Background The influence of family members, peers and sexual partners on initiation to injection drug use is well established. Furthermore, research on gender differences in injection initiation has recognized the increased vulnerability of women, in particular, to injection-related health risks, and the gendered nature of the injection initiation experience. Yet more research is needed on the interpersonal and structural dynamics that shape injection initiation within intimate partnerships. Methods This paper draws on narrative data from semi-structured ethnographic interviews with 25, relatively stable, drug-using couples from two New York City neighborhoods. The study was conducted between 2007–2009. Our analyses focus on retrospective accounts of injection initiation from IDUs who were initiated to injection (or initiated their partners) in current or former intimate partnerships. In particular we analyze narratives of injection initiation events where both partners participated as initiates or initiators. Results Transition to injection within intimate partnerships was common, especially for women, and occurred in specific contexts. Structural and interpersonal dynamics, including the ubiquity of drugs in poor communities and the gendered nature of drug acquisition and use strategies, as well as the problem of increased drug tolerance, situational impediments to drug access, and the perceived cost-benefit of injecting, all influenced the process of initiation to injection drug use within couples. The data also suggest that, even when risks associated with injection initiation were understood, both pragmatic and emotional considerations within relationships tended to offset concerns about potential dangers. Conclusion The findings suggest the need for a broad range of interventions (including couples-focused interventions) to minimize rates of injection initiation within intimate partnerships.

Consistency, quality, and duration of sleep are important determinants of health. We describe sleep patterns among demographically defined subgroups from the Youth Risk Behavior Surveillance System reported in 4 successive biennial representative samples of American high school students (2007 to 2013). Across the 4 waves of data collection, 6.2% to 7.7% of females and 8.0% to 9.4% of males reported obtaining 9 or more hours of sleep. Insufficient duration of sleep is pervasive among American high school students. Despite substantive public health implications, intervention research on this topic has received little attention.

Background This article reports on the first web-based implementation of an opioid-overdose prevention, recognition and response training for professional first responders. The training was disseminated nationally over one listserv in November, 2014. The same year, following Act 139, which mandated the provision of an online training for police officers in Pennsylvania, the Pennsylvania Department of Health approved the training. It was subsequently adopted as the primary training tool for police and other first responders in Pennsylvania and has been used as a training tool by first responders nationally. Methods Analyses employed descriptive statistics to report characteristics of a sample of 387 professional first responders who completed a survey about their experience with the online training. Z-ratios were used to compare independent proportions related to overdose, naloxone, and satisfaction with the training between key subgroups, and paired t-tests were used to compare participant responses to a range of items pre- and post-participation in the training. Results Between January – October 2015, 4,804 first responders took the training; 1,697 (35.3%) agreed to be contacted; of these, 387 (22.8%) completed a survey about the training and subsequent overdose response experiences. The majority (86.4%) were from Pennsylvania, with police representing over half of the sample. Analysis of the post-training survey indicates high satisfaction with content, format and mode of delivery, and high satisfaction with items related to confidence and overdose reversal preparedness. Conclusions This study demonstrates the feasibility and acceptability of implementing online training for first responders in overdose prevention, recognition and response.

Background: Many adolescent mothers are parenting young children under highly stressful conditions as they are managing first-time parenthood, poverty, lack of housing, school and work, and challenging peer and familial relationships. Mobile health (mHealth) technology has the potential to intervene at various points in the emotion regulation process of adolescent mothers to provide them support for more adaptive emotional and behavioral regulation in the course of their daily life. Objective: The goal of this study was to examine the acceptability, feasibility, use patterns, and mechanisms by which a mobile technology used as an adjunct to in-person, provider-delivered sessions fostered adolescent mothers’ adaptive emotion regulation strategies under real-life conditions. Methods: Participants (N=49) were enrolled in the intervention condition of a larger pilot study of homeless adolescent mothers living in group-based shelters. The mHealth technology. Calm Mom, consisted of a mobile app and a wrist-worn sensorband for the ambulatory measurement and alerting of increased electrodermal activity (EDA), a physiological measurement of stress. We examined logs of mobile app activity and conducted semistructured qualitative interviews with a subsample (N=10) of participants. Qualitative data analysis was guided by the theoretical frames of the intervention and a technology acceptance model and included an analysis of emerging themes and concepts. Results: Overall, participants indicated that one or more of the elements of Calm Mom supported their ability to effectively regulate their emotions in the course of their daily life in ways that were consonant with the intervention’s theoretical model. For many adolescent mothers, the app became an integral tool for managing stress. Due to technical challenges, fewer participants received sensorband alerts; however, those who received alerts reported high levels of acceptability as the technology helped them to identify their emotions and supported them in engaging in more adaptive behaviors during real-life stressful situations with their children, peers, and family members. Conclusions: Calm Mom is a promising technology for providing theoretically driven behavioral intervention strategies during real-life stressful moments among a highly vulnerable population. Future research efforts will involve addressing technology challenges and refining tailoring algorithms for implementation in larger-scale studies.