Erika Montanaro

Exploring the Relationship of Functional Network Connectivity to Latent Trajectories of Alcohol Use and Risky Sex

Alcohol use is a major risk factor associated with unprotected sexual behavior, leading to higher risk of sexually transmitted infections (STI) including the human immunodeficiency virus (HIV). Emerging largely cross-sectional data suggest functional network connectivity strength is associated with problematic alcohol use, and as evidence supports a relationship between risky sexual behaviors and alcohol use, we hypothesized that functional connectivity might be associated with both categories of risk behavior. As part of a sexual risk reduction intervention study, juvenile justice-involved adolescents (N = 239) underwent a baseline functional magnetic resonance imaging scan and completed questionnaires about their alcohol use and risky sexual behavior at 3-month intervals over 12 months of follow up. To test both cross-sectional and longitudinal relationships between alcohol use and sexual risk behaviors, we estimated a parallel process latent growth model that simultaneously modeled the trajectories of alcohol use and sexual risk behavior. Functional connectivity strength was included as an exogenous variable to evaluate its relationship with level of risk and change in risk over time in both behaviors. Associations were found between baseline alcohol use and risky sex, and between longitudinal trajectories of alcohol use and risky sex. Network functional connectivity strength of the dorsal default mode network was associated with initial and longitudinal alcohol use, which may suggest that self-awareness of the effects of alcohol could serve as a useful target to decrease subsequent risky sexual behavior in adolescence.

Using Videogame Apps to Assess Gains in Adolescents' Substance Use Knowledge: New Opportunities for Evaluating Intervention Exposure and Content Mastery.

Background Videogame interventions are becoming increasingly popular as a means to engage people in behavioral interventions; however, strategies for examining data from such interventions have not been developed. Objective The objective of this study was to describe how a technology-based intervention can yield meaningful, objective evidence of intervention exposure within a behavioral intervention. This study demonstrates the analysis of automatic log files, created by software from a videogame intervention, that catalog game play and, as proof of concept, the association of these data with changes in substance use knowledge as documented with standardized assessments. Methods We analyzed 3- and 6-month follow-up data from 166 participants enrolled in a randomized controlled trial evaluating a videogame intervention, PlayForward: Elm City Stories (PlayForward). PlayForward is a videogame developed as a risk reduction and prevention program targeting HIV risk behaviors (substance use and sex) in young minority adolescents. Log files were analyzed to extract the total amount of time spent playing the videogame intervention and the total number of game levels completed and beaten by each player. Results Completing and beating more of the game levels, and not total game play time, was related to higher substance use knowledge scores at the 3- (P=.001) and 6-month (P=.001) follow-ups. Conclusions Our findings highlight the potential contributions a videogame intervention can make to the study of health behavior change. Specifically, the use of objective data collected during game play can address challenges in traditional human-delivered behavioral interventions. Trial Registration Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6cV9fxsOg)

Measurement invariance of alcohol instruments with Hispanic youth

INTRODUCTION Despite their widespread use across clinical and research settings, no study has yet investigated the fit of several standard alcohol measures for Hispanic youth, including those used to assess motivation to change, self-efficacy, peer norms, and problem drinking. This study thus served to address this gap by evaluating measurement invariance with substance-using youth. METHODS We enrolled a large sample of regular substance-using youth who were involved with the justice system (N=368; 72.9% male; 76.9% Hispanic; M age=16.17years). Similar to the broader Hispanic population of the southwest United States (U.S.), Hispanic youth in the sample were on average 3.5th generation (with at least 1 foreign-born grand-parent). Following standard administration and scoring procedures, all youth completed measures of motivation to change (e.g., readiness rulers, intentions to change), self-efficacy (e.g., drink refusal in social situations), peer norms (e.g., peer norms for substance use), and problem drinking (e.g., substance use quantity/frequency; Alcohol Use Disorders Identification Test; Rutgers Alcohol Problems Index; Timeline FollowBack). Measurement equivalence was evaluated via multiple group confirmatory factor analysis. RESULTS Our results indicated that each measure evaluated herein worked equally well for Hispanic and Caucasian youth. We found measurement invariance at every level tested. CONCLUSIONS This study supports the validity and future use of these important and widely-used alcohol use measures for high-risk substance-using Hispanic youth. Further, given the representativeness of this sample within the southwestern U.S., these results show promise for generalizability to U.S.-born Hispanic youth within this geographic region.

What Works? An Empirical Perspective on How to Retain Youth in Longitudinal Human Immunodeficiency Virus (HIV) and Substance Risk Reduction Studies

BACKGROUND Low retention rates are a problem for longitudinal studies involving adolescents, and this is particularly true for justice-involved youth. METHODS This study evaluates (1) strategies used to retain high-risk adolescents participating in a longitudinal research project; (2) the extent to which retention efforts were different in a justice-involved versus a non-justice-involved (school-based) sample; and (3) differential characteristics of justice-involved versus school-based adolescents that might explain differences in retention difficulty. RESULTS Compared with the school-based youth, justice-involved youth required significantly more phone calls to be successfully reached. Additionally, baseline substance use (alcohol and marijuana use frequency) was higher in the justice-involved sample and significantly related to retention difficulty. CONCLUSIONS High retention rates for justice-involved and substance-using youth are possible with focused efforts on frequent communication and effortful contact.

An event-level examination of successful condom negotiation strategies among young women

This study examines the effect of condom negotiation strategies on condom use and partner type and substance use before sex as moderators of strategy effectiveness. Women reported their daily sexual behavior during the last month. Withholding sex was more strongly associated with condom use when utilized with a non-casual sex partner. Directly requesting condom use was more strongly and using deceptive reasons to influence condom use was less strongly related to condom use during substance use. Results underscore the importance of understanding the contexts in which condom negotiation strategies are successful in order to improve HIV/sexually transmitted infection prevention efforts among women.