There are gaps in research regarding medication adherence, self-efficacy in proper medication adherence, and health literacy among breast cancer survivors. This pilot randomized controlled study was conducted to provide information addressing health literacy with respect to medication adherence and self-efficacy in African American breast cancer survivors. The study sample consisted of an intervention group (n = 24) of medication adherence skills training (MST) and a control group (n = 24), with a total sample population of 48 participants. The MST workshop was a collaborative intervention between pharmacy and social work and was designed to address issues that may be encountered while taking multiple medications for various acute and chronic conditions, increase participant confidence in accessing necessary resources for improved medication usage, and enhance personal self-efficacy regarding health care. A statistically significant relationship was detected between initial health literacy and medication adherence, as well as initial health literacy and self-efficacy. These findings indicated that individuals with higher health literacy were more likely to have higher levels of self-efficacy and were more likely to adhere to medication instructions. Analysis of the intervention and treatment groups did not show a statistically significant effect on health literacy, medication adherence, or self-efficacy from pre-test to post-test.

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Young adults ages 18 to 25 have the highest percentage (5%) of cannabis use disorder (CUD) among all age groups, and are the least likely to receive treatment compared with other age groups. Because this population is in need of creative approaches for treatment engagement, we tested Peer Network Counseling-txt (PNC-txt), a 4-week, automated text-delivered cannabis treatment that focuses on close peer relations with 96 treatment seeking young adults. Participants meeting CUD criteria were randomized to PNC-txt, or assessment only control condition and followed for 3-months. At 3-months, the PNC-txt group reduced number of heavy cannabis-use days and relationship problems due to cannabis use compared with controls. Subgroup analyses were conducted with cases having more and fewer CUD symptoms than the full sample. For cases with fewer symptoms, but not for those with more, PNC-txt reduced past 30-day use, urges to use, memory problems, and relationship problems due to cannabis use compared with controls. Treatment satisfaction data from the full sample indicated that participants thought the intervention texts helped them reduce or manage their cannabis use and increased their understanding of the negative relational effects associated with ongoing cannabis use. Findings provide evidence of the efficacy of PNC-txt in treating CUD in young adults, support clinically targeting peer relations, and suggest that PNC-txt may be most helpful for those with mild to moderate CUD severity.

Adolescents with depression disorders have higher rates of substance use. In order to advance contextually relevant mental health interventions, basic research is needed to test social ecological mechanisms hypothesized to influence adolescent depression and substance use. Accordingly, we conducted growth curve modeling with a sample of 248 urban adolescents to determine if depression's effect on substance use was dependent upon peer network health (sum of peer risk and protective behaviors) and activity space risk (likelihood of high-risk behaviors at routine locations). Results showed that peer network health moderated the effects of depression on substance use, but this effect was not altered by activity space risk. These findings suggest the importance of peer network health relative to depression and substance use, particularly for young adolescents.

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