BackgroundHigh-risk HPV DNA testing has been proposed as a primary tool for cervical cancer screening (HPV-CCS) as an alternative to the Papanicolaou cytology- method. This study describes factors associated with women’s intentions to attend cervical cancer screening if high-risk HPV DNA testing (HPV-CCS) was implemented as a primary screening tool, and if screening were conducted every 4 years starting after age 25.MethodsThis online survey was designed using the Theory of Planned Behaviour to assess factors that impact women’s intentions to attend HPV-CCS among women aged 25–69 upon exit of the HPV FOCAL trial. Univariate and regression analyses were performed to compare the demographic, sexual history, and smoking characteristics between women willing and unwilling to screen, and scales for intention to attend HPV-CCS. A qualitative analysis was performed by compiling and coding the comments section of the survey.ResultsOf the 981 women who completed the survey in full, only 51.4 % responded that they intended to attend HPV-CCS with a delayed start age and extended screening interval. Women who intended to screen were more likely to have higher education (AOR 0.59, 95 % CI [0.37, 0.93]), while both positive attitudes (AOR 1.26, 95 % CI [1.23, 1.30]) and perceived behavior control (AOR 1.06, 95 % CI [1.02, 1.10]) were significant predictors of intention to screen. Among women who provided comments in the survey, a large number of women expressed fears about not being checked more than every 4 years, but 12 % stated that these fears may be alleviated by having more information.ConclusionsAcceptability of increased screening intervals and starting age could be improved through enhanced education of benefits. Program planners should consider measures to assess and improve women’s knowledge, attitudes and beliefs prior to the implementation of new screening programs to avoid unintended consequences.

Clarifying the prevalence and nature of such characteristics can help pediatric providers improve patient care and minimize unnecessary medical interventions with early detection of risk for somatoform processes, provision of psychoeducation for patients and families, and early referral to mental health clinicians.

Future perspectives of transgender youth and their caregivers may be shaped by knowledge of discrimination and adverse mental health among transgender adults. Qualitative data from the Trans Youth Family Study were used to examine how transgender and gender nonconforming (TGN) youth and their caregivers imagine the youth's future. A community-based sample of 16 families (16 TGN youth, ages 7-18 years, and 29 caregivers) was recruited from two regions in the United States. Participants completed in-person qualitative interviews and surveys. Interview transcripts were analyzed using grounded theory methodology for coding procedures. Analyses yielded 104 higher order themes across 45 interviews, with eight prominent themes: comparing experiences with others, gender affirming hormones, gender affirming surgery, gender norms, questioning whether the youth is really transgender, expectations for romantic relationships, uncertainty about the future, and worries about physical and emotional safety. A conceptual model of future perspectives in TGN youth and caregivers is presented and clinical implications are discussed.

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Increasingly, social life—and accordingly, social research—is conducted in online environments. Asynchronous online focus groups (AOFGs) have emerged as an important tool to conduct remote research with geographically diverse populations. However, there remain few systematic accounts of AOFG methods to guide researchers’ decision-making in designing and implementing studies. This paper seeks to address this gap by describing a recent study on body image and health among transgender and gender diverse (TGD) young adults. In this study, eight AOFGs were conducted in August-October 2019 with 66 TGD young adults residing in 25 U.S. states. Each AOFG lasted four consecutive days with two prompts posted by moderators per day. Overall, participant satisfaction with AOFGs was high: 98% reported their experience was excellent, very good, or good and 95% would be somewhat or very likely to sign up for another AOFG. This example is used to illustrate key methodological decision-points, acceptability of the method to participants, and lessons learned. The goal of this paper is to encourage other researchers, particularly health researchers, to consider using AOFGs and to engage with the method’s strengths and limitations in order to develop new opportunities for online technologies to enrich the field of qualitative health research.

SOTs are now performed worldwide, with over 19 000 pediatric transplants completed in the United States in the past 10 years. 1 Further exploration into the behavioral health needs of patients before, during, and after SOT is critical to tailor interventions effectively and improve clinical outcomes for these patients and their families. 2 Pediatric psychology and consultation-liaison child psychiatry have emerged as subspecialty fields in response to the psychosocial needs of children, adolescents, and young adults with medical conditions such as SOT. Given the medical and psychosocial complexities of organ transplantation, including the crucial need for lifelong medication adherence, it is important that behavioral health providers develop a high level of clinical skill as well as necessary scientific knowledge specific to pediatric transplantation. 3 As many

Introduction This study describes psychotropic medication use in a pediatric and young adult solid organ transplant population. Methods We conducted a retrospective review of the lifetime incidence of psychotropic medication use and associated characteristics in patients seen over a 6‐year period at a large pediatric transplant center utilizing univariate and multivariate statistical analyses. Results The lifetime incidence of psychotropic medication use was 36.5% in 393 patients. Transplant psychiatry provided psychopharmacological consultation to 21.9% of patients. Controlling for age and sex, there were significant associations between psychotropic use and thoracic organ disease (heart/lung) (AOR = 2.14; 95% CI: 1.2‐3.8; P = 0.01), White race (P = 0.0002), histories of depressive/mood disorders (AOR = 3.68; 95% CI: 1.8‐7.7; P = 0.0005), attention/learning disorders (AOR = 3.30; 95% CI: 1.6‐6.9; P = 0.001), acute and post‐traumatic stress disorders (AOR = 10.54; 95% CI: 2.6‐42.8; P = 0.001), and experiencing bullying (AOR = 2.16; 95% CI: 1.03‐4.55; P = 0.04). In unadjusted tests, significant associations were found between lifetime psychotropic usage and patient anxiety history (OR = 2.26; 95% CI: 1.5‐3.5; P = 0.0002), end‐of‐life disease progression (OR = 3.04; 95% CI: 1.7‐5.4; P = 0.0002), family psychiatric history (OR = 2.17; 95% CI: 1.4‐3.4; P = 0.0007), and adherence concerns (OR = 2.67; 95% CI: 1.7‐4.1; P < 0.0001). Discussion The lifetime incidence of psychotropic medication use among pediatric and young adult transplant patients is substantial. Patients with thoracic organ disease, end‐of‐life illness, individual/family psychiatric histories, trauma, and bullying histories have particularly high rates. Integrating child psychiatry as part of pediatric transplant teams should be an important consideration for the care of these patients.

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