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Exploring Tobacco and E-Cigarette Use among Queer Adults during the Early Days of the COVID-19 Pandemic

Valera, P., Owens, M., Malarkey, S., & Acuna, N. (2021). Exploring tobacco and e-cigarette use among queer adults during the early days of the COVID-19 pandemic. Int J Environ Res Public Health,18, 12919. doi: 10.3390/ijerph182412919.

Abstract: The purpose of this narrative study is to describe the vaping and smoking characteristics of Queer people ages 18–34 before March of 2020 and to better understand how the COVID-19 pandemic as impacted those behaviors since March of 2020. In total, 31 participants were screened. Thirteen participants were screened prior to the emergence of COVID-19, and 18 were screened when study protocols transitioned to a remote setting (pre and during). Of the 27 eligible participants, a total of 25 participants completed the study. Most participants (n = 13) self-identified as male, followed by five identified as female, four self-identified as gender non-binary, and three identified as transgender. The most common sexual orientation amongst participants was gay (n = 10), with bisexual being the second-most reported. Approximately 20 Queer participants reported using cigarettes, 14 participants self-reported using electronic devices, and 11 reported using hookah. Twenty participants reported smoking ten or less, and four self-reported using 11–20 cigarettes per day. Approximately, 92% of participants (n = 23) indicate that they are using an e-cigarette and regular cigarettes, and 57% of participants (n = 12) report using one pod or cartridge per day. The three themes that emerged in this study are: (1) Queer people during COVID-19 are experiencing heightened minority stress; (2) Queer people are unfamiliar with smoking cessation; and (3) vaping and smoking are attributed to stress and anxiety. Queer participants are likely to be dual users of cigarette and vaping products. This present study provides increasing evidence that Queer people are experiencing heightened stress and anxiety and using cigarette smoking and vaping to cope during the COVID-19 pandemic.

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Lewis, K., Cunningham, D., & Valera, P. (2024). Marketing strategies used by tobacco companies targeting the queer community. Tobacco Use Insights,17. doi:10.1177/1179173X241265743

Abstract

Background: This study described the marketing strategies tobacco companies use to advertise tobacco products to the Queer community. Methods: In this secondary qualitative analysis, 15 Queer participants were interviewed to explore their life experiences with tobacco product advertisements during the early days of the COVID-19 pandemic. Results: Participants self-reported as male (n = 5), followed by female (n = 4), gender non-binary (n = 4) and, transgender (n = 2). In addition, most participants identified as Black/African American (n = 7) or White (n = 7). Many participants identified as Bisexual (n = 5) or Queer (n = 4). Using narrative analysis, the themes for this study were: (1) tobacco and vaping companies target minoritized and Queer people; (2) tobacco and vape companies maintain their presence by sponsoring local Lesbian, gay, bisexual, transgender, questioning, intersex, asexual, and other community (LGBTQIA+) bars and Pride events, often through giveaways and coupons; and (3) the use of social media influencers represents a new social marketing technique. As a result, Queer participants were more likely to encounter many different types of advertisements from tobacco companies and, most recently, social media influencers. Conclusion: Social media influencers are a new factor that needs further study to understand the new tobacco advertising landscape.

Valera, P., Malarkey, S., Smith, N., & McLaughlin, C. (2024). Exploring the role of telehealth: A novel approach to group-based smoking cessation treatment for men incarcerated in a rural state prison. Journal of Telemedicine and Telecare, 30, 42-150. doi:10.1177/1357633X211034734

Abstract

Introduction. Tobacco smoking remains an important public health issue in the United States (US), specifically among people who are incarcerated. There is little to no information about smoking behaviors of incarcerated people in rural areas and there is a lack of resources for smoking cessation interventions in rural settings. Telehealth might be efficient for delivering care to incarcerated people in rural areas. The purpose of this study was to determine the feasibility of delivering group-based smoking cessation treatment via telehealth to incarcerated male smokers in a rural prison. Methods. A 6-week group-based smoking cessation treatment program was conducted with 1-month follow up. Video conferencing was used from Weeks 2–5 to deliver treatment. A cross-sectional survey was administered collecting measures including criminal justice experience, smoking behaviors, withdrawal and triggers, mental health, physical health, and substance use. Baseline exhaled carbon monoxide (CO) levels were collected at Session 1, and a final CO level at Session 6 and 1-month follow-up. Results. Twenty (n = 20) incarcerated male smokers were recruited from a rural prison facility. The majority of the inmates were White (85%). Approximately, 80% of the inmates smoked about 20 or more cigarettes per day, and on average smoked for 28 years (SD = 9). Most inmates scored a moderate or high dependence score on the Fagerström Test for Nicotine Dependence. Conclusion. Telehealth programs such as video conferencing smoking cessation treatment ought to be implemented to reduce tobacco-related disparities among incarcerated smokers housed in rural prisons.

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Valera, P., Malarkey, S., Owens, M., Sinangil, N., Bhakta, S., & Chung, T. (2024). Remote mental health first aid training for correctional officers: A pilot study. Psychological Services, 21(2), 328–336. https://doi.org/10.1037/ser0000860

Abstract

Mental health first aid (MHFA) training is a low-cost, evidence-based intervention that teaches trainees to recognize signs of mental distress. Thirty correctional officers (COs) were recruited to participate in a remote MHFA intervention study. The COs were divided into three MHFA training sessions, with no more than 10 COs per group. Data collection assessments included pretest and posttest surveys and a focus group meeting. Of the 30 eligible CO participants, 27 completed the study, including follow-up assessments. Nine COs participated in a focus group meeting—one third (n = 9) of the CO participants identified as female, and the remaining identified as male. Most CO participant s self-identified as White (n = 17), and two thirds (n = 18) of the CO participants were 35–54 years old. There was a strong military influence, with about close to half (48%) of COs identifying as a veteran. A paired sample t test was used to analyze whether there were any differences in mental health knowledge scores from pre- and postintervention. There were no significant differences between the pre- and postintervention results for the five MHFA knowledge items. The Wilcoxon signed-rank test was used to analyze differences in pre- and postintervention data for mental health referral items. From pre- to posttraining, COs reported that it would be easier to make a mental health referral for someone experiencing a mental health challenge (Z = −2.087, p = .037). At 12 weeks, COs referred 2.6 (SD: 4.30, range 1–20) people incarcerated for mental health services. The reasons for referral included: “suicidal thoughts,” “experiencing anxiety over being incarcerated during COVID,” and “considering self-harm.” A phenomenological approach was used to analyze the focus group meeting. The themes identified were: (a) COs experience with MHFA training was viewed positively (facilitators); (b) there is a need to improve mental wellness in correctional settings (barriers); and (c) mental health referral process for incarcerated individuals needs enhancement when implementing MHFA (barriers). MHFA training for COs is necessary to equip COs with the skills to safely support and refer incarcerated people experiencing a mental health crisis.

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Valera, P., Carmona, D., Singh, V., Malarkey, S., Baquerizo, H., & Smith, N. (2024). Understanding search autocompletes from the perspectives of English and Spanish speakers during the early months of the COVID-19 pandemic. J Community Psychol, 52, 665-683. doi: 10.1002/jcop.23013. 

Abstract
The purpose of the study was to explore differences in Google search autocompletes between English and Spanish-speaking users during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. Twenty-nine individuals who were in areas with shelter-in-place state orders participated in a virtual focus group meeting to understand the algorithm bias of COVID-19 Google autocompletes. The three focus group meetings lasted for 90–120 minutes. A codebook was created and transcripts were coded using NVivo qualitative software with a 95% intercoder reliability between two coders. Thematic analysis was used to analyze the data. Among the 29 participants, six self-identified as White, seven as Black/African American, five as American Indian or Alaska Native, four as Asian Indian, and three as Native Hawaiian or Pacific Islander. In terms of ethnicity, 21 participants identified as Hispanic/Latino. The themes that emerged from the study were: (1) autocompletes evoked fear and stress; (2) skepticism and hesitation towards autocomplete search; (3) familiarity with COVID-19 information impacts outlook on autocomplete search; (4) autocompletes can promote preselection of searches; and (5) lesser choice of autocomplete results for Spanish-speaking searchers. Spanish speakers expressed concerns and hesitation due to social factors and lack of information about COVID-19.

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Potter, D., & Valera, P. (2024). Health Is Power, and Health Is Wealth: Understanding the motivators and barriers of African American/Black Male Immigrants with gastrointestinal conditions. American Journal of Men’s Health, 18(1). doi:10.1177/1557988324122733

Abstract
The digestive health of African American/Black male immigrants in the United States has not been previously studied. Much of what is known about gastrointestinal (GI) concerns in this population is based on studies conducted on the overall Black American population. The purpose of this narrative study was to understand how African American/Black male immigrants with GI concerns navigated their GI condition. Fifteen African American/Black male immigrants from various cities in the United States participated in two remote focus groups to discover what motivates them to take control of their illness. Narrative analysis was used to analyze the qualitative data. Most men, 47% (n = 7), did not have health insurance, and 67% (n = 10) reported their income was less than US$52,000. The themes identified were: (1) lack of knowledge of GI, (2) denial of initial diagnosis, (3) self-discipline, (4) positive provider interactions, (5) health as a priority, and (6) advice to other African American/Black male immigrants experiencing GI. A strengths-based approach is necessary for describing the health-seeking behaviors among African American/Black male immigrants.

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Acevedo, S., Malarkey, S., Baquerizo, H, Lefebre, A., Sackey, J., & Valera P. (2024). Social determinant of health framework to examine the impact of COVID-19 on Latino health. J Racial Ethn Health Disparities,11, 2236-2246. doi: 10.1007/s40615-023-01691-6.

Abstract

Objectives: Evaluated how COVID-19 impacted Latino health across social, economic, and emotional dimensions and differentiated whether adverse COVID-19-related effects persisted across respondents.
Methods: In both English and Spanish, a cross-sectional survey was conducted in the USA from June 2021 to April 2022. Chi-square tests, Z-tests, and T-tests were used to test for significant differences between Spanish- and English-speaking respondents. Multiple linear regressions were carried out to understand whether previously established determinants of health for Latinos accounted for greater COVID-19-related adversity across social, economic, and mental health dimensions. English as a primary language was significantly related to greater adverse emotional/mental health COVID-19 experiences after controlling for other social determinants of health factors (β = – 0.355, p < 0.001). Individuals who reported worrying about housing loss were significantly more likely to experience more adverse economic adversity due to COVID-19 (β = – 0.234, p < 0.001). Household income < $35,000 (β = 0.083, p < 0.05), having more than 5 people living in the same home (β = -0.102, p < 0.05), and work-related transportation barriers (β = – 0.114, p < 0.05) all increased the likelihood of household-related stressors occurring because of the pandemic.
Conclusions: The study highlights the heterogeneity in the Latino community and the key social, economic, and community-level factors most strongly correlated with adverse COVID-19-related outcomes.

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