Objective: Confirmatory factor analysis was used to assess the factor structure of the 6-item version of the Kessler Psychological Distress Scale (K6). Methods: A subsample of emerging adults, aged 18-29 (n ¼ 20,699), from the 2013 National Survey of Drug Use and Health were used in this study. Results: Each of the models (one-factor, two-factor depression and anxiety and second-order two-factor psychological distress by depression and anxiety) demonstrated good fit, with significant loadings on each factor. The second-order two-factor model and the two-factor model were equivalent and a better fit than the one-factor model. Conclusions: Findings suggest that researchers and practitioners may confidently use the K6 to screen for psychological distress symptoms within the emerging adult population.

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The acceptability of lifelong antiretroviral therapy (ART) among HIV-positive women in high-burden Nigeria, is not well-known. We explored readiness of users and providers of prevention of mother-to-child transmission of HIV (PMTCT) services to accept lifelong ART -before Option B plus was implemented in Nigeria. We conducted 142 key informant interviews among 100 PMTCT users (25 pregnant-newly-diagnosed, 26 pregnant-in-care, 28 lost-to-follow-up (LTFU) and 21 postpartum women living with HIV) and 42 PMTCT providers in rural North-Central Nigeria. Qualitative data were manually analyzed via Grounded Theory. PMTCT users had mixed views about lifelong ART, strongly influenced by motivation to prevent infant HIV and by presence or absence of maternal illness. Newly-diagnosed women were most enthusiastic about lifelong ART, however postpartum and LTFU women expressed conditionalities for acceptance and adherence, including minimal ART side effects and potentially serious maternal illness. Providers corroborated user findings, identifying the postpartum period as problematic for lifelong ART acceptability/adherence. Option B plus scale-up in Nigeria will require proactively addressing PMTCT user fears about ART side effects, and continuous education on long-term maternal and infant benefits. Structural barriers such as the availability of trained providers, long clinic wait times and patient access to ART should also be addressed.

We examined the relationship between social isolation and health among parents and their adolescent children. Data came from the 2014 Family Life, Activity, Sun, Health, and Eating Study (FLASHE), a cross-sectional internet study from the National Cancer Institute. Parents and their adolescent children (ages 12-17) completed surveys about demographics, physical activity, and diet; analyses include all dyads in which at least one member provided information for any of the analyzed variables (N = 1851). Actor Partner Interdependence Models in Mplus with demographic covariates tested whether parent and adolescent perceived social isolation (2 items from the UCLA Loneliness Scale) were associated with each person's selfreported health. Most dyads included a mother (38% mother-daughter, 36% mother-son). Most parents were non-Hispanic White (69%), married/partnered (77%), and reported household income below $100,000 (79%). Both social isolation and self-reported health were significantly correlated between parents and their adolescent children (Pearson correlation = .38 for isolation, .32 for health). There were negative associations between parent isolation and parent health, adolescent isolation and adolescent health, and parent isolation and adolescent health (all ps < .05), but no association between adolescent isolation and parent health. The finding that parents' social isolation was linked to lower self-reported health not only for themselves but also for their adolescent children highlights the importance of addressing social isolation in clinical social work practice. Family interventions, or interventions to reduce adults' negative social cognitions or promote social connections, may improve health for both adults and their adolescent children.