A Qualitative Study Exploring Reproductive Desires and Parenting Attitudes among Ethnically Diverse Teens at Risk of Unintended Pregnancy.

Objectives: There is minimal research eliciting teen reproductive desires and parenting attitudes. Behavioral, educational, and public health interventions to prevent teen pregnancy often highlight the negative consequences of teen pregnancy or benefits of delaying parenting. However, limited empirical information is available regarding what factors teens perceive to influence the desire to delay pregnancy.

Community health worker insights on promoting research engagement with diverse populations.

Representation of diverse populations in health research enhances our ability to understand the factors that impact health, generalize results, implement findings, and promote social justice. The primary objective of the study was to understand the unique perspectives of frontline community health workers (CHWs) to identify actionable barriers and facilitators that may impact representation of diverse groups in health research. Focus groups with CHWs were conducted followed by thematic analysis.

Informed Contraceptive Decisions: A Qualitative Study of Hispanic Teens in New Mexico.

Objectives: U.S. Hispanic teens experience higher rates of unintended pregnancy than white teens.

National Email Communication Platforms May Indicate or Contribute to Gender Disparities: Preliminary Analysis of an Academic Medicine Listserv.

Gender disparities are well documented in the academic medicine literature and have been shown to impact representation, rank, and leadership opportunities for women. Social media platforms, including electronic mailing lists (listservs), may contribute to disparities by differentially highlighting or promoting individuals' work in academic and public health settings. Because of this, they provide a record by which to assess the presence of gender disparities; therefore, they become tools to identify gender differences in the frequency or pattern of representation.

Hepatitis C virus infection and polysubstance use among young adult people who inject drugs in a rural county of New Mexico.

Aims: We assessed prevalence and correlates for hepatitis C virus (HCV) infection in young adult people who inject drugs (PWID) in rural New Mexico, where opioid use has been historically problematic.

Methods: Participants were 18-29 years old with self-reported injection drug use in the past 90 days. We conducted testing for HCV antibodies (anti-HCV) and HCV ribonucleic acid (RNA) and assessed sociodemographic and risk exposures.

Pilot Study of an Overdose First Aid Program in Juvenile Detention.

Objectives: The purpose of this study was to evaluate the feasibility and short-term impact of a brief opioid overdose prevention and mitigation training administered to detained youth at risk for witnessing an overdose.

Methods: Adolescents seen in the medical clinic in a youth detention center were screened to determine risk for witnessing an overdose. Eligible adolescents completed a pretraining assessment that included opioid witnessing experiences and knowledge of and attitudes toward opioid overdose prevention.

Development and differentiability of three brief interventions for risky alcohol use that include varying doses of motivational interviewing.

Background: While brief intervention (BI) for risky alcohol use generally yields positive effects among those identified by screening, effect sizes are small and there is unexplained heterogeneity in outcome. The heterogeneity may be related to differences in intervention style and content, including elements of motivational interviewing (MI). To date, it has been difficult to interpret the role of MI in BI and these gaps in knowledge interfere with efforts to train, disseminate and implement BI that retains and maximizes efficacy.

An equivalence study of interview platform: Does videoconference technology impact medical school acceptance rates of different groups?

Web-based interviewing may be an effective element of a medical school's larger approach to promotion of holistic review, as recommended by the Association of American Medical Colleges, by facilitating the feasibility of including rural and community physicians in the interview process. Only 10% of medical schools offer videoconference interviews to applicants and little is known about the impact of this interview modality on the admissions process. This study investigated the impact of overall acceptance rates using videoconference interviews and face-to-face interviews in the medical school selection process using an equivalence trial design.

Pilot RCT of bidirectional text messaging for ART adherence among nonurban substance users with HIV.

Objective: This pilot study tested the preliminary efficacy of a theory-based bidirectional text messaging intervention (TEXT) on antiretroviral (ART) adherence, missed care visits, and substance use among people with HIV.

Method: Participants with recent substance use and ART nonadherence from 2 nonurban HIV clinics were randomized to TEXT or to usual care (UC). The TEXT intervention included daily queries of ART adherence, mood, and substance use.

Missed Opportunities: Screening and Brief Intervention for Risky Alcohol Use in Women's Health Settings.

Background: Although women's health settings could provide access to women for screening, brief intervention, and referral to treatment (SBIRT) for risky alcohol use, little is known about rates of alcohol use or associated risk for alcohol-exposed pregnancy (AEP) among women's health patients, receipt of SBIRT services in these settings, or patient attitudes towards SBIRT services.

Methods: This study reports the results of a self-administered survey to a convenience sample of women's health patients attending public clinics for family planning or sexually transmitted infection visits.

Results: Surveys were analyzed for 199 reproductive-aged women who had visited the clinic within the past year.

Education and counseling in the methadone treatment setting improves knowledge of viral hepatitis.

The aim of this study was to evaluate the effectiveness of an educational method of providing viral hepatitis education for methadone maintenance patients. Four hundred forty participants were randomly assigned to either a control or a motivationally-enhanced viral hepatitis education and counseling intervention. Viral hepatitis A (HAV), B (HBV), and C (HCV) knowledge tests were administered at baseline, following each of two education sessions (post-education), and at a 3-month follow-up assessment.

Parallel processes: using motivational interviewing as an implementation coaching strategy.

In addition to its clinical efficacy as a communication style for strengthening motivation and commitment to change, motivational interviewing (MI) has been hypothesized to be a potential tool for facilitating evidence-based practice adoption decisions. This paper reports on the rationale and content of MI-based implementation coaching Webinars that, as part of a larger active dissemination strategy, were found to be more effective than passive dissemination strategies at promoting adoption decisions among behavioral health and health providers and administrators. The Motivational Interviewing Treatment Integrity scale (MITI 3.

Ethnically diverse patients' perceptions of clinician computer use in a safety-net clinic.

Electronic health record (EHR) implementation may affect patient-clinician communication for diverse safety-net populations. We conducted a cross-sectional survey of English-, Spanish-, and Cantonese-speaking patients in a public hospital clinic with a basic EHR. We examined multivariate associations of patient race/ethnicity, language, and education with perceptions of primary-care provider (PCP) computer use.

Development of a personalized bidirectional text messaging tool for HIV adherence assessment and intervention among substance abusers.

We describe the development of a two-way text messaging intervention tool for substance users who are non-adherent with HIV medications, and examine message flow data for feasibility and acceptability. The assessment and intervention tool, TxText, is fully automated, sending participants mood, substance use, and medication adherence queries by text message. Participants respond, the tool recognizes the category of response, and sends the personalized intervention message that participants designed in return.

A randomized trial of a hepatitis care coordination model in methadone maintenance treatment.

Objectives: We evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients.

Methods: We conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2008 through June 2011. We randomized participants to a control arm (n = 245) and an intervention arm (n = 244), which included on-site screening, motivational-enhanced education and counseling, on-site vaccination, and case management services.

Depressive symptoms moderate treatment response to brief intervention for prevention of alcohol exposed pregnancy.

The previously published randomized controlled trial, EARLY, tested the efficacy of a motivational interviewing (MI) plus feedback condition against a video information (VI) condition and an informational brochure (IB) condition in reducing drinking and/or increasing contraception effectiveness, and found that drinking and rates of effective contraception improved in all conditions. In this reanalysis of the data from EARLY, potential moderating effects of depressive, global distress, and anxiety symptoms in response to the three brief interventions to reduce alcohol exposed pregnancy risk were examined. Women with higher levels of depression at baseline reported greater improvements in the MI plus feedback condition versus the VI and IB conditions with depression moderating both drinking and contraceptive effectiveness.

Feasibility and promise of a remote-delivered preconception motivational interviewing intervention to reduce risk for alcohol-exposed pregnancy.

Background: Alcohol-exposed pregnancy (AEP) is a leading cause of birth defects. Effective face-to-face preconception interventions based on motivational interviewing (MI) exist and should be translated into remote formats for maximum public health impact. This study investigated the feasibility and promise of a one-session, remote-delivered, preconception, MI-based AEP intervention (EARLY Remote) for non-treatment-seeking community women.

Preconceptional motivational interviewing interventions to reduce alcohol-exposed pregnancy risk.

Alcohol exposed pregnancy (AEP) is a leading cause of preventable birth defects. While randomized controlled trials (RCTs) have shown that multi-session motivational interviewing-based interventions reduce AEP risk, a one-session intervention could facilitate broader implementation. The purposes of this study were to: (1) test a one-session motivational AEP prevention intervention for community women and (2) compare outcomes to previous RCTs.

Feasibility and reliability of interactive voice response assessment of HIV medication adherence: research and clinical implications.

Background: There are well-documented negative consequences of nonadherence to HIV medications. Telephone-based interactive voice response (IVR) technologies may hold promise for assessing nonadherence in both research and clinical contexts; however, little psychometric research has been conducted on this topic.

Objective: In the present pilot study, we test the feasibility and reliability of a simplified patient-initiated, daily IVR system with a convenience sample of HIV patients attending a university-affiliated infectious disease clinic.

A SBIRT curriculum for medical residents: development of a performance feedback tool to build learner confidence.

A major barrier to actualizing the public health impact potential of screening, brief intervention, and referral to treatment (SBIRT) is the suboptimal development and implementation of evidence-based training curricula for healthcare providers. As part of a federal grant to develop and implement SBIRT training in medical residency programs, the authors assessed 95 internal medicine residents before they received SBIRT training to identify self-reported characteristics and behaviors that would inform curriculum development. Residents' confidence in their SBIRT skills significantly predicted SBIRT practice.

Preconception markers of dual risk for alcohol and smoking exposed pregnancy: tools for primary prevention.

Objective: Effective preconception primary prevention strategies are needed for women who are at dual risk for alcohol and smoking exposed pregnancies. The current study seeks to identify risk factors that can be used to target intervention strategies at women who are at dual risk.

Methods: During a 2-year period from January 2007 through December 2009, 109 women at dual risk for alcohol exposed pregnancy (AEP) and smoking exposed pregnancy (SEP) and 108 women at risk only for AEP were recruited from central Virginia cities.

A pilot randomized clinical trial of two medication adherence and drug use interventions for HIV+ crack cocaine users.

Background: Crack cocaine use undermines adherence to highly active antiretroviral therapy (HAART). This pilot randomized clinical trial tested the feasibility and efficacy of 2 interventions based on the Information-Motivation-Behavioral Skill model to improve HAART adherence and reduce crack cocaine problems.

Methods: Participants were 54 adults with crack cocaine use and HIV with <90% HAART adherence.

Motivational interviewing for smoking cessation: a meta-analytic review.

Objective: Motivational interviewing (MI) is a treatment approach that has been widely examined as an intervention for tobacco dependence and is recommended in clinical practice guidelines. Previous reviews evaluating the efficacy of MI for smoking cessation noted effects that were modest in magnitude but included few studies. The current study is a comprehensive meta-analysis of MI for smoking cessation.

Motivational enhancement therapy to increase resident physician engagement in substance abuse education.

Rates of screening, brief intervention, and referral to treatment (SBIRT) for alcohol and drug use by physicians remain low, despite evidence of efficacy. Motivational enhancement therapy (MET) may be a promising means to help physicians resolve ambivalence about intervening with alcohol and drug users and take advantage of educational opportunities. In the present study, 9 internal medicine residents received brief MET prior to standard education in SBIRT.

Access to Care for Methadone Maintenance Patients in the United States.

This policy commentary addresses a significant access to care issue that faces methadone maintenance patients seeking residential treatment in the United States. Methadone maintenance therapy (MMT) has demonstrated strong efficacy in the outpatient treatment of opiate dependence. However, many opiate dependent patients are also in need of more intensive interventions, such as residential care.