Learning to embrace one's stress: the selective effects of short videos on youth's stress mindsets

BACKGROUND AND OBJECTIVES

Stress is not inherently negative. As youth will inevitably experience stress when facing the various challenges of adolescence, they can benefit from developing a stress-can-be-enhancing mindset rather than learning to fear their stress responses and avoid taking on challenges. We aimed to verify whether a rapid intervention improved stress mindsets and diminished perceived stress and anxiety sensitivity in adolescents.

DESIGN AND METHODS

An online experimental design randomly exposed 233 Canadian youths aged 14-17 (83% female) to four videos of the Stress N' Go intervention (how to embrace stress) or to control condition videos (brain facts). Validated questionnaires assessing stress mindsets, perceived stress, and anxiety sensitivity were administered pre- and post-intervention, followed by open-ended questions.

RESULTS

The intervention content successfully instilled a stress-can-be-enhancing mindset compared to the control condition. Although Bayes factor analyses showed no main differences in perceived stress or anxiety sensitivity between conditions, a thematic analysis revealed that the intervention helped participants to live better with their stress.

CONCLUSIONS

Overall, these results suggest that our intervention can rapidly modify stress mindsets in youth. Future studies are needed to determine whether modifying stress mindsets is sufficient to alter anxiety sensitivity in certain adolescents and contexts.

Using latent profile analysis to uncover the combined role of anxiety sensitivity and test anxiety in students' state anxiety

Background

Studies report a growing tendency for students to experience state anxiety in schools. However, the combination of individual susceptibilities likely to trigger students' anxious states remains unclear.

Aims

This study examined whether distinct profiles of students emerge regarding their susceptibility to anxiety sensitivity and/or test anxiety and evaluated whether students' profile predicted anxious states. We also verified whether susceptibility profiles varied across gender, school level, and school type.

Sample and methods

In total, 1,404 Canadian students in Grades 5 and 10 (589 boys; M _age = 15.2, SD = 2.1) from 13 public and private schools completed self-reported measures of state/trait anxiety, anxiety sensitivity, and test anxiety.

Results

Latent profile analyses identified four susceptibility profiles: (1) Double-susceptibility: highest anxiety sensitivity and test anxiety scores; (2) Unique-susceptibility to test anxiety: high test anxiety score and low anxiety sensitivity score; (3) Unique-susceptibility to anxiety sensitivity: high anxiety sensitivity score and low test anxiety score; and (4) No-susceptibility: lowest anxiety sensitivity and test anxiety scores. The profiles comprised 12, 9, 6, and 73% of the sample, respectively, and their membership varied across gender and school type, but not across school levels. A linear mixed-effect model showed that state anxiety varied significantly between profiles, where the Double-susceptibility profile predicted the highest state anxiety scores, followed by the two Unique-susceptibility profiles (indifferently), and the No-susceptibility profile.

Conclusion

Beyond their theoretical contribution to the state-trait anxiety literature, these findings suggest that selective interventions designed more specifically for students with the Double-susceptibility profile may be worthwhile. Results also highlight the high proportion of students with the No-susceptibility profile and shed light on the reassuring portrait regarding students' anxiety.

Human papillomavirus (HPV) vaccination across a cascade of knowledge, willingness, and uptake among gay, bisexual, and other men who have sex with men in Canada's three largest cities

BACKGROUND

Some Canadian jurisdictions offer publicly funded HPV vaccine to gay, bisexual, and other men who have sex with men (GBM) aged ≤26 years. We characterized factors associated with being in different stages of HPV vaccination.

METHODS

Engage is a sexual health study of GBM in the three largest Canadian cities recruited via respondent driven sampling (RDS). We categorized participants as: (1) unaware of HPV vaccine, (2) undecided/unwilling to get vaccinated, (3) willing to get vaccinated, (4) vaccinated with one or more doses. Our RDS-II weighted analyses used multinomial logistic regression to identify factors associated with being in earlier stages of the cascade compared to Stage 4.

RESULTS

Across the cities, 26-40%, 7-14%, 33-39%, and 13-28% were in Stages 1 to 4, respectively. Compared to Stage 4, being in earlier stages of the cascade was associated with bisexual-identification (Stage 1: adjusted odds ratio[aOR] = 2.84, 95% confidence interval[CI] = 1.06-7.62; Stage 2: aOR = 3.09, 95%CI = 1.19-8.05), having immigrated to Canada (Stage 1: aOR = 1.79, 95%CI 1.07-2.99), preference to keep same-sex romantic relationships private (Stage 1: aOR = 1.25, 95% CI = 1.05-1.48; Stage 2: aOR = 1.24, 95%CI = 1.05-1.46), not receiving sexual health information (Stage 1: aOR = 0.31, 95% CI = 0.13-0.71; Stage 2: aOR = 0.27, 95%CI = 0.12-0.64), not accessing a health-care provider (Stage 2: aOR = 0.36, 95%CI = 0.15-0.83), and no past hepatitis A/B vaccination (Stage 1: aOR = 0.16, 95% CI = 0.09-0.30; Stage 2: aOR = 0.18, 95%CI = 0.09-0.35; Stage 3: aOR = 0.38, 95%CI = 0.21-0.61).

DISCUSSION

Interventions are needed to reduce social and financial barriers, increase sexual health knowledge, and improve GBM-competent health-care access to increase vaccine uptake among GBM.

Staying informed without a cost: No effect of positive news media on stress reactivity, memory and affect in young adults

INTRODUCTION

We read, see and hear news from various media sources every day. A large majority of the news is negative. A previous study from our laboratory showed that reading negative news is associated with both increased stress reactivity (measured via the stress hormone cortisol) and recall of the negative news segments in women.

OBJECTIVES

The present study investigated the effects of positive news on cortisol stress reactivity, memory and affect using a methodology highly similar to the study on negative news that was previously used by our team.

METHODS

Sixty-two healthy participants aged between 18 and 35 years (81% women) were randomly exposed to either positive or neutral news segments, followed by a laboratory stressor. We assessed participants' affect three times during the procedure and measured cortisol in saliva eight times (at 10-minute intervals). Twenty-four hours later, participants were contacted by phone to assess their recall of the news segments.

RESULTS

Results showed that exposure to positive news, relative to neutral news, did not modulate participants' cortisol levels in response to the laboratory stressor. Positive news had no impact on memory recall of the news and did not change participants' positive or negative affect. Bayes factors suggested that these nonsignificant results are not attributable to low statistical power.

CONCLUSION

Contrary to negative news, positive and neutral news do not modulate stress reactivity, memory and affect. These results suggest that people can stay informed without physiological and psychological costs when the news to which they are exposed adopt a positive or neutral approach.

Human papillomavirus (HPV) vaccine uptake among a community-recruited sample of gay, bisexual, and other men who have sex with men in the three largest cities in Canada from 2017 to 2019

INTRODUCTION

In 2015/2016, Canada's largest provinces implemented publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) ≤ 26 years old. We sought to describe HPV vaccine uptake among GBM and determine barriers and facilitators to vaccine initiation with a focus on healthcare access and utilization.

METHODS

Engage is a cohort study among GBM aged 16 + years in three Canadian cities recruited from 2017 to 2019 via respondent driven sampling (RDS). Men completed a comprehensive questionnaire at baseline. By publicly-funded vaccine eligibility (≤26 years old = eligible for vaccination, ≥27 years old = ineligible), we described HPV vaccine uptake (initiation = 1 + dose, completion = 3 doses) and explored factors associated with vaccine initiation using Poisson regression. All analyses were weighted with the RDS-II Volz-Heckathorn estimator.

RESULTS

Across the three cities, 26-35% and 14-21% of men ≤ 26 years and 7-26% and 2-9% of men ≥ 27 years initiated and completed HPV vaccination, respectively. Vaccine initiation was significantly associated with STI/HIV testing or visiting a HIV care specialist in the past six months (≤26: prevalence ratio[PR] = 2.15, 95% confidence interval[CI] 1.06-4.36; ≥27: PR = 2.73, 95%CI 1.14-6.51) and past hepatitis A or B vaccination (≤26: PR = 2.88, 95%CI 1.64-5.05; ≥27: PR = 2.03, 95%CI 1.07-3.86). Among men ≥ 27 years old, vaccine initiation was also positively associated with accessing PrEP, living in Vancouver or Toronto, but negatively associated with identifying as Latin American and increasing age. Vaccine initiation was twice as likely among men ≥ 27 years with private insurance versus no insurance.

CONCLUSIONS

Sixty-five to 74% of men eligible for publicly-funded vaccine across the three cities remained unvaccinated against HPV by 2019. High vaccine cost may partly explain even lower uptake among men ≥ 27 years old. Men seeking sexual health care were more likely to initiate vaccination; bundling vaccination with these services may help improve HPV vaccine uptake.

Improved neural control of body temperature following heat acclimation in humans

KEY POINTS

With the advent of more frequent extreme heat events, adaptability to hot environments will be crucial for the survival of many species, including humans. However, the mechanisms that mediate human heat adaptation have remained elusive. We tested the hypothesis that heat acclimation improves the neural control of body temperature. Skin sympathetic nerve activity, comprising the efferent neural signal that activates heat loss thermoeffectors, was measured in healthy adults exposed to passive heat stress before and after a 7 day heat acclimation protocol. Heat acclimation reduced the activation threshold for skin sympathetic nerve activity, leading to an earlier activation of cutaneous vasodilatation and sweat production. These findings demonstrate that heat acclimation improves the neural control of body temperature in humans.

ABSTRACT

Heat acclimation improves autonomic temperature regulation in humans. However, the mechanisms that mediate human heat adaptation remain poorly understood. The present study tested the hypothesis that heat acclimation improves the neural control of body temperature. Body temperatures, skin sympathetic nerve activity, cutaneous vasodilatation, and sweat production were measured in 14 healthy adults (nine men and five women, aged 27 ± 5 years) during passive heat stress performed before and after a 7 day heat acclimation protocol. Heat acclimation increased whole-body sweat rate [+0.54 L h^-1 (0.32, 0.75), P < 0.01] and reduced resting core temperature [-0.29°C (-0.40, -0.18), P < 0.01]. During passive heat stress, the change in mean body temperature required to activate skin sympathetic nerve activity was reduced [-0.21°C (-0.34, -0.08), P < 0.01] following heat acclimation. The earlier activation of skin sympathetic nerve activity resulted in lower activation thresholds for cutaneous vasodilatation [-0.18°C (-0.35, -0.01), P = 0.04] and local sweat rate [-0.13°C (-0.24, -0.01), P = 0.03]. These results demonstrate that heat acclimation leads to an earlier activation of the neural efferent outflow that activates the heat loss thermoeffectors of cutaneous vasodilatation and sweating.

Low prevalence of vaccine-type HPV infections in young women following the implementation of a school-based and catch-up vaccination in Quebec, Canada

BACKGROUND

In Quebec, Canada, a school-based HPV vaccination for girls has been offered since 2008. The vaccine used in the program targets HPV16/18, responsible for ∼70% of cervical cancers and HPV6/11, responsible for the majority of anogenital warts. The objective of this study was to assess the prevalence of HPV in vaccinated and unvaccinated women.

METHODS

Women aged 17-29 years were eligible to participate. Participants' age, vaccination status and diverse risk factors were assessed by a computer-assisted questionnaire. Biological specimens were obtained by self-sampling. HPV genotyping was performed by Linear Array.

RESULTS

A total of 2,118 women were recruited. 2,042 completed the questionnaire and 1,937 provided a vaginal sample. Vaccination coverage varied from 83.5% in women aged 17-19 to 19.1% in those aged 23-29. The overall prevalence of HPV in sexually active women was 39.4% (95%CI: 37.0-41.7) and 56.7% of infected women had multiple type infections. The prevalence of vaccine HPV types varied by age and vaccination status except for women aged 23-29 for whom similar results were observed. Vaccine HPV types were detected in 0.3%, 1.4% and 10.5% of vaccinated women aged 17-19, 20-23, and 23-29 (p<0.05), respectively. HPV16 or HPV18 were detected in 10 women having received at least one dose of vaccine. Nine of these women were already sexually active at the time of vaccination.

CONCLUSION

Infections with HPV types included in the vaccine are rare in women aged less than 23 years and are virtually absent in those who received at least one dose of vaccine before sexual debut.

Determinants of parents' decision to vaccinate their children against rotavirus: results of a longitudinal study

Rotavirus disease is a common cause of health care utilization and almost all children are affected by the age of 5 years. In Canada, at the time of this survey (2008-09), immunization rates for rotavirus were <20%. We assessed the determinants of a parent's acceptance to have their child immunized against rotavirus. The survey instruments were based on the Theory of Planned Behavior. Data were collected in two phases. In all, 413 and 394 parents completed the first and second interviews, respectively (retention rate 95%). Most parents (67%) intended to immunize their child against rotavirus. Factors significantly associated with parental intentions (Phase 1) were as follows: perception of the moral correctness of having their child immunized (personal normative belief) and perception that significant others will approve of the immunization behavior (subjective norm), perceived capability of having their child immunized (perceived behavioral control) and household income. At Phase 2, 165 parents (42%) reported that their child was immunized against rotavirus. The main determinant of vaccination behavior was parental intention to have their child vaccinated, whereas personal normative beliefs influenced both intention and behavior. The acceptability of the rotavirus vaccine will be higher if health promotion addresses parental knowledge, attitudes and beliefs regarding the disease and the vaccine.

Clinicians' opinions on new vaccination programs implementation

In Canada, several new vaccines were recently approved for clinical use or are expected to be soon. Decision-makers are faced with the choice whether or not to include these vaccines in publicly funded vaccination programs. The aim of this study was to assess Canadian pediatricians' and family physicians' opinions regarding 7 new vaccines, and perceived priority for the introduction of new programs. A self-administered, anonymous, mail-based questionnaire was sent during fall 2009 to a random sample of 1182 family physicians and to all 1852 Canadian pediatricians. Responses to 8 statements regarding frequency and severity of the diseases, efficacy and safety of the vaccines as well as feasibility of immunization programs were used to calculate priority scores to rank the 7 potential new vaccination programs (calculated scores ranging from 0 to 100). Overall response rate was 43%. The majority of respondents perceived the health and economic burden of diseases prevented by the seven new vaccines as important and considered new vaccines to be safe and effective. More than 90% of physicians strongly agreed or agreed that the new vaccines would be or are currently well accepted by the public and by the health professionals who administer vaccines, except for the HPV and rotavirus vaccines (respectively 30% and 29% strongly agreed or agreed). Mean priority scores were: 77.4 out of 100 for the measles, mumps, rubella and varicella (MMRV) combined vaccine; 75.6 for the hexavalent (DTaP-IPV-Hib-HBV) vaccine; 73.1 for the new pneumococcal conjugate vaccines; 69.8 for the meningococcal ACYW135; 68.9 for the combined hepatitis A and B; 63.5 for the human papillomavirus vaccine and 56.9 for the rotavirus vaccine. Health professionals' opinion is an important element to consider in the decision-making process regarding implementation of new immunization programs. Without health professional support, the introduction of a new vaccination program may be unsuccessful. In this study, the MMRV and the hexavalent (DTaP-IPV-Hib-HBV) vaccines received the highest ratings.