Comparative Effectiveness of Community-Based vs Clinic-Based Healthy Choices Motivational Intervention to Improve Health Behaviors Among Youth Living With HIV: A Randomized Clinical Trial.

Importance: Youth living with HIV make up one-quarter of new infections and have high rates of risk behaviors but are significantly understudied. Effectiveness trials in real-world settings are needed to inform program delivery.

Objective: To compare the effectiveness of the Healthy Choices intervention delivered in a home or community setting vs a medical clinic.

Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents.

Unlabelled: : media-1vid110.1542/5804911922001PEDS-VA_2017-3737 BACKGROUND: African American adolescents appear to be the most at risk for asthma morbidity and mortality even compared with other minority groups, yet there are few successful interventions for this population that are used to target poorly controlled asthma.

Methods: African American adolescents (age 12-16 years) with moderate-to-severe persistent asthma and ≥1 inpatient hospitalization or ≥2 emergency department visits in 12 months were randomly assigned to Multisystemic Therapy-Health Care or an attention control group ( = 167).

The Detroit Young Adult Asthma Project: Pilot of a Technology-Based Medication Adherence Intervention for African-American Emerging Adults.

Purpose: To conduct a randomized controlled pilot of a multicomponent, technology-based intervention promoting adherence to controller medication in African-American emerging adults with asthma. The intervention consisted of two computer-delivered sessions based on motivational interviewing combined with text messaged reminders between sessions.

Methods: Participants (N = 49) were 18-29 years old, African-American, with persistent asthma requiring controller medication.

Multisystemic therapy for high-risk African American adolescents with asthma: a randomized clinical trial.

Objective: The primary purpose of the study was to determine whether Multisystemic Therapy adapted for health care settings (MST-HC) improved asthma management and health outcomes in high-risk African American adolescents with asthma.

Method: Eligibility included self-reported African American ethnicity, ages 12 to 16, moderate to severe asthma, and an inpatient hospitalization or at least 2 emergency department visits for asthma in the last 12 months. Adolescents and their families (N = 170) were randomized to MST-HC or in-home family support.

Adherence to asthma medication regimens in urban African American adolescents: application of self-determination theory.

Objective: Asthma medication adherence is low, particularly among African American adolescents, a high-risk group with respect to asthma prevalence, morbidity, and mortality. This study tested the utility of self-determination theory (SDT), a theory of motivation, to explain adherence to asthma medication regimens in African American adolescents.

Method: We used baseline data from 168 urban African American adolescents (Mage = 13.

Asthma medication device skills in high-risk African American adolescents.

Objective: To describe the asthma medication device skills of high-risk African American adolescents and associations between skills and other components of illness management,

Methods: 170 African American adolescents, with at least one hospitalization or two emergency department visits in the last year, demonstrated how they use their asthma quick-relief and controller medication devices. Observations were scored using an in vivo observation asthma skills checklist. To assess other areas of asthma management, adolescents and their primary caregiver were interviewed using the Family Asthma Management System Scales,

Results: Only 5% of adolescents correctly demonstrated all controller skills, and none of the adolescents correctly showed all quick-relief inhaler skills (5% showed between 90 and 95% of skills).

Text messaging to measure asthma medication use and symptoms in urban African American emerging adults: a feasibility study.

Objective: Urban African American adolescents and young adults face disproportionate risk of asthma morbidity and mortality. This study was the first to assess the feasibility of Ecological Momentary Assessment via text messaging to measure asthma medication use and symptoms in African Americans aged 18-25 years.

Methods: This study used automated text messaging with N = 6 participants for 14 consecutive days.

Development and preliminary validation of an indirect screener for drug use in the perinatal period.

Aims: This study sought to develop and begin validation of an indirect screener for identification of drug use during pregnancy, without reliance on direct disclosure.

Design: Women were recruited from their hospital rooms after giving birth. Participation involved (i) completing a computerized assessment battery containing three types of items: direct (asking directly about drug use), semi-indirect (asking only about drug use prior to pregnancy) and indirect (with no mention of drug use), and (ii) providing urine and hair samples.

A randomized trial of computer-delivered brief intervention and low-intensity contingency management for smoking during pregnancy.

Introduction: Implementation of evidence-based interventions for smoking during pregnancy is challenging. We developed 2 highly replicable interventions for smoking during pregnancy: (a) a computer-delivered 5As-based brief intervention (CD-5As) and (b) a computer-assisted, simplified, and low-intensity contingency management (CM-Lite).

Methods: A sample of 110 primarily Black pregnant women reporting smoking in the past week were recruited from prenatal care clinics and randomly assigned to CD-5As (n = 26), CM-Lite (n = 28), CD-5As plus CM-Lite (n = 30), or treatment as usual (n = 26).

Drug use during pregnancy: validating the Drug Abuse Screening Test against physiological measures.

This study examined the ability of the Drug Abuse Screening Test (DAST-10) to identify prenatal drug use using hair and urine samples as criterion variables. In addition, this study was the first to use "best practices," such as anonymity, ACASI technology, and a written screener, to facilitate disclosure in this vulnerable population. 300 low-income, post-partum women (90.

Health literacy and antiretroviral adherence among HIV-infected adolescents.

Objective: This study investigates HIV positive adolescents' health literacy and whether factors associated with health literacy in HIV-positive adults are associated with health literacy among HIV-positive adolescents.

Methods: Adolescents in this study were behaviorally and perinatally HIV-infected youth (n=186) from five U.S.

Brief report: maintenance of effects of motivational enhancement therapy to improve risk behaviors and HIV-related Health in a randomized controlled trial of youth living with HIV.

Objective: To examine the maintenance of effects of Motivational Enhancement Therapy (MET) shown to improve risk behaviors and viral load in youth living with HIV (YLH) immediately posttreatment.

Methods: Sixty-five youth (ages 16-25 years) were randomized to Healthy Choices or a waitlist control. Frequency of substance use, frequency of unprotected intercourse, and viral load were obtained at baseline, 3, and 6 months after study entry.

Social support and disclosure as predictors of mental health in HIV-positive youth.

The purpose of this study was to describe mental health symptoms in a sample of 66 HIV-positive youth (ages 16-25) and to evaluate social support, disclosure, and physical status as predictors of symptoms. Data were collected from January 2002 to May 2003. As measured by the Brief Symptom Inventory (BSI), 50% of the youth scored above the cutoff for clinically significant mental health symptoms, thus highlighting the need for mental health services.

Stigma scale revised: reliability and validity of a brief measure of stigma for HIV+ youth.

The purpose of this study was to shorten a human immunodeficiency virus (HIV) stigma scale to make it less burdensome for HIV-positive (HIV+) youth without compromising psychometric properties. The shortened questionnaire showed good internal consistency and validity, suggesting that a 10-item measure of stigma has promise for assessing this important construct in HIV+ youth.

Healthy choices: motivational enhancement therapy for health risk behaviors in HIV-positive youth.

This study piloted a brief individual motivational intervention targeting multiple health risk behaviors in HIV-positive youth aged 16-25. Interviews about sexual behavior and substance use and viral load testing were obtained from 51 HIV-positive youth at baseline and post intervention. Youth were randomized to receive a four-session motivational enhancement intervention (N = 25) or to a wait-list control (N = 26).

Psychosocial factors and medication adherence in HIV-positive youth.

The purpose of this study was to test variables consistently identified in the adult HIV literature as predictors of adherence (self-efficacy, social support, and psychological distress) in a sample of 24 HIV-positive youth (ages 16-24). Self-efficacy and psychological distress were significantly correlated with adherence but social support was not. Social support specific to taking medications was correlated with self-efficacy.