Recovery housing provides critical support for individuals with opioid use disorder (OUD), yet residents who use medications for OUD (MOUD) often face barriers to entry and long-term support. No existing validated instruments currently assess these barriers, which can differ by MOUD type and reflect both attitudinal stigma and logistical capacity within recovery housing settings.

We developed and tested two parallel versions (Operator and Resident) of a novel tool, the Recovery Housing Barriers to Medications for Addiction Treatment (RHB-MAT) measure. Item generation was informed by literature review and structured input from current housing operators and residents, resulting in scales addressing attitudinal barriers (for both operators and residents) and capacity barriers (for operators) and MOUD type (buprenorphine, methadone, naltrexone). Surveys were administered to 145 recovery housing operators and 250 residents across the United States. Exploratory and confirmatory factor analyses were conducted to establish dimensionality. Internal consistency, and convergent, divergent, and concurrent criterion validity were examined using established measures of stigma and related constructs.

Factor analyses supported a multidimensional structure, distinguishing attitudinal barriers across both groups and capacity barriers among operators. Internal consistency across scales was acceptable to strong (α = 0.74-0.92) across all but one subscale. Convergent validity was supported while divergent validity was less consistent. Concurrent criterion validity was generally demonstrated with associations between Operator RHB-MAT scores and their house's unique medication acceptance policies by MOUD type. Overall, residents evidenced higher attitudinal barrier scores than operators.

The RHB-MAT represents the first validated measure of MOUD-related barriers in recovery housing, with tailored versions for both operators and residents. This tool can be used in research, policy, and practical quality improvement efforts to identify and address attitudinal and capacity-related barriers that impede access to evidence-based OUD treatment in recovery residences.

Racial and ethnic inequities persist in medication treatment initiation and adherence for pregnant and postpartum people with opioid use disorder (OUD). Our objective was to understand the experiences of "positive outliers," specifically pregnant and postpartum people of color with OUD who utilized medication treatment and engaged in a randomized clinical trial for buprenorphine despite historical, cultural, and structural barriers.

We conducted two sets of semi-structured qualitative interviews. First, trained peers with lived expertise as mothers in recovery interviewed individuals who identified with a non-white race and/or ethnicity and enrolled in the Medication Treatment for OUD in Expectant Mothers (MOMs) trial (NCT03918850). Second, we interviewed principal investigators, clinicians, and research coordinators from the 13 MOMs trial sites. We used an inductive thematic approach informed by the Social Ecological Model of Racism and Anti-Racism. Transcripts were double-coded and reviewed until consensus was reached. Preliminary findings from participant and staff interviews were merged and triangulated with peers to inform theme development.

We completed 17 interviews with MOMs trial participants from 7 sites. Participants identified as Hispanic (29%), Black non-Hispanic (24%), multi-racial Hispanic (18%), multi-racial non-Hispanic (18%), and American Indian, Native Hawaiian, or Pacific Islander (12%). Thirty-two interviews with trial staff were also completed. Three themes emerged: (1) Although some participants expected racist treatment and research exploitation, all participants interviewed reported non-discriminatory, non-judgmental care within the MOMs trial; (2) Compassionate care, frequent, personalized, and integrated encounters, and emotional support helped counteract prior stigmatizing and discriminatory health care interactions, enabling participants of color to feel particularly supported, trusted, and empowered during the MOMs trial; and (3) Despite pervasive cultural stigma around addiction and concerns about taking an investigational drug while pregnant, participants expressed that pregnancy status, care team trust, and transparent communication with MOMs trial staff encouraged medication utilization and adherence.

Facilitators of successful engagement in the MOMs trial and retention in medication treatment among pregnant and postpartum people of color with OUD included non-judgmental care, sustained trust, and frequent contact. Key perinatal OUD clinical interventions and trial improvements include personalized communication and scheduling flexibility to promote engagement of marginalized populations.

The purpose of this study is to explore ways in which interpersonal mindfulness and other foundations of healing are manifested during the TCM encounter and how they may affect the practitioner-patient relationship and support health equity and quality of life.

US-based TCM practitioners with the following licenses-L.Ac., O.M., C.H.,-were recruited to participate in a 45-min recorded Zoom interview about their professional background, practitioner-patient interactions, and the role mindfulness may play in their professional practice. Using a Grounded Theory approach, research team members engaged in open, axial, and selective group-based coding to create higher-order categories and themes from the original codes. Saturation was documented.

In total, 11 TCM practitioners were interviewed, resulting in 168 unique codes. Saturation was met for 81% of the codes. Axial coding yielded 16 higher-order categories, and four overarching themes: 1) Mindful Healing in TCM, which included the roles of intentional presence, emotional awareness of self and others, body anchored presence, and mindful responding; 2) Essentials of TCM Diagnosis, with emphasis on the patient narrative, body language, practitioner's mental health routine, and therapeutic touch; 3) Bridging Cultural Gaps in Education and Understanding, highlighting TCM's medical integration and modern acceptance and; 4) Practice Motivators & Logistics for practitioners.

This study offers important insights directly from TCM practitioners on the importance they place on creating an empathic and compassionate environment based on trust, awareness, and connection in order for healing to occur. This is consistent with TCM theory, which emphasizes mindful qualities, supporting holistic healing in physical and mental health.

Substance use disorders (SUDs) are highly associated with other mental health conditions and disparities exist across sociodemographic characteristics. We aimed to estimate the incidence of specific SUDs and comorbidities with United States electronic health record data.

We harnessed data from the All of Us Research Program cohort from Jan 1, 2017 to Jun 30, 2022 (N = 266,472). We identified newly documented SUDs after a two-year washout period, along with related mental health diagnoses. Multivariate logistic regression models estimated associations between incident SUDs and comorbidities.

Participants included 160,792 females (60.3%) aged 51.6 years on average [SD= 16.7]. The incidence of any SUD was 4.8%; among these, 74.4% had at least one mental health comorbidity. Alcohol (1.6%) and cannabis use (1.6%) disorders were the most common. Individuals with newly documented SUDs (vs. non-SUD) were more often male, Black, socioeconomically disadvantaged, and unmarried (all p < 0.001). Overall, anxiety (25.3%) and depression (23.1%) were the most frequent comorbidities, though the prevalence of comorbid mental health conditions ranged from 48% to 77% across SUD subtypes. Most other mental health conditions were associated with elevated odds of newly documented SUDs (AOR range=4.6-9.7, p < 0.001), particularly for stimulant, cocaine, and opioid use disorders.

Newly documented SUDs in this diverse cohort frequently co-occurred with other mental health conditions, with diagnostic patterns varying across sociodemographic groups. Findings underscore the importance of integrated behavioral health screening and interventions that account for comorbidity. These patterns further highlight the need for strategies that enhance equitable access to prevention and treatment for individuals with SUDs.

Empathy is central to humanised nursing but vulnerable to erosion in demanding academic and clinical settings. Positive mental health (PMH) encompassing emotional, psychological, and social well-being, may regulate how self-compassion is statistically linked to empathic engagement. However, evidence in nursing students remains limited.

To examine the statistical association of positive mental health in the relationship between self-compassion and empathy among undergraduate nursing students within a structural equation modelling (SEM) framework.

Observational, analytical, cross-sectional study.

A total of 402 nursing students from a public university completed validated measures of self-compassion, empathy, and PMH. SEM with latent variables was conducted using diagonally weighted least squares (DWLS) to account for ordinal and non-normal data. Model fit was assessed using multiple indices, acknowledging the complexity of the latent structure.

Self-compassion was positively associated with PMH (β = 0.772, p < 0.001), which related positively to empathy (β = 0.689, p < 0.001). The indirect effect via PMH was positive (β = 0.532, p < 0.001), while the direct effect of self-compassion on empathy was negative when controlling for PMH (β = -0.553, p < 0.001), indicating an inconsistent mediation pattern. The model explained 59.6% of the variance in positive mental health and 19.3% in empathy.

PMH appears to be a key correlate in the association between self-compassion and empathy. Findings suggest that emotional well-being may be an important foundation for relational competence, although the study's cross-sectional nature precludes causal inferences and the marginal model fit warrants a cautious interpretation.

Fostering empathy may require more than interpersonal skills training. Nursing curricula could benefit from integrating positive mental health promotion, including training in self-compassion and emotional regulation, to support empathic and humanised nursing practice across educational and clinical contexts.

Listing tools were found to ameliorate drug treatment in older people; the FORTA (Fit-fOR-The-Aged) list is a clinically validated positive-negative list of medication appropriateness. Here, we retrospectively analyze longitudinal correlations between the FORTA score and key measures of physical and cognitive function in older people.

504 participants of a multi-center cohort study (AgeCoDe/AgeQualiDe) for whom the FORTA score (sum of over- and under-treatment errors) had been assessed were studied at three follow-up (FU) time points (FU 6-8; mean age range 87.9-89.7 years); comparisons between data at these FUs separated by 10 months were available for 292-328 patients.

The univariate analysis of the association between FORTA_Delta_76 (change of FORTA score between FU 6 and 7) and ADL (Activities of Daily Living)_Delta_76 (- 0.155, p < 0.01) and between FORTA_Delta_76 and MMSE (Mini-Mental State Examination)_Delta_76 (- 0.203, p < 0.01) revealed significant correlations. Multivariable analysis (using a forward selection model, p < 0.05) revealed a significant association between FORTA_Delta_76 and MMSE_Delta_76 (p < 0.05). Univariate analyses for other comparisons were only significant for FORTA_Delta_86 and MMSE_Delta_86.

This study indicates that longitudinal non-interventional changes of the FORTA score as an integral index of medication appropriateness are associated with changes in ADL and MMSE: the lower this score the better the functional outcome. These findings are in line with earlier interventional data and underscore the potential of FORTA to improve clinical endpoints in older people.

Intimate partner violence (IPV) remains a significant public health concern in New York City (NYC), with psychological and physical abuse highly prevalent. Hispanic and Latine adults may face elevated IPV risk due to gender norms, immigration-related stressors, and barriers to accessing services. However, differences in IPV patterns by nativity remain insufficiently understood. Data from the 2020 NYC Community Health Survey, a population-based survey of non-institutionalized adults, were analyzed. The analytic sample included 2,229 Hispanic and Latine respondents. Weighted descriptive statistics and stratified logistic regression models were used to estimate lifetime physical and psychological IPV prevalence and associated factors by nativity. U.S.-born Hispanic and Latine (USBH/L) adults reported higher prevalence of IPV than foreign-born Hispanic and Latine (FBH/L) respondents. However, nativity was not independently associated with IPV after adjustment. Risk factors varied across nativity groups. Among FBH/L adults, female gender and marital disruption were the strongest and most consistent predictors of IPV. Among USBH/L adults, binge drinking, disability, and mental health treatment showed stronger and more consistent associations. Having ≥2 sexual partners was associated with higher odds of IPV across models. Older age (≥65 years) was consistently associated with lower IPV odds. IPV remains prevalent among Hispanic and Latine adults in NYC, with distinct patterns of associated risk factors by nativity. Prevention strategies should be culturally and linguistically responsive and address gender norms, substance use, and structural vulnerabilities, including disability and relationship instability. These findings highlight the importance of continued IPV surveillance to inform equitable, population-level interventions.

People with severe mental illness (SMI) experience disparities in cancer care, including delayed diagnosis, poorer symptom management, and reduced quality of life. This study aimed to explore the lived experiences of individuals with SMI who have also been diagnosed with cancer.

A qualitative, grounded theory study was conducted with 11 adults in England with lived experience of both SMI and cancer. Participants were recruited via NHS and voluntary organisations. Semi-structured interviews, conducted via telephone or video call, were transcribed verbatim. Coding progressed through initial, focused, and theoretical coding alongside constant comparative methods and memoing.

Stigma emerged as a main theme, derived through participant explanations of limited information sharing, restricted involvement in decision-making, and the misattribution of physical symptoms to mental illness. These perceived forms of stigma contributed to delays in cancer diagnosis, reduced opportunities for informed decision-making, and feelings of disempowerment. Collectively, they reinforced existing health inequities and negatively affected participants' mental and physical wellbeing throughout their cancer care and beyond.

Structural and public stigma intersect, resulting in health-related stigma, creating barriers across cancer care pathways for people with SMI. Stigma may compromise quality care and contribute to poorer clinical and experiential outcomes in people with cancer and SMI.

Interventions are needed to reduce stigmatising behaviours and beliefs in healthcare settings, to distribute power within clinical settings, and promote shared, person-centred decision-making to ensure comprehensive information provision and recognition of patient expertise. Collectively, these actions may improve early diagnosis, cancer symptom management, recovery, and overall quality of life for cancer survivors with SMI.

Understanding public beliefs about patients at memory centers may inform efforts to promote early diagnosis and guide clinical discussions of Alzheimer's disease (AD). Adults (N=3,527) read a vignette describing a fictional person at a memory center and rated the person's condition as a mental illness, part of typical aging, and psychological or biological origins. Vignettes varied by AD biomarker result, symptom stage, and treatment availability. Participants most strongly believed that the condition was part of typical aging and biological in origin, though beliefs varied across subgroups. Black and Asian participants reported stronger beliefs than White participants that the condition was a mental illness (β=0.39, P<0.001) and psychological (β=0.46, P<0.001). Men reported stronger beliefs that the condition was a mental illness (β=0.19, P<0.001), psychological (β=0.14, P<0.001), and part of typical aging (β=-0.08, P=0.04). Biomarker positivity heightened biological and lowered psychological attributions (all P<0.05). The findings offer specific insights to guide intervention.

Health-related quality of life (HRQoL) is a vital indicator of evaluating care outcomes and prognosis, yet little is understood about its developmental trajectories in older patients with chronic pain. This study aimed to identify latent HRQoL trajectories and their predictors, and to develop explainable machine learning models for predicting HRQoL deterioration.

This prospective cohort study assessed 608 older patients with chronic pain at admission and at 1, 3, and 6 months post-admission, collecting data on HRQoL, general characteristics, pain level, activities of daily living (ADL), depression, and perceived social support. Growth mixture modeling was applied to identify trajectories of physical and mental HRQoL. Predictors were selected using LASSO regression and SVM-RFE. Nine explainable machine learning models were developed for both components, and SHAP interpreted the outputs. An HRQoL decision-support dashboard was developed to facilitate potential clinical application.

Three physical HRQoL trajectories were identified: Stable High, Decline and Low Stability, alongside two mental HRQoL trajectories: Improvement and Decline. Key predictors included education level, pain duration, pain level, ADL, depression, and perceived social support, with ADL and pain level being the most influential for physical and mental HRQoL, respectively.

This dual-trajectory study identified five distinct HRQoL patterns in older patients with chronic pain, elucidating key predictors via explainable machine learning. The proposed HRQoL decision-support dashboard may provide an interpretable tool to support understanding of predictive relationships and assist healthcare professionals in HRQoL assessment.

Not applicable.