Background To understand whether patient-reported experiences with lung cancer may create teachable moments (TM) for their relatives as evidenced by shifts in their risk perceptions, affective response, and self-image and in turn, motivation to quit smoking. Methods Patients at a comprehensive cancer center (n = 152) completed a survey within 6 months of lung cancer diagnosis to assess their cancer-related symptoms and openness and enumerated relatives who were smokers. Relative smokers (n = 218) then completed a survey assessing their risk perceptions, affective response, and self-image as a smoker related to the patient’s diagnosis (TM mechanisms), and their motivation to quit smoking. Cross-sectional mediation and moderation analyses were conducted to explore the links between patient-reported experiences, and relatives’ TM mechanisms, and motivation to quit smoking. Results Relative-reported affect was a significant mediator of the association between patient-reported symptoms and relative smoker’s desire to quit. Relatives’ self-image was a significant moderator of the association between patient-reported symptoms and relative smoker’s desire to quit, such that patients’ reported symptoms were associated with relatives’ desire to quit only when the relative smoker reported a generally positive self-image as a smoker. No evidence was found for moderated mediation. However, the link between symptoms and negative affect was moderated by perceptions of risk. Conclusion Whether smokers experience a family member’s lung cancer as a TM is influenced by multiple interrelated cognitive and affective factors that warrant further exploration. Clearer understanding of these factors could inform how to re-invigorate and sustain this motivation to promote concrete actions toward smoking cessation.

We examined correlates of sources of parental knowledge of youths’ experiences in Mexican American families, including child self-disclosure, parental solicitation, spouse, siblings, and individuals outside the family. Home and phone interviews were conducted with mothers, fathers, and their seventh-grade male and female offspring in 246 Mexican American families. Results indicated that mothers and fathers relied on different sources of knowledge; parent-child relationship quality and cultural orientations predicted parents’ sources of knowledge; and different sources had different implications for youth adjustment. Specifically, child disclosure to mothers and fathers’ reliance on their spouse were consistently linked to better youth outcomes. Moderation analyses revealed that correlates of parents’ knowledge sources were not always uniform across mothers and fathers or daughters and sons.

Purpose This study examined links between diurnal patterns of the stress hormone, cortisol, and adolescents’ time in nine common daily activities. Method During eight consecutive nightly telephone interviews, 28 youths (n = 12 girls), 10-18 years of age, reported their day’s activities. On four days, four saliva samples also were collected and assayed for cortisol. Multilevel models assessed within- and between-person associations between time in each activity and cortisol Area Under the Curve (AUC), cortisol awakening response (CAR), morning peak (30 minutes after wake up) and daily decline (morning peak to bedtime). Results Links with AUC were found for most activities; significant associations with cortisol rhythms suggested that most effects were due to anticipation of the day’s activities. Specifically, on days when youths spent more time than usual on videogames and TV they had lower AUCs, with lower morning peaks. Youths who spent more time reading (within-person) and in computer activities (between-person) had higher AUCs, with stronger CARs (within-person). Youths who slept more had lower AUCs, with lower morning peaks on both the between- and within-person levels. Amounts of time spent in clubs, and for older adolescents, sports, were also linked to lower AUCs. Finally, youths who spent more time in school/schoolwork had lower AUCs, but on days when youths spent more time than usual in school, they had higher AUCs, stronger CARs, and steeper daily declines. Conclusion Beyond their known implications for psychological adjustment, youths’ everyday activities are linked to stress physiology.

The recognition of the role of the environment in contributing to the obesity epidemic has led to increasing efforts to address obesity through environmental or place-based approaches in the past decade. This has challenged the use of the quasi-experimental design for evaluating community interventions. The objective of this study is to describe the development of an index of dose of exposure to community interventions that impact early childhood obesity. The goal is to provide an alternative means for evaluating the impact of multiple intervention strategies that target the same community at the same time. Two workgroups developed domains, constructs and protocols for estimating a "community intervention dose index" (CIDI). Information used to develop the protocol came from multiple sources including databases and reports of major funding organizations on obesity-related interventions implemented in Los Angeles County from 2005 to 2015, key informant interviews, and published literature. The workgroups identified five domains relevant to the consideration of dose of exposure to interventions: physical resources, social resources, context, capacity development, and programs and policies; developed a system for classifying programs and policies into macro- and micro-level intervention strategies; and sought ratings of strategy effectiveness from a panel of 13 experts using the Delphi technique, to develop an algorithm for calculating CIDI that considers intervention strength, reach and fidelity. This CIDI can be estimated for each community and used to evaluate the impact of multiple programs that use a myriad of intervention strategies for addressing a defined health outcome.

After 12 months, Reducing the Risk was unsuccessful at changing sexual behaviors. Other results were mixed, but promising evidence (e.g., behavioral impacts at 1 site, impacts on intermediate outcomes) suggests potential for more widespread behavioral impacts over a longer term.