Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans.

Purpose: Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination.

Design: Cross-sectional survey administered by Research America, Inc.

Setting: West Virginia (WV).

Factors associated with transitions in tobacco product use states among young adults aged 18-29 years.

Background And Objectives: This study examined young adults' tobacco use transitions based on their past 30-day use states, and identified factors associated with their transitions.

Methods: Participants (N = 12377) were young adults aged 18-29 years at Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. Self-reported tobacco use states were categorized by the number of past-month use days (0, 1-4, 5-8, 9-12, 13-30 days) for cigarettes, electronic cigarettes [e-cigarettes], traditional cigars, filtered cigars, cigarillos, smokeless tobacco (SLT), and hookah.

Community-engaged research in vascular surgery: An approach to decrease amputation disparities and effect population-level change.

Community-engaged research (CEnR) is a powerful tool to create sustainable and effective change in health outcomes. CEnR engages community members as equal partners, amplifying their voices and priorities by including them throughout the research process. Such engagement increases the relevance and meaning of research, improves the translation of research findings into sustainable health policy and practice, and ultimately enhances mutual trust among academic, clinical, and community partners for ongoing research partnership.

Longitudinal transitions in adolescent polytobacco use across waves 1-4 of the Population Assessment of Tobacco and Health study.

Aims: This study aims to identify adolescent patterns of polytobacco use and measure transitions between patterns over time.

Design: Longitudinal analysis using data derived from waves 1-4 (2013-18) of the Population Assessment of Tobacco and Health (PATH) study. Transitions in tobacco use patterns were examined via latent transition analysis, and then, socio-demographic characteristics were used to predict transitions via logistic regression.

Telemedicine versus in-Person Primary Care: Impact on Visit Completion Rate in a Rural Appalachian Population.

Introduction: The use of telemedicine increased during the global Coronavirus disease 2019 (COVID-19) pandemic. Rural populations often struggle with adequate access to care while simultaneously experiencing multiple health disparities. Yet, telemedicine use during the COVID-19 pandemic has been understudied on its effect on visit completion in rural populations.

Perceptions and Expectations of School-Based Professionals Surrounding School-Based Mindfulness Training in Appalachia During the COVID-19 Pandemic: A Qualitative Study.

Background: School-based professionals often report high burnout, particularly in geographic areas like Appalachia, where school-aged children are exposed to high levels of adverse childhood experiences, which may be exacerbated by the COVID-19 pandemic. While school-based mindfulness trainings can reduce burnout, their efficacy is influenced by the expectations of intervention personnel ahead of implementation. The present study assessed expectations and perceptions of a school-based mindfulness training among school personnel in 21 Appalachian schools during the COVID-19 pandemic.

Transitions in tobacco use profiles among adolescents: Results from the Population Assessment of Tobacco and Health (PATH) study waves 3 and 4.

Introduction: Despite increases in adolescents' polytobacco use, little work has utilized recent national data to examine transitions in polytobacco use over time or predictors of such transitions.

Methods: Data derived from the Population Assessment of Tobacco and Health (PATH) study. Participants used at least one tobacco product (cigarettes, electronic cigarettes [ECIGs], traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco [SLT], hookah) at Wave 3 (W3; 2015-2016) or 4 (W4; 2016-2018) and had Wave 1 (W1) data (N = 1072; M= 13.

Predicting Adolescent Electronic Cigarette Use: Differences by Never, Ever, and Current Users.

Objective: Rising rates of adolescent electronic cigarette (ECIG) use is concerning because it can lead to adverse health outcomes and increased risk behavior. There are known predictors of ever versus never ECIG use, but less are known about risk factors for ever versus current use of ECIGs. Problem behavior theory (PBT) was used to evaluate possible risk factors for different ECIG use status.

Timing of smoking cessation treatment integrated into outpatient treatment with medications for opioid use disorder: Feasibility trial.

Introduction: Cigarette smoking rates among individuals with opioid use disorder (OUD) are notoriously high and may be improved by considering the timing of treatment integration for these two substances. The current study examined the feasibility of a method for assessing the timing of integrating smoking cessation pharmacotherapy within three different phases of outpatient treatment with medication for OUD (MOUD).

Methods: Seventy-four buprenorphine-maintained smokers were enrolled in a quasi-experimental study across three MOUD treatment phases: 0-90 (Phase 1), 91-365 (Phase 2), and > 365 days of MOUD treatment (Phase 3).

Usability testing of an electronic health application for patient activation on weight management.

Background: Obesity is a leading public health concern in the United States. One promising method for enhancing patient activation to engage in health promoting behaviors is with technology in the primary care setting. The primary purpose of this study was to test the usability of a patient activation tool, called mWRAPPED, for weight management during primary care wait times.

Personality and impulsivity as predictors of tobacco use among emerging adults: A latent class analysis.

The tobacco industry markets their products toward emerging adults (18-29), with the goal of increasing use among this age group. To inform prevention efforts, researchers are investigating how specific demographic and psychological traits may predict tobacco initiation and continuation. Participants were 578 incoming university freshmen from the Appalachian region.

Amplifying Expertise in Rural West Virginia through Project ECHO: Impactful Partnerships and Community-Engagement.

Background: Limited specialty care access is a major contributor to rural health disparities. Extensions for Community Healthcare Outcomes (ECHO) is an innovative training and education strategy to address the need for trained specialty care in rural areas, such as West Virginia (WV). This article describes the successful implementation of ECHO projects in diverse subject areas facilitated by unique partnerships between the WV Clinical and Translational Science Institute (WVCTSI) and its practice partners.

Geographic isolation predicts tobacco product use among youth: A latent class analysis.

Purpose: The purpose of the current study was to evaluate associations between geographic rurality and tobacco use patterns among adolescents.

Methods: High school students (N = 566) from north-central Appalachia reported on their lifetime and/or current use of cigarettes, electronic cigarettes (ECIGs), cigars, and smokeless tobacco. Geographic rurality was measured via the Isolation scale, whereby residential ZIP Codes determined the degree to which respondents have access to health-related resources.

Measurement of cigarette smoking: Comparisons of global self-report, returned cigarette filters, and ecological momentary assessment.

Prior work suggests that prospective measurement of cigarette use may be more reliable and valid than retrospective self-reports. Despite several studies comparing retrospective and prospective methods, there are a myriad of prospective methods that have not been directly compared, including spent cigarette filters that are returned to the laboratory by participants and diary logs of cigarette use on an electronic device via ecological momentary assessment. The current secondary data analysis compared the reliability of retrospective global self-report, returned cigarette filters, and electronic diary logs among a sample of cigarette smokers that also use smokeless tobacco (SLT; N = 51) over two consecutive weeks.

Cigarette smokers' concurrent use of smokeless tobacco: dual use patterns and nicotine exposure.

Background: The concurrent use of cigarettes with other tobacco products, such as smokeless tobacco (SLT), is increasingly common. Extant work with cigarette smokers who also use SLT is based heavily on retrospective reports and between-group comparisons. The purpose of this study was to assess prospectively the patterns of dual users' product use and nicotine exposure on days when cigarettes were smoked exclusively (single use) versus concurrently with SLT (dual use).

Piloting a clinical laboratory method to evaluate the influence of potential modified risk tobacco products on smokers' quit-related motivation, choice, and behavior.

Research methods are needed that can predict whether the availability of potential modified risk tobacco products (MRTPs) may influence smokers' quit-related motivation, choice, and behavior. This pilot study assessed the primary outcomes of feasibility and adherence to address this need using an electronic cigarette (ECIG) as a model MRTP. Cigarette smokers were randomly assigned to use only their own brand of cigarettes (OB-only) or a second-generation ECIG (18 ng/ml nicotine) plus their OB cigarettes (ECIG+OB) ad libitum for four weeks.

A Comparison of Rural and Academic Training Environments for Third-Year Medical Students on a Family Medicine Rotation.

Background And Objectives: Medical students have been training in rural environments for many years. However, there is sparse research demonstrating that training in a rural environment provides an equivalent learning experience to training in an academic medical setting. This study addresses that gap by comparing student performance after training in rural or community environment versus an academic setting while completing the family medicine clerkship.

A Latent Class Analysis of the Co-occurrence of Risk Behaviors among Adolescents.

In this study, we examined the co-occurrence of multiple health-risk behaviors to determine whether there are any differences in the pattern of co-occurrence by sex. We conducted latent class analysis using the national 2013 Youth Risk Behavior Survey data for the overall sample, and separately by sex (N = 13,583). Over half of the sample (53%) belonged to the low risk subgroup (Class 1).

Physical Activity and Quit Motivation Moderators of Adolescent Smoking Reduction.

Objectives: We examined participant characteristics as moderators of adolescents' smoking cessation outcomes as a function of intervention: Not-on-Tobacco (N-O-T), N-O-T with a physical activity (PA) module (N-O-T+FIT), or Brief Intervention (BI).

Methods: We randomly assigned youth (N = 232) recruited from public high schools to an intervention, and measured their baseline levels of PA and motivation to quit. The number of cigarettes/day for weekdays and weekends was obtained at baseline and 3-month follow-up.

Barriers to Parent Support for Physical Activity in Appalachia.

Background: Parent support for child physical activity is a consistent predictor of increased childhood activity. Little is known about factors that prevent or facilitate support. The purpose of this research was to identify barriers to parent support for child physical activity in Appalachian parents.

Understanding Genomic Knowledge in Rural Appalachia: The West Virginia Genome Community Project.

Purpose: Rural communities have limited knowledge about genetics and genomics and are also underrepresented in genomic education initiatives. The purpose of this project was to assess genomic and epigenetic knowledge and beliefs in rural West Virginia.

Sample: A total of 93 participants from three communities participated in focus groups and 68 participants completed a demographic survey.

Patient Attitudes toward Weight Related Discussions in Rural Appalachian Primary Care Clinics.

Purpose: West Virginia (WV) consistently has one of the highest rates of obesity, nationally, yet previous studies suggest that conversations about weight with providers are infrequent. This study's aim was to determine frequency and type of weight-related discussions occurring in WV primary care clinics and whether discussions differed according to weight status.

Methods: A cross-sectional survey was completed by patients in rural primary care practices.

Developing a Dissemination Model to Improve Intervention Reach among West Virginia Youth Smokers.

The not-on-tobacco program is an evidence-based teen smoking cessation program adopted by the American Lung Association (ALA). Although widely disseminated nationally via ALA Master Trainers, in recent years, adoption and implementation of the N-O-T program in West Virginia (WV) has slowed. WV, unfortunately, has one of the highest smoking rates in the US.