between bisexual and lesbian women, findings indicate that bisexual women evaluated vignettes depicting psychological IPV occurring among women in same-gender relationships with more negative sentiment than lesbian women. Significant associations between enacted and internalized forms of stigma and perceptions of psychological IPV also varied among bisexual and lesbian women. No significant relationships were found between perceived stigma and perceptions of IPV in either group. Furthermore, no moderation effects were detected for childhood exposure to domestic violence or sexual orientation in the relationship between sexual minority stigma and perceptions of IPV. Implications and suggestions are discussed with particular attention to the heterogeneity of experiences among SMW as a necessary area of further study.

E-Cigarette Beliefs and Intentions Among U.S. Adults Before and After EVALI Outbreak

PURPOSE

This study examined attitudes, perceived control, perceived norms, intention, and policy support before and after the peak of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) cases among 2 independent samples of U.S. adults.

DESIGN

This study used a successive independent samples design.

SETTING

Data was collected through online surveys in July 2019 (n = 521) and October 2019 (n = 536).

SUBJECTS

Participants were recruited through the Qualtrics Survey Panel. Eligibility criteria included: 1) 18 years or older, and 2) currently living in the U.S.

MEASURES

The 2 surveys were collected from 2 separate samples examined e-cigarette attitudes, perceived control, perceived norms, intention, and policy support.

ANALYSIS

Linear regressions were used to examine the association between time, attitudinal, and belief factors associated with intention and policy support.

RESULTS

Participants in the October sample (n = 521) were significantly more likely to have negative attitudes towards e-cigarettes when compared to the July sample (n = 536), F(8,1047) = 52.671, p < .01, R² = 0.287. Lower perceived social acceptance towards e-cigarettes and negative attitudes were related to higher support for restricting where e-cigarettes could be used, F(11, 1042) = 63.218, p < .010, R² = .401. Higher perceived control over accessing e-cigarettes, but lower social acceptance of e-cigarettes and negative beliefs were associated with higher support for limiting places where e-cigarettes could be purchased, F(11,1039) = 36.200, p < .01, R² = .277.

CONCLUSION

Results indicate that EVALI cases may have had an immediate negative effect on attitudes but did not appear to decrease intention to use e-cigarettes. Results could inform future public health campaigns' programming and research. More research is needed to understand the long-term impact of EVALI on e-cigarette use.

Black American Fathers Employed in Higher-Risk Contexts for Contracting COVID-19: Implications for Individual Wellbeing and Work-Family Spillover

Black Americans remain disproportionately affected by the COVID-19 pandemic. Emerging data suggests that employment in certain occupations (e.g., essential; frontline) may place individuals at higher-risk for contracting COVID-19. The current investigation examined how Black American fathers' COVID-19 perceived work risk was associated with their individual well-being (COVID-19 diagnosis; depressive and anxiety symptoms; sleep disturbance; sleep quality) as well as spillover into family contexts. Participants were 466 Black American fathers (M = 36.63; SD = 11.00) who completed online surveys in June-July 2020. Adjusted binomial logistic and multiple regressions were estimated to examine how fathers' work context was associated with COVID-19 health outcomes, psychological functioning, sleep health, and family stress. Descriptive analyses revealed that 32% of fathers reported a personal diagnosis of COVID-19 and 21% indicated that an immediate family member had been diagnosed. Adjusted binomial logistic regression analyses revealed that fathers working in higher-risk contexts for contracting COVID-19 had a greater odds ratio for both a personal (OR: 1.68, 95% CI: 1.05, 2.68) and an immediate family member diagnosis (OR: 2.58, 95% CI: 1.52, 4.36). Working in a higher-risk context for contracting COVID-19 was associated with poorer psychological functioning, greater sleep disturbance, and higher levels of family discord. Findings suggest that Black fathers working in higher risk contexts may be at risk for COVID-19 exposure and infection. Further, this study indicates that these effects extend to their own well-being, including mental and sleep health as well as increased family stress.

Differences in the Gut Microbiome of Women With and Without Hypoactive Sexual Desire Disorder: Case Control Study

Background

The gut microbiome is receiving considerable attention as a potentially modifiable risk factor and therapeutic target for numerous mental and neurological diseases.

Objective

This study aimed to explore and assess the difference in the composition of gut microbes and fecal metabolites between women with hypoactive sexual desire disorder (HSDD) and healthy controls.

Methods

We employed an online recruitment method to enroll “hard-to-reach” HSDD populations. After a stringent diagnostic and exclusion process based on DSM-IV criteria, fecal samples collected from 24 women with HSDD and 22 age-matched, healthy controls underwent microbiome analysis using 16S ribosomal RNA gene sequencing and metabolome analysis using untargeted liquid chromatography–mass spectrometry.

Results

We found a decreased abundance of Ruminococcaceae and increased abundance of Bifidobacterium and Lactobacillus among women with HSDD. Fecal samples from women with HSDD showed significantly altered metabolic signatures compared with healthy controls. The abundance of Bifidobacterium, Lactobacillus, and several fecal metabolites correlated negatively with the sexual desire score, while the number of Ruminococcaceae correlated positively with the sexual desire score in all subjects.

Conclusions

Our analysis of fecal samples from women with HSDD and healthy controls identified significantly different gut microbes and metabolic signatures. These preliminary findings could be useful for developing strategies to adjust the level of human sexual desire by modifying gut microbiota.

Trial Registration

Chinese Clinical Trial Registry ChiCTR1800020321; http://www.chictr.org.cn/showproj.aspx?proj=34267

Temporal Associations Between Social Media Use and Depression

INTRODUCTION

Previous studies have demonstrated cross-sectional associations between social media use and depression, but their temporal and directional associations have not been reported.

METHODS

In 2018, participants aged 18-30 years were recruited in proportion to U.S. Census characteristics, including age, sex, race, education, household income, and geographic region. Participants self-reported social media use on the basis of a list of the top 10 social media networks, which represent >95% of social media use. Depression was assessed using the 9-Item Patient Health Questionnaire. A total of 9 relevant sociodemographic covariates were assessed. All measures were assessed at both baseline and 6-month follow-up.

RESULTS

Among 990 participants who were not depressed at baseline, 95 (9.6%) developed depression by follow-up. In multivariable analyses conducted in 2020 that controlled for all covariates and included survey weights, there was a significant linear association (p<0.001) between baseline social media use and the development of depression for each level of social media use. Compared with those in the lowest quartile, participants in the highest quartile of baseline social media use had significantly increased odds of developing depression (AOR=2.77, 95% CI=1.38, 5.56). However, there was no association between the presence of baseline depression and increasing social media use at follow-up (OR=1.04, 95% CI=0.78, 1.38). Results were robust to all sensitivity analyses.

CONCLUSIONS

In a national sample of young adults, baseline social media use was independently associated with the development of depression by follow-up, but baseline depression was not associated with an increase in social media use at follow-up. This pattern suggests temporal associations between social media use and depression, an important criterion for causality.

African American Activism: The Predictive Role of Race Related Stress, Racial Identity, and Social Justice Beliefs

Historically, African American activism has played a pivotal role in advancing social change in the United States. As such, there is an interest in examining possible factors that may engender activism among African Americans. Therefore, the purpose of this study was to extend research by Szymanski and Lewis (2015), which explored potential predictors of activism among African Americans. With a sample of 458 African American undergraduates, race-related stress, racial identity dimensions, and social justice variables were examined. A four-stage, multiple linear hierarchical regression model and two multiple mediation bootstrap analyses were employed. Race-related stress and racial identity attitudes significantly and uniquely predicted involvement in African American activism, complementing existing literature. Beyond that, social justice beliefs predicted African American activism over and above racial identity and race-related stress. More specifically, social justice subjective norms (i.e., social influence) was the most important predictor of activism for African American undergraduates. Implications for social justice development within institutions of higher education are discussed.

Understanding Elementary Classroom Teachers' Use of Movement Integration Resources

Movement integration (MI)-infusing physical activity (PA) into normal classroom time during school-is an evidence-based strategy to support public health goals and enhance educational outcomes for elementary children. However, few elementary classroom teachers in the United States appear to be using MI resources. In order to understand teachers' MI resource use, this study's purpose was 3-fold: (a) to examine teachers' perceptions about MI and MI resources, (b) to identify teachers' latent class membership based on their perceptions, and (c) to determine the extent to which teachers' MI preferences, demographics, background, and school context predict class membership. We recruited a national sample of participants (N = 420) who completed an electronic survey including six sections: perceived benefits of MI, perceived barriers to using MI resources, satisfaction with MI resources, perceived importance of different MI resource characteristics, MI resource preferences, and participant demographics, background, and school context. Data analysis consisted of descriptive analyses, exploratory factor analysis, confirmatory factor analysis, latent profile analysis, and multinomial regression analysis. Participants mostly agreed about the benefits of MI and were satisfied with the MI resources they were using but had varying perceptions about the presence of barriers to using MI resources. Participants rated the integration of an MI resource with the academic curriculum, the amount of time required for teacher training, the type of training materials provided, and the timing of the training as the most important characteristics they would consider before adopting a resource. Factor analyses supported single factor solutions for perceived benefits, perceived barriers, and satisfaction, and a three-factor solution for perceived importance of different MI resource characteristics (Curriculum Integration, Training Logistics, and Feasibility). Based on these factors, we identified five latent classes of teachers. Regression results showed that desirable latent class membership depended on certain MI preferences and demographic, background, and school context characteristics. Teacher educators and interventionists should consider teachers' MI perceptions, the nature of MI trainings, teacher characteristics, and school context in efforts to increase teachers' use of MI resources. Further research is needed to explore the intrinsic value of MI for teachers, given MI's education- and public health-related benefits.

Use of Telephone and Digital Channels to Engage Socioeconomically Disadvantaged Adults in Health Disparities Research Within a Social Service Setting: Cross-Sectional Study

Background

Engaging socioeconomically disadvantaged populations in health research is vital to understanding and, ultimately, eliminating health-related disparities. Digital communication channels are increasingly used to recruit study participants, and recent trends indicate a growing need to partner with the social service sector to improve population health. However, few studies have recruited participants from social service settings using multiple digital channels.

Objective

This study aimed to recruit and survey 3791 adult clients of a social service organization via telephone and digital channels. This paper aimed to describe recruitment outcomes across five channels and compare participant characteristics by recruitment channel type.

Methods

The Cancer Communication Channels in Context Study recruited and surveyed adult clients of 2-1-1, a social service–focused information and referral system, using five channels: telephone, website, text message, web-based live chat, and email. Participants completed surveys administered either by phone (if recruited by phone) or on the web (if recruited from digital channels, ie, website, text message, Web-based live chat, or email). Measures for the current analysis included demographic and health characteristics.

Results

A total of 3293 participants were recruited, with 1907 recruited by phone and 1386 recruited from digital channels. Those recruited by phone had a moderate study eligibility rate (42.23%) and the highest survey completion rate (91.24%) of all channels. Individuals recruited by text message had a high study eligibility rate (94.14%) yet the lowest survey completion rate (74.0%) of all channels. Sample accrual goals were achieved for phone, text message, and website recruitment. Multivariable analyses found differences in participant characteristics by recruitment channel type. Compared with participants recruited by phone, those recruited from digital channels were younger (adjusted odds ratio [aOR] 0.96, 95% CI 0.96-0.97) and more likely to be female (aOR 1.52, 95% CI 1.23-1.88), married (aOR 1.52, 95% CI 1.22-1.89), and other than non-Hispanic black (aOR 1.48, 95% CI 1.22-1.79). Those recruited via phone also were more likely to have more than a high school education (aOR 2.17, 95% CI 1.67-2.82), have a household income ≥US $25,000 a year (aOR 2.02, 95% CI 1.56-2.61), and have children living in the home (aOR 1.26, 95% CI 1.06-1.51). Additionally, participants recruited from digital channels were less likely than those recruited by phone to have public health insurance (aOR 0.75, 95% CI 0.62-0.90) and more likely to report better overall health (aOR 1.52, 95% CI 1.27-1.83 for good-to-excellent health).

Conclusions

Findings indicate the feasibility and utility of recruiting socioeconomically disadvantaged adults from the social service sector using multiple communication channels, including digital channels. As social service–based health research evolves, strategic recruitment using a combination of traditional and digital channels may be warranted to avoid underrepresentation of highly medically vulnerable individuals, which could exacerbate disparities in health.

Emotional support from social media and face-to-face relationships: Associations with depression risk among young adults

BACKGROUND

Emotional support is highly protective against poor mental health. Though several measures of emotional support exist, none specifically addresses social media (SM) as a source of emotional support. Therefore, the objectives of this study were to determine if SM-based emotional support is an extension of or distinct construct from face-to-face (FTF) emotional support and to assess the independent associations between each domain of emotional support and depression risk among U.S. young adults.

METHODS

In March 2018, we surveyed 2408 18-30 year olds. We assessed perceived FTF emotional support with the brief PROMIS emotional support scale and perceived SM-based emotional support using a new four-item measure. Depression risk was assessed using the PHQ-9. We performed factor analysis (FA) to determine the underlying factor structure of all items and to develop composite scales. Multivariable logistic regression was used to examine the independent association between each resulting emotional support scale and depression risk.

RESULTS

FA revealed two distinct constructs. FTF emotional support was associated with 43% lower odds of depression per 1-unit increase on the 5-point scale (AOR = 0.57, 95% CI = 0.52-0.63). However, SM-based emotional support was significantly associated with 20% greater odds of depression per 1-unit increase on the 5-point scale (AOR = 1.20, 95% CI = 1.09-1.32).

LIMITATIONS

This study utilized a cross-sectional design and self-report data.

CONCLUSIONS

While FTF emotional support was associated with slightly lower odds of depression, SM-based emotional support was associated with slightly greater odds of depression. It may be valuable for clinicians treating individuals with depression to ask about sources of emotional support.

Impact of the Terms "Regular" or "Pasable" as Spanish Translation for "Fair" of the Self-Rated Health Question Among US Latinos: A Randomized Experiment

Objectives. To examine measurement comparability of a Spanish version of self-rated health (SRH) with pasable as an alternative to regular for the response category "fair" in the English version.Methods. We translated "fair" into 2 Spanish versions: regular and pasable. We implemented a split-half experiment in 3 surveys independently conducted from October 2015 to January 2016, from April to November 2016, and from August to November 2017. Within each survey, we randomly assigned Spanish-interviewed Latino respondents to 1 of the 2 SRH versions. The total sample included 3261 Latino and 738 non-Latino White adults in the United States.Results. Spanish-interviewed Latinos reported substantively more favorable health on SRH with pasable than with regular. When pasable instead of regular was used for SRH, we observed a larger difference between respondents reporting positive versus negative SRH on objective health measures, including the frequency of doctor's visits. Furthermore, when we accounted for correlates of health, Latino-White disparities were attenuated with pasable.Conclusions. We recommend using pasable instead of regular for SRH Spanish translations to improve measurement equivalence in cross-lingual and cross-cultural research.

Online recruitment of a non-help-seeking sample for an internet intervention: Lessons learned in an alcohol-exposed pregnancy risk reduction study

BACKGROUND

Recruiting a hidden population, such as the population of women at risk for alcohol-exposed pregnancy (AEP) who binge drink and are at risk of an unintended pregnancy, is challenging as this population is not typically seeking help or part of an identifiable group. We sought to identify affordable and efficient methods of recruitment for hidden populations.

METHODS

Several popular online social media and advertising sites were identified. Cities with high rates of binge drinking among women were targeted. We placed advertisements and study notices using Facebook, Twitter, Craigslist, University postings, and ClinicalTrials.gov.

RESULTS

For this study, 75 women at risk for AEP were recruited from across the U.S. within 7 months. Online advertising for study participants on Craigslist resulted in enrollment of the majority 51 (68%) of the study participants. While Craigslist advertising could be tailored to specific locations with high rates of binge drinking among women, there were challenges to using Craigslist. These included automated deletion due to repeated postings and mention of sexual behavior or drinking, requiring increased efforts and resources by the study team. Several strategies were developed to optimize advertising on Craigslist. Approximately 100 h of staff time valued at $2500 was needed over the 7-month recruitment period.

DISCUSSION

Despite challenges, the target sample of women at risk for AEP was recruited in the 7 month recruitment period using online advertising methods. We recommend that researchers consider online classified advertisements when recruiting from non-help seeking populations. By taking advantage of national data to target specific risk factors, and by tailoring advertising efforts, it is possible to efficiently and affordably recruit a non-treatment seeking sample.