Reducing the Risk for Postpartum Depression in Adolescent Mothers: A Randomized Controlled Trial.

Objective: To estimate the effect of an interpersonal therapy-based intervention on reducing the risk of postpartum depression in adolescents.

Methods: A randomized controlled trial enrolled 250 pregnant adolescents who were aged 18 years or younger at conception. The initial sample size calculation estimated 276 participants (324 with attrition) were needed to detect a 50% reduction in risk of the primary outcome, postpartum major depressive episode, with an alpha of 0.

The Role of Inclusion Benefits in Ethics Committee Assessment of Research Studies.

The relationship between risks and benefits is central to the ethics of research involving human participants. Traditionally, to be ethically justifiable, risks should be reasonable in relation to anticipated benefits (if any) to subjects and to the potential social benefits resulting from research. This calculus is being further complicated by findings from an increasing number of social science studies that reveal that prospective and actual research participants frequently describe various types of inclusion benefits (for example, personal benefits such as access to or improved health care, increased knowledge about their disease or condition, and greater solidarity with the local community) as important to them.

School Support as Structural HIV Prevention for Adolescent Orphans in Western Kenya.

Purpose: Using a clustered randomized controlled trial design, we evaluated whether support to keep Kenyan orphaned adolescents in school reduces the risk of HIV infection.

Methods: Participants included 835 orphaned boys and girls in grades 7 and 8 (mean age at the baseline = 15 years) in western Kenya. Primary schools (N = 26) were randomized to the study condition.

Process Evaluation of a Clinical Trial to Test School Support as HIV Prevention Among Orphaned Adolescents in Western Kenya.

Orphaned adolescents are a large and vulnerable population in sub-Saharan Africa, at higher risk for HIV than non-orphans. Yet prevention of new infection is critical for adolescents since they are less likely than adults to enter and remain in treatment and are the only age group with rising AIDS death rates. We report process evaluation for a randomized controlled trial (RCT) testing support to stay in school (tuition, uniform, nurse visits) as an HIV prevention strategy for orphaned Kenyan adolescents.

Coaching mental health peer advocates for rural LGBTQ people.

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals.

Stakeholders' Recommendations to Improve Patient-centered "LGBTQ" Primary Care in Rural and Multicultural Practices.

Purpose: Individuals among gender/sexual minorities share experiences of stigma and discrimination, yet have distinctive health care needs influenced by ethnic/racial minority and rural realities.

Methods: We collected qualitative data from lesbian/gay/bisexual/transgender (LGBT) and queer persons across the largely rural, multicultural state of New Mexico, particularly those from understudied ethnic groups, regarding factors facilitating or impeding patient-centered primary care. The themes identified formed the basis for a statewide summit on LGBT health care guidelines and strategies for decreasing treatment gaps.

Tobacco Denormalization as a Public Health Strategy: Implications for Sexual and Gender Minorities.

Although the population-level success of tobacco denormalization is widely accepted, it remains unclear whether these strategies alleviate health inequities for sexual and gender minorities. The high risk of smoking among sexual and gender minorities together with research that documents a relationship between stigma-related processes and smoking prevalence for these groups raises questions about whether tobacco-related stigma intensifies the disadvantages associated with the stigmas of other social identities. We have not adequately considered how tobacco-related stigma overlaps with other social identity stigmas.

Disclosure of HSV-2 serological test results in the context of an adolescent HIV prevention trial in Kenya.

Objectives: Herpes simplex virus type 2 (HSV-2) biomarkers are often used in adolescent sub-Saharan HIV prevention studies, but evaluations of test performance and disclosure outcomes are rare in the published literature. Therefore, we investigated the proportion of ELISA-positive and indeterminate samples confirmed by western blot (WB), the psychosocial response to disclosure and whether reports of sexual behaviour and HSV-2 symptoms are consistent with WB confirmatory results among adolescent orphans in Kenya.

Methods: In 2011, 837 Kenyan orphan youth in grades 7 and 8 enrolled in an HIV prevention clinical trial with HSV-2 biomarker outcomes.

The impact of school subsidies on HIV-related outcomes among adolescent female orphans.

Purpose: We examine effects of school support as a structural HIV prevention intervention for adolescent female orphans in Zimbabwe after 5 years.

Methods: Three hundred twenty-eight orphan adolescent girls were followed in a clustered randomized controlled trial from 2007 to 2010. The experimental group received school fees, uniforms, and school supplies and were assigned a school-based "helper.

Discordance of HIV and HSV-2 biomarkers and self-reported sexual behaviour among orphan adolescents in Western Kenya.

Background: This paper examines the discordance between biological data of HIV and herpes simplex virus type 2 (HSV-2) infections and self-reported questionnaire responses among orphan adolescents in Western Kenya.

Methods: In 2011, 837 orphan adolescents from 26 primary schools were enrolled in an HIV prevention trial. At baseline, blood samples were drawn for HIV and HSV-2 infection biomarker testing, and participants completed an audio computer-assisted self-interviewing survey.

Building a conceptual framework to culturally adapt health promotion and prevention programs at the deep structural level.

The debate on the effectiveness and merit for the amount of time, effort, and resources to culturally adapt health promotion and prevention programs continues. This may be due, in large part, to the lack of theory in commonly used methods to match programmatic content and delivery to the culture of a population, particularly at the deep structural level. This paper asserts that prior to the cultural adaptation of prevention programs, it is necessary to first develop a conceptual framework.

Measuring Fidelity and Adaptation: Reliability of a Instrument for School-Based Prevention Programs.

There is a need to standardize methods for assessing fidelity and adaptation. Such standardization would allow program implementation to be examined in a manner that will be useful for understanding the moderating role of fidelity in dissemination research. This article describes a method for collecting data about fidelity of implementation for school-based prevention programs, including measures of adherence, quality of delivery, dosage, participant engagement, and adaptation.

Does screening classification predict long-term outcomes of DWI offenders?

Objectives: To determine the usefulness of a screening classification system in predicting treatment use, current substance abuse disorders (SUD), and driving over the alcohol limit (DOL) at 15-year follow-up.

Methods: Interviewed 583 driving while imparied (DWI) first offenders with SUDs. Univariate and multivariate statistics were used to determine predictors of long-term outcomes.

A Bayesian model for estimating the effects of drug use when drug use may be under-reported.

Aims: We present a statistical model for evaluating the effects of substance use when substance use might be under-reported. The model is a special case of the Bayesian formulation of the 'classical' measurement error model, requiring that the analyst quantify prior beliefs about rates of under-reporting and the true prevalence of substance use in the study population.

Design: Prospective study.

The effect of a jail methadone maintenance therapy (MMT) program on inmate recidivism.

Aims: To evaluate the effects of a jail-based continuation of methadone maintenance therapy (MMT) on subsequent inmate recidivism risks.

Design: Prospective, longitudinal, observational study.

Setting: A large, Southwestern United States jail that continues MMT for heroin-addicted inmates on MMT at the time of booking.

Construct and differential item functioning in the assessment of prescription opioid use disorders among American adolescents.

Objective: To examine the psychometric properties of diagnostic criteria for prescription analgesic opioid use disorders (OUDs) and to identify background predictors of a latent continuum for OUD liability.

Method: Data were drawn from the adolescent sample of the 2006 National Survey of Drug Use and Health. Item response theory (IRT) and multiple indicators-multiple causes methods were used to examine DSM-IV criteria for OUDs in a subsample of adolescents who reported nonmedical prescription opioid use in the past year (N = 1,290).

Validation of a DIS-III-R rescoring algorithm for DSM-IV alcohol-use disorders.

Objective: The aim of this study was to evaluate the validity of the Diagnostic Interview Schedule, Version III, Revised (DIS-IIIR), rescoring algorithm when compared with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnoses established using the Composite International Diagnostic Interview (CIDI). The research question is "Does our DIS-III-R rescore accurately reflect DSM-IV diagnoses established independently using the CIDI?"

Method: One hundred subjects were administered the CIDI and the DISIII-R alcohol-use modules. The DIS-III-R criteria were rescored to the DSM-IV diagnosis using our published algorithm.

The effects of extended-release naltrexone on holiday drinking in alcohol-dependent patients.

A post hoc analysis examined the effect of extended-release naltrexone (XR-NTX) treatment combined with psychosocial support on alcohol consumption during holiday and nonholiday periods in a cohort of alcohol-dependent patients who had maintained at least 4 days of continuous abstinence before receiving their first treatment. Three parameters of drinking behavior were examined: percentage of drinking days, percentage of heavy drinking days, and the number of drinks per day. Patients receiving XR-NTX 380 mg reported significantly lower median percentages of drinking days, heavy drinking days, and the number of drinks per day compared with the placebo group.

Does federal policy support the use of scientific evidence in school-based prevention programs?

Since 1998, federal policy has explicitly required the use of "evidence-based" prevention programs in schools. We review how this policy has been implemented through state recipients of the Safe and Drug Free Schools (SDFS) Program, and how other federal and private agencies have supported the policy by providing guidance about the scientific evidence for specific programs' effectiveness. We report data from a survey of SDFS state office directors, and we compare and contrast the most popular lists of effective programs.