Objective To assess the type and quality of the studies evaluating the effects of electronic media-based interventions on health and safety behavior change. Data Sources Studies were identified from searches in MEDLINE (1950 to September 2010) a and PsycINFO (1967 to September 2010). Study Selection Included were published studies of interventions that used electronic media and focused on health/safety behavior change in children aged 18 years or younger. Intervention Electronic media-based intervention. Main Outcome Measure Health or safety behavior change. Results Nineteen studies met criteria and focused on at least one behavior change outcome. Of these studies, 7 employed interventions related to physical activity and/or nutrition, 6 focused on asthma, 3 focused on safety behaviors, 2 focused on sexual risk behaviors, and 1 targeted diabetes. Seventeen studies reported at least one statistically significant effect on behavior change outcomes, including an increase in fruit, juice, or vegetable consumption, an increase in physical activity, improved asthma self-management, acquisition of street and fire safety skills, and sexual abstinence. Only five of the 19 studies were rated as being of excellent quality. Conclusions Our systematic review suggests that interventions using electronic media can improve health/safety behaviors in young people. However, there is a need for higher quality, rigorous interventions that promote behavior change.

Background HIV infected (HIV+) individuals may be more susceptible to alcohol-related harm than uninfected individuals. Methods We analyzed data on HIV+ and uninfected individuals in the Veterans Aging Cohort Study (VACS) with an Alcohol Use Disorders Identification Test-Consumption AUDIT-C score from 2008–2012. We used Cox proportional hazards models to examine the association between alcohol exposure and mortality through July, 2014; and linear regression models to assess the association between alcohol exposure and physiologic injury based on VACS Index Scores. Models were adjusted for age, race/ethnicity, smoking, and Hepatitis C infection. Results The sample included 18,145 HIV+ and 42,228 uninfected individuals. Among HIV+ individuals, 76% had undetectable HIV-1 RNA (<500 copies/ml). The threshold for an association of alcohol use with mortality and physiologic injury differed by HIV status. Among HIV+ individuals, AUDIT-C score ≥4 (hazard ratio [HR] 1.25, 95% CI 1.09–1.44) and ≥30 drinks per month (HR, 1.30, 95% CI 1.14–1.50) were associated with increased risk of mortality. Among uninfected individuals, AUDIT-C score ≥5 (HR, 1.19, 95% CI 1.07–1.32) and ≥70 drinks per month (HR 1.13, 95% CI 1.00–1.28) were associated with increased risk. Similarly, AUDIT-C threshold scores of 5–7 were associated with physiologic injury among HIV+ individuals (beta 0.47, 95% CI 0.22, 0.73) and a score of 8 or more was associated with injury in uninfected (beta 0.29, 95% CI 0.16, 0.42) individuals. Conclusions Despite antiretroviral therapy, HIV+ individuals experienced increased mortality and physiologic injury at lower levels of alcohol use compared with uninfected individuals. Alcohol consumption limits should be lower among HIV+ individuals.

Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the game design and behavior change procedures that best promote G4H effectiveness and to identify and minimize possible adverse effects. Guidelines for ideal use of different types of G4H by children and adolescents should be elucidated to enhance effectiveness and minimize adverse effects. G4H stakeholders include organizational implementers, policy makers, players and their families, researchers, designers, retailers, and publishers. All stakeholders should be involved in G4H development and have a voice in setting goals to capitalize on their insights to enhance effectiveness and use of the game. In the future, multiple targeted G4H should be available to meet a population's diverse health needs in developmentally appropriate ways. Substantial, consistent, and sophisticated research with appropriate levels of funding is needed to realize the benefits of G4H.

Objective. Food insecurity may be a modifiable and independent risk factor for worse control of medical conditions, but it has not been explored among veterans. We determined the prevalence of, and factors independently associated with, food insecurity among veterans in the Veterans Aging Cohort Study (VACS).

Purpose There has been an increase in the abuse of prescription opioids, especially in younger individuals. The current study explores the association between alcohol, cigarette, and/or marijuana use during adolescence and subsequent abuse of prescription opioids during young adulthood. Methods We used demographic/clinical data from community-dwelling individuals in the 2006–2008 National Survey on Drug Use and Health. We used logistic regression analyses, adjusted for these characteristics, to test whether having antecedent alcohol, cigarette, or marijuana use was associated with an increased likelihood of subsequently abusing prescription opioids. Results 12% of the survey population of 18–25 year olds (n=6496) reported current abuse of prescription opioids. For this population, prevalence of prior substance use was 57% for alcohol, 56% for cigarettes, and 34% for marijuana. We found prior alcohol use was associated with the subsequent abuse of prescription opioids in young men but not young women. Among both men and women, prior marijuana use was 2.5 times more likely than no prior marijuana to be associated with subsequent abuse of prescription opioids. We found that among young boys, all prior substance use (alcohol, cigarettes, and marijuana) but only prior marijuana use in young girls was associated with an increased likelihood of subsequent abuse of prescription opioids during young adulthood. Conclusions Prior alcohol, cigarette and marijuana use were each associated with current abuse of prescription opioids in 18–25 year old men but only marijuana use was associated with subsequent prescription opioids in young women. Prevention efforts targeting early substance abuse may help to curb the abuse of prescription opioids.