Purpose: To understand the contextual and psychosocial factors associated with youth vaping in Colorado, the state with the highest youth vaping rates in 2019, and to propose strategies for prevention interventions. Design: Focus groups. Setting: In-person. Participants: 24 youth aged 11-17, including youth who had vaped (n = 11) and who had never vaped (n = 13). Method: Qualitative responses using a semi-structured focus group guide were analyzed using a matrix approach with a mixed deductive/inductive content analysis. Results: Analysis revealed the highly social nature of vaping initiation and use; the use of vaping to control negative emotions; and the acquisition of vaping products through retail outlets, friends, family, and other youth who sell a variety of substances and devices to youth. Youth provided insight into how vaping is concealed from parents and teachers, and their attitudes about the health risks and benefits of vaping. Conclusion: When considered with other studies, our findings suggest a universality in the youth vaping experience that is highly social. Interventions should include peer-to-peer messaging with an emphasis on changing social norms and highlighting undesirable outcomes of vaping such as negative reactions by friends and close adults, adverse effects on athletic success and future aspirations, expense, addiction, and punishment. Parent education is also recommended. Rigorous research is needed to test interventions to reverse the growing trend of youth vaping.

Background: The left ventricular assist device (LVAD) has become a common medical option for patients with end-stage heart failure. Although patients’ chances of survival may increase with an LVAD compared with medical therapy, the LVAD poses many risks and requires major lifestyle changes, thus making it a complex medical decision. Our prior work found that a decision aid for LVADs significantly increased decision quality for both patients and caregivers and was successfully implemented at 6 LVAD programs. Methods: In follow-up, we are conducting a nationwide dissemination and implementation project, with the goal of implementing the decision aid at as many of the 176 LVAD programs in the United States as possible. Guided by the Theory of Diffusion of Innovations, the project consists of 4 phases: (1) building a network; (2) promoting adoption; (3) supporting implementation; and (4) encouraging maintenance. Developing an LVAD network of contacts occurs by using a national baseline survey of LVAD clinicians, existing professional relationships, and an internet-based strategy. A suite of resources targeted to promote adoption and support implementation of the decision aid into standard LVAD education processes are provided to the network. Evaluation is guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework, where clinician and patient surveys and qualitative interviews determine the reach, effectiveness, adoption, implementation, and maintenance achieved. Conclusions: This project is a true dissemination study in that it targets the entire population of LVAD programs in the United States and is unique in its use of social marketing principles to promote adoption and implementation. The implementation plan is intended to serve as a test case and model for dissemination and implementation of other evidence-based decision support aids and strategies.

Puritans Behaving Badly - by Monica D. Fitzgerald May 2020

(1) Background: This study aimed to examine adult participants perceptions of the Thiwáhe Gluwáš’akapi (TG) program. We recruited 13 of 85 (15.3%) adult participants from various previous cohorts of the TG program, separated into lower and higher participation groups. Qualitative semi-structured interviews were conducted. This study was conducted on a Northern Plains reservation, and interviews took place via phone. (2) Methods: Semi-structured interviews with 13 adult participants with children aged 10–12 were completed. Audio files were transcribed and analyzed with ATLAS.ti. (3) Results: Qualitative analysis of these interviews revealed several themes: positive reception by families, enhanced connections to Lakota culture and community, and improved familial relationships. Several barriers to participation emerged, such as difficulties with transportation, scheduling conflicts, and lack of time, which can inform implementation strategies. Observed themes showcase positive impacts of TG on parent–child relationships and cultural connection, aiding overall wellbeing and substance use discourse. (4) Conclusions: Participants in the TG program expressed high satisfaction with the program, gained new skills, and improved family dynamics. Future implementation of TG should include additional transportation support and session scheduling options, in addition to updated implementation strategies to further improve Lakota families’ mental health and wellbeing.