BACKGROUND: Persons with mental illnesses (MI) who use tobacco are likely to experience poorer physical health and worsened psychiatric symptomology as compared to their non–tobacco-using counterparts. Therefore, engaging them in treatment is an important aspect of evidence-based care. OBJECTIVE: To use the theory of planned behavior to examine factors associated with intentions to provide and the provision of evidence-based tobacco treatment. DESIGN: This study is based on a cross-sectional analysis of survey data from 195 staff at a state psychiatric hospital. Results: When controlling for demographic variables, attitudes, subjective norms, and perceived behavioral control toward providing tobacco treatment were associated with intentions to provide tobacco treatment, but only subjective norms and perceived behavioral control were associated with reported provision of evidence-based tobacco treatment. CONCLUSIONS: Understanding factors that influence provider delivery of tobacco treatment can better determine strategies to reduce the disproportionate tobacco use and related illnesses in behavioral health settings.

Background: Overdose (OD) deaths have continued to rise in the United States posing a critical public health challenge. Various factors have been associated with increased likelihood of OD, including history of injection drug use. Purpose: This study examined multi-level factors associated with non-fatal OD among current people who inject drugs (PWID) in Appalachian Kentucky. Methods: This cross-sectional study utilized data from 324 PWID recruited via Respondent-Driven Sampling techniques in three Appalachian counties. The analysis focused on correlates of overdose history among people who inject drugs (PWID). Findings: Approximately 36.7% of our sample reported having overdosed in their lifetime, with only 21.4% currently having access to a naloxone kit for OD reversal. Respondents who had injected fentanyl alone or in combination with another drug (OR = 4.26, 95% CI= 2.31,7.86) had 4 times higher odds of an OD than those who did not. Our study found those who injected buprenorphine as primary drug (OR = 0.29, 95% CI = 0.10,0.81) had lower odds of OD compared to those who injected heroin. Conclusions/Importance: Given an increase in OD prevalence among PWID in the U.S, and especially among people living in the Appalachian region of Kentucky, assessing factors associated with OD is critical in development of tailored public health interventions to address the disparate rates of non-fatal OD in this vulnerable population.

Black LGBTQ+ adults face significant health disparities stemming from intersecting minority stressors. While community belongingness is often theorized as a protective factor, these communities can also be sites of exclusion, creating a complex dynamic. This study’s objective was to test whether community belongingness moderates the relationship between minority stress, operationalized as microaggressions, and subjective well-being in a national sample of Black LGBTQ+ adults. Data were taken from a national online survey of 345 Black LGBTQ+ adults conducted between November 2020 and January 2021. We used validated scales to measure experiences of microaggressions, subjective well-being, and community belongingness. A moderated multiple regression analysis was conducted using the PROCESS macro to test for an interaction effect, controlling for demographic covariates. Minority stress was significantly negatively associated with well-being (b = −0.11, p = 0.005), while community belongingness was positively associated with well-being (b = 0.43, p < 0.001). A significant interaction emerged (b = −0.01, p = 0.021). Simple slopes analysis revealed that the negative relationship between minority stress and well-being was strongest for individuals with high community belongingness (b = −0.18, p < 0.001) and was not significant for those with low belongingness, potentially indicating an exacerbating effect. Contrary to the buffering hypothesis, community belongingness paradoxically amplified the negative impact of minority stress on well-being. This paradox of belonging suggests that highly connected communities may become sites for trauma bonding, which can amplify distress. Public health efforts must focus not only on fostering connection but on building communities that are resourceful, inclusive, and capable of transforming shared experiences into collective empowerment.

Background: Tobacco-related morbidity and mortality is high among people with mental illnesses (PMI); yet tobacco treatment (TT) is often not provided by mental health care providers (MHPs). Studies that examine barriers to TT for people with MI are critical in addressing this disparity. Aims: To determine factors associated with MHPs’ opinions of, self-efficacy in, barriers to and training needs for providing TT by job role. Methods: 205 MHPs in a psychiatric facility were surveyed using a standardized questionnaire on demographics and opinions, self-efficacy, barriers and needs to providing TT. Descriptive and multivariate regression analyses examined factors associated with the main outcomes. Results: MHP’s gave high ratings to both the appropriateness of delivering evidence-based TT and their confidence in providing TT medications. In regards to perceived barriers to providing TT, MHP’s further endorsed that patients should be provided nicotine replacement therapy and be motivated to engage in TT. Key needs were for training in cessation counseling, cessation materials and community support for TT. Conclusions: Based on our findings, future studies are needed to address providers’ biases and concerns, eliminate system-barriers and determine effective provider training. Moreover, these findings may guide research, practice and policies toward enhancing TT in PMI.