Research Spotlight

Adolescent Health Evidence Synthesis
Mental Health
Aging & Gerontology Global Health
Maternal & Child Health
Cancer Health Disparities & Culture
Physical Activity & Obesity
Drugs & Alcohol Healthcare Policy
Environmental Health  HIV/AIDS

Lending a Helping Hand: The DEKA Arm Reduces Perceived Disability in Prosthesis Users

As the availability of and consumer demand for more advanced and expensive upper limb prosthetic devices increases, so does the need for studies that compare the effectiveness of these devices. The DEKA Arm, also known as the Luke Arm, is an example of a new technologically advanced upper limb prosthesis. Although the technological capabilities of the DEKA Arm promise increase functionality, limited research has compared functional abilities with the DEKA Arm to function with conventional prostheses and no studies have compared outcomes such as quality of life and community integration. This study, published by PLoS One and led by Linda Resnik, professor of health services, policy, and practice, sought to 1) compare self-reported function, dexterity, activity performance, quality of life and community integration of the Gen 3 DEKA Arm to conventional prostheses; and 2) examine differences in outcomes by conventional prosthesis type, terminal device type and by DEKA Arm configuration level. READ MORE

College Students’ Heaviest Drinking Occasions are Influenced by their Peers

This study, published in Addictive Behaviors and conducted by lead author Matthew K. Meisel, assistant professor of behavioral and social sciences, aimed to 1) describe the network of members who are present in the drinking occasions of their peers, and 2) examine the relationship between participants’ position in the network of heavy drinking day ties and the total number of drinks consumed on their maximum drinking day. The authors sought to describe the network ties that link together high-risk drinking occasions to help better inform interventions that account for the social influence of peers. READ MORE

A Multi-level Intervention in Worksites to Increase Fruit and Vegetable Access and Intake

Fruit and vegetable consumption is an important contributor to chronic disease prevention. However, most Americans do not eat adequate amounts. The worksite is an advantageous setting to reach large, diverse segments of the population with interventions to increase fruit and vegetable intake, but research gaps exist. No studies have evaluated the implementation of mobile produce markets at worksites nor compared the effectiveness of such markets with or without nutrition education.  This paper, led by Patricia Risica, associate professor of behavioral and social sciences, and published in Contemporary Clinical Trials, describes the protocol for Good to Go, a cluster randomized trial to evaluate fruit and vegetable intake change in employees from worksites randomized into three experimental arms. The Good to Go program was initiated by Professor Kim Gans in 2009, aimed at increasing fruit and vegetable consumption.  READ MORE

Nativity Disparities in HPV Vaccination among US Adults

Several studies have identified disparities in human papillomavirus (HPV)-related outcomes by nativity status (i.e., U.S.- versus foreign-born). However, few studies have explored whether vaccination differences exist by nativity status. Vaccination disparities have the potential to exacerbate HPV-related cancer disparities in the long term if left unaddressed. This study, led by Ashley PerezScM ’17, behavioral and social health sciences alumna, and published in the American Journal of Preventive Medicine, investigated whether there were significant differences in HPV vaccination initiation and completion between U.S.-born and foreign-born men and women. READ MORE

HIV Testing among Men Who Have Sex with Men in the Northeastern US

This study, headed by Tyler Wray, assistant professor of behavioral and social sciences, and published in Aids and Behavior, examined rates and predictors of having tested for HIV within CDC-recommended intervals among MSM in the northeastern U.S. who were recruited from several online sources. Researchers explored whether certain demographic and behavioral factors were associated with having tested within at least the minimum recommended interval of 12 months, as well as those that were associated with having tested at the more optimal recommended interval of every six months. READ MORE

MSM at Highest Risk for HIV Express Greater Preference for Injectable Antiretroviral PrEP Compared to Daily, Oral Medication

Men who have sex with men (MSM) account for nearly 70% of new HIV diagnoses, with young black MSM at the highest risk for infection in the US. Pre-exposure prophylaxis (PrEP) can decrease HIV acquisition in at-risk individuals by over 90%. However, therapeutic efficacy requires a daily pill, posing adherence challenges. Experimental modalities, including injectable PrEP given once every two months, may improve adherence among those most in need. This study, published by AIDS and Behavior, and spearheaded by lead author Katie Biello, assistant professor of behavioral and social sciences and epidemiology, aimed to assess differences in interest in and preference for oral versus injectable PrEP, and reasons for not being interested in injectable PrEP, among a national sample of MSM in the U.S. READ MORE

Conditional Economic Incentives Reduce Sexually Transmitted Infection Risks in Mexico

Conditional economic incentives (CEIs), previously used for poverty alleviation and economic development, are now being utilized as an intervention strategy specifically targeted to people who are highly vulnerable to HIV and other sexually transmitted infections. CEIs involve reinforcing positive behavioral change through using cash or other material incentives in exchange for meeting specific behavioral goals or conditions. There is growing evidence from numerous studies that suggests CEIs can reduce HIV/STI risks, however researchers have not yet investigated whether incentives are a feasible and acceptable intervention strategy for men who have sex with men, a key population at risk for HIV and Sexually Transmitted Infections. This study, led by Omar Galarraga and published in AIDS and Behavior, associate professor of health services, policy, and practice, tested the feasibility and acceptability of a conditional economic incentive intervention for male sex workers in Mexico City. READ MORE

Positive Incidental Affect and Exercising Are Reciprocally Influential during the Course of a Day

Previous research suggests that how people feel throughout the course of a day (i.e. incidental affect) is predictive of exercise behaviour. Essentially, a mostly separate literature suggests that exercise can lead to more positive incidental affect. This study was conducted by three researchers in the department of behavioral and social sciences: Jessica Emerson, current doctoral student; Shira Dunsiger, assistant professor; and David Williams, associate professor. The study, published in Psychological Health, examined the potential reciprocal effects of incidental affect and exercise behaviour within the same day. READ MORE

Hospital Readmissions for Severe Dysglycemia, Its Potential Predictors, and the Impact of Severe Hypoglycemic and Hyperglycemic Events

Andrew Zullo, assistant professor of health services, policy, and practice, published a commentary in the Journal of General Internal Medicineon a recently published retrospective cohort study by McCoy et al. (2017). This study utilized administrative data from commercially insured and Medicare Advantage beneficiaries with diabetes to describe the relative frequency of hospital readmissions for severe dysglycemia (hypoglycemia and hyperglycemia) and other causes. It also examined potential predictors of such events. READ MORE

Inquiry on Telephone-Delivered Mindfulness Training for People Living with HIV

For people living with HIV and AIDS (PLWHA), life stress often undermines quality of life and interferes with medical care. Stress management interventions seek to help PLWHA to cope more adaptively with life stressors. Recently, mindfulness-based interventions have been implemented in the context of chronic illness. Mindfulness training (MT) involves teaching people to focus their attention on both internal (e.g., sensations, thoughts, emotions), and external (e.g., sounds) events unfolding in the present, in a non-judgmental way. Overall, extant studies of MT in the context of HIV disease have been limited methodologically by small sample sizes, low numbers of female participants, non-random assignment, inadequate comparison conditions, and relatively short follow-ups. Given these challenges, researchers were interested in exploring the adaptation of MT to the unique needs of PLWHA. This study, authored by Rochelle K. Rosen, assistant professor of behavioral and social sciences, sought to explore telephone delivery as a potentially more feasible approach for MT. READ MORE

Partner Notification for Youth Living with HIV in 14 Cities in the United States

Nearly one in four youth living with HIV in the U.S. don’t notify sex or drug-use partners about potential HIV exposure - despite medical professionals and others urging them to do so, a study of teens and young adults by Jacob van den BergAssistant Professor of Behavioral and Social Sciences, suggests. This high-risk population continues to contract HIV at alarming rates, so identifying individuals unaware of their infection is imperative to prevent further transmission, as well as to link and retain patients into medical care, the study team writes in the Journal of Acquired Immune Deficiency Syndrome. READ MORE

New Website Provides Drug Overdose Surveillance Information and Resources in Rhode Island

The drug overdose epidemic is a national crisis that continues to grow. In Rhode Island, the state with the 5th highest rate of drug overdose deaths in 2015, half of all overdose deaths involved fentanyl and fentanyl analogs. In response to this crisis, Rhode Island’s governor established the Overdose Prevention and Intervention Task Force in 2015. The task force set out to draft a strategic plan to reduce overdose deaths in Rhode Island by one-third in three years. A key component of this strategic plan was the development of a publicly visible, online “dashboard” to communicate overdose-related data, promote transparency, and track progress towards reaching the plan’s goals. As a result, the interactive, publicly available, data-focused website, was established in June 2016.  This project, authored by Brandon D. L. Marshall, associate professor of epidemiology, primarily sought to create a public website using timely public health surveillance information about the overdose epidemic in Rhode Island.  READ MORE

Studying a music program for nursing home residents with dementia

With a new grant from the National Institute on Aging, researchers plan to conduct a randomized trial of whether a nursing home program that involves listening to a personalized music playlist can improve care and outcomes among residents with dementia. “While MUSIC & MEMORY has been introduced to many residents with dementia living in nursing homes over the past few years, there is little systematic data on how the program is implemented nor on how it affects the behavior of the population of nursing home residents with dementia,” said Vincent Mor, professor of health services, policy and practice at Brown’s School of Public Health and principal investigator on the grant of up to $3.7 million over five years. “Our study will remedy this by systematically documenting how well the program is able to positively affect the lives of people who are exposed.” READ MORE

Video Conferencing is an Effective Way to Administer Brief Motivational Interventions to Patients

This study, led by Mark Celio, assistant professor of behavioral and social sciences, and published in Addiction and Research Theorysought to examine the acceptability and logical feasibility of utilizing video-conference technology to deliver motivational interventions targeting emergency department patients with heavy drinking and risky sexual behavior as an alternative to in-person sessions. READ MORE

Discrepancies Exist Between Personal and Perceived Approval of Intoxicated Behaviors

This study, authored by recent Behavioral and Social Health Sciences masters graduate Ashley Lowery, and published in Addictive Behaviorssought to examine self-other differences or SODs, for college students’ ratings of the approval of intoxicated behaviors. The authors had two primary objectives: (1) to determine if significant differences exist between students’ personal approval and perceived approval of student peers in regards to intoxicated behaviors, and (2) to identify demographic factors associated with SODs. READ MORE

Simulation shows the high cost of dementia, especially for families

A new simulation by Eric Jutkowitz, an assistant professor of health services, policy and practice, of how the costs and the course of the dementia epidemic affect U.S. families finds that neurodegenerative conditions can more than double the health care expenditures of aging and that the vast majority of that financial burden remains with families rather than government insurance programs. READ MORE

What to expect: the FDA’s plan to limit nicotine in cigarettes

When the U.S. Food and Drug Administration announced on July 28 a new push to substantially reduce and limit the amount of nicotine in cigarettes, the policy was informed by an evidence base developed with critical contributions from Brown University’s Center for Alcohol and Addiction Studies (CAAS) in the School of Public Health.

For years, a group of faculty members, postdoctoral researchers and students has been studying many dimensions of nicotine reduction, including the impact such a policy might have on smoking behavior in general and on specific populations of smokers, some of whom might face unintended consequences. Among those researchers is Jennifer Tidey, a professor of psychiatry and human behavior and of behavioral and social sciences, who co-authored a particularly influential paper in the New England Journal of Medicine in 2015. READ MORE

High-dose Flu Vaccine Reduces Hospital Visits for Nursing Home Residents

Lead author Dr. Stefan Gravenstein, a professor at both the Warren Alpert Medical School and the School of Public Health at Brown University, said that while a prior study showed that older individuals could respond better to the high-dose vaccine, that study focused on relatively healthy older adults.

“It still needed to be established that it would help even the frailest folks, like those who reside in nursing homes,” Gravenstein said. “In our study, a quarter of the sample was over 90. So we asked if the high-dose vaccine also would work better than regular-dose vaccine in the population we consider least able to respond. This paper says yes, it can.” READ MORE

Injection Drug Use and Overdose among Young Adults Who Use Prescription Opioids Non-Medically

Non-medical prescription opioid (NMPO) use is a critical public health problem in the United States, with 2.1 million new initiates annually. Young adut NMPO users are at high risk for initiating injection drug use. This study, supported by the US National Institute on Drug Abuse and published in Addictive Behaviors, was led by Elliott Liebling, MPH'17. The study aimed to assess sociodemographic, structural, childhood, and drug-related correlates of lifetime injection drug use among young adults who use prescription opioids non-medically in Rhode Island, a state heavily impacted by opioid overdose. READ MORE

First Study of an Online Alcohol Prevention Program for College Students Living off Campus

Students living in off-campus housing consume more alcohol and experience more alcohol-related consequences than those living on campus, yet prevention efforts have not targeted this high-risk group specifically. This study, supported by the NIAAA and published in The Journal of Studies on Alcohol and Drugs, was led by Kate Carey, professor of behavioral and social sciences. The study evaluated the efficacy of a brief, computer-delivered, alcohol intervention (the College Drinkers Check-Up) in reducing alcohol use and related consequences in a sample of college students living off campus. READ MORE

Unconditional Government Cash Transfers in Support of Orphaned and Vulnerable Adolescents in Western Kenya: Is there an Association with Psychological Well-being?

Sub-Saharan Africa is home to approximately 53.6 million orphaned children, a majority of whom live in extreme poverty, often with relatives or guardians of limited means, and in households with many other dependent children. Children who live in poor households often do not have access to basic necessities such as shelter, food, clean water, health care, and education. To address poverty and its adverse child health and developmental consequences, economic incentives are increasingly used in African countries.  This study, supported by grants from the NIH Fogarty International Center and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and led by Sylvia Shangani, doctoral candidate in behavioral and social health sciences, assessed the association between living in a household that received monthly unconditional government CTs and psychological wellbeing. READ MORE

Insomnia Severity Impacts Symptoms of Depression and PTSD on Alcohol Use and Related Consequences in Veterans

Excessive alcohol consumption is one of largest barriers to physical and mental health in the U.S. It is especially concerning among military personnel. Heavy-drinking service report higher levels of general stress, anxiety, depression, posttraumatic stress, and suicidal ideation than their lower-drinking counterparts. This study, led by Mary Beth Miller, adjunct assistant professor of behavioral and social sciences (research), and published in Drug and Alcohol Dependencefound that approximately half of the participants reported clinically significant symptoms of insomnia and depression, and more than a third met screening criteria on a self-report measure of PTSD. The prevalence of these mental health issues and their respective influences on alcohol-related outcomes indicate a need to prevent and treat these problems in young adults who have been discharged from military service.  READ MORE

Parent-adolescent Relationship Factors Have a Larger Influence on Age of Alcohol and Marijuana Onset for Hispanics than for Caucasians

This study, published in Addictive Behaviors, was funded by NIAA grants for which Kristina Jackson, professor of behavioral and social sciences (research), served as principal investigator. It examined whether ethnicity moderated the effect of parental relationships on the onset of alcohol and marijuana use. Study authors hypothesized that protective effects of positive parental relationship factors (for both paternal and maternal figures) would be stronger for Hispanics as compared to Caucasians. They also hypothesized that negative effects of parental relationship factors (for both paternal and maternal figures) would be reduced for Hispanics as compared to Caucasians. READ MORE

HIV patients sticking with therapy longer, Medicaid data show

A large study based on Medicaid data identifies a clear trend of people staying on their HIV medications longer than they used to. “This represents a lot of people who are not dying and not infecting others,” said Dr. Ira Wilson, corresponding author of the new study in AIDS and chair of the department of Health Services Policy and Practice.  “These differences represent tremendous, very real benefit.” READ MORE

Study casts doubt about link between eczema, cardiovascular disease

Despite mixed evidence recently about an association between atopic dermatitis and cardiovascular disease, a new study that analyzed more than 250,000 medical records suggests there is no link.  The study, led by Dr. Aaron Drucker, ScM '17, assistant professor of dermatology at the Warren Alpert Medical School,  appears in the British Journal of Dermatology. READ MORE

Naltrexone Does Not Improve Smoking Cessation Outcomes for Heavy Drinking Smokers

Alcohol use is positively associated with smoking initiation and escalation to regular cigarette use, and is among the most common smoking relapse precipitants. In the past, smoking cessation interventions that have incorporated counseling to reduce drinking have shown some success. An intriguing possibility for enhancing the effectiveness of such interventions is adding pharmacotherapies that impact alcohol use, such as naltrexone. The results of this study, led by Christopher Kahler, professor of behavioral and social sciences, and published in Alcohol: Clinical and Experimental Research, indicate that a smoking cessation intervention that includes counseling on alcohol use can have positive effects for heavy drinking smokers. However, this study provided no evidence that naltrexone is effective for enhancing reductions in drinking or improving smoking cessation in this population. READ MORE

Review of Neighborhood Environments and Sexual Risk Behaviors for HIV Infection in U.S. Women

The associations between neighborhood environments and HIV sexual risk behaviors among U.S. women are mixed, according to a new review led by Chanelle Howe, Assistant Professor of Epidemiology, and published in AIDS and Behavior. READ MORE

Organophosphate Flame Retardant Metabolites among Pregnant Women in Rhode Island

Consumer products are often treated with chemical flame retardants. Following the 2004 phase out of specific mixtures of flame retardants due to health concerns, organophosphate flame retardants have been increasingly used in consumer products including residential furniture and baby products. Data on both human exposure to these chemicals and associated potential adverse health outcomes is still limited, particularly during the sensitive window of pregnancy. The purpose of this study, led by Megan Romano, Adjunct Assistant Professor of Epidemiology, and published in Environmental Health, was to assess the concentrations of nine urinary metabolites of organophosphate flame retardant among pregnant women in Rhode Island and the associations of these urinary metabolites with sociodemographic and dietary predictors. READ MORE

The Effects of a Brief, Parent-focused Intervention for Substance Abuse

By the time teens reach the 12th grade, 46.7 percent report having been drunk and 44.7 percent report cannabis use. Youth who initiate alcohol and other drug use early in adolescence are more likely to develop substance abuse diagnoses, and drinking to intoxication is highly associated with high-risk sexual behavior, high deviance, young adult arrests, and low educational attainment. Adolescent alcohol and other drug use can be directly and indirectly influenced by parental modelling, punishment for experimentation, and advice about peer selection. The purpose of this study, published in Journal of Substance Abuse Treatment, and led by Anthony Spirito and Lynn Hernandez, faculty members in the Center for Alcohol and Addiction Studies, was to evaluate the efficacy of Family Check-up, a parent-focused brief motivational intervention, in families where parents were concerned about one adolescent’s alcohol or marijuana use and the referred adolescent also had a sibling close in age. READ MORE

Dietary Carbohydrates Intake Related to Cardiovascular Disease Risk Factor

Diets characterized by low glycemic load, low sugar, and higher fiber content may be associated with higher serum sex hormone-binding globulin (SHBG) levels in postmenopausal women, according to a new study led by graduate student Menga Huang and Simin Liu, Professor of Epidemiology. The results of this study, published in the Journal of Diabetes, suggest that low glycemic load/index diets with low sugar and high fiber content are associated with higher circulating levels of SHBG in this population, which may reduce the risk of a variety of adverse health outcomes. READ MORE

Innovative, Technology-Assisted Intervention for Parents of Adolescents in Substance Abuse Treatment

According to the National Survey of Substance Abuse Treatment Services, there are 3450 residential substance use treatment facilities in the Us and 10.3% of all adolescents who seek treatment for substance use disorder (SUD) will receive treatment in this setting. Adolescents in residential SUD treatment are also at extremely high risk of relapse, with follow-up studies suggesting that 60% of adolescents discharged from residential SUD facilities will relapse within 90 days. Parents have been established as a critical influence on adolescents’ initiation and maintenance of substance abuse, as well as their substance use outcomes and likelihood of relapse following treatment. Two parenting processes that appear to be particularly important protective factors against adolescent SUDs are monitoring and supervision, and communication with the adolescent. However, parents of adolescents with SUDs have traditionally been difficult to engage in behavioral treatments. The purpose of this study, published in Addiction Science & Clinical Practice and led by Sara Becker, Assistant Professor of Behavioral and Social Sciences, was to adapt and evaluate a technology-assisted intervention for parents of adolescents in residential SUD treatment.  READ MORE

Contingency Management for Alcohol Use Reduction Using a Transdermal Alcohol Sensor

Contingency management is among the more effective strategies for promoting abstinence in the treatment of substance use disorders. Contingency management programs are designed to reinforce target behaviors (e.g., a negative urine drug screen) by delivering a tangible reward when the target behavior occurs, and withholding the reward when the target behavior does not occur. Historically, the application of contingency management to the treatment of alcohol use disorders has been limited by reliance on breath alcohol tests as the primary measure of alcohol use. Given the short half-life of breath alcohol, breath alcohol tests will not detect drinking beyond a relatively brief period. One approach that can address the limitations of other objective measures of recent alcohol use is transdermal alcohol monitoring, which provides a continuous measure of alcohol excreted through the skin. The purpose of this study, published in Addictionled by Nancy Barnett, professor of behavioral and social sciences, was to test the efficacy of daily contingent reinforcement for reducing alcohol use using a transdermal alcohol sensor to detect alcohol use. READ MORE

Longitudinal Study of Persistent Smoking among HIV-Positive Gay and Bisexual Men

Tobacco use continues to be one of the leading causes of preventable morbidity and premature mortality and is a well-recognized risk factor for chronic diseases including cardiovascular disease, pulmonary disease, and cancer. In HIV-positive gay, bisexual, and other men who have sex with men, smoking is a highly prevalent behavior that, in addition to more general adverse outcomes, has been linked to an increased likelihood of HIV-related medical complications and has been shown to negatively impact immune and virologic response. However, smoking cessation rates among this population remain low. Within couples affected by HIV, primary partners play a positive role in HIV-related outcomes. The purpose of this study, published in Addictive Behaviors and led by Kristi Gamarel, Assistant Professor of Behavioral and Social Sciences, was to longitudinally assess smoking status in a population of HIV-positive men in same-sex relationships, and the impact of partner smoking status. READ MORE

Innovative Methodology to Identify Medicare Beneficiaries Residing in Large Assisted Living Facilities

The purpose of this study, published in Medical Care, and led by Kali Thomas, Assistant Professor of Health Services, Policy and Practice, and faculty member in the Center for Gerontology and Healthcare Research, was to develop and test a novel methodology to identify residents in large assisted living facilities using secondary data sources, specifically the 9-digit ZIP code reported in Medicare enrollment records. READ MORE

Epigenetic Mediators between Socioeconomic Disadvantage and Mid-Life Body Mass Index

The purpose of this study, published in Psychosomatic Medicine and led by Eric Loucks, assistant professor of epidemiology, was to evaluate whether associations of childhood socioeconomic disadvantage and adult body mass index are mediated by DNA methylation, an epigenetic mechanism. Participants for this study were 141 men and women from the New England Family Study, who were prospectively followed prenatally though a mean age of 47 years. read more

The Exercise-affect-adherence Pathway

A paper published in Frontiers in Psychology and led by Harold Lee, a doctoral student in the Department of Behavioral and Social Sciences, examined the exercise-affect-adherence relationship from an evolutionary perspective. The authors argue that low rates of physical exercise in the general population are a function of the evolved human tendency to avoid unnecessary physical exertion. read more