Parents, referral sources, and even therapists wonder whether the gender and racial match between therapists and patients contributes to poorer alliances and treatment dropout. Six hundred adolescent substance abusers and their therapists from a large randomized clinical trial were grouped according to matches and mismatches on both gender and race, and alliance ratings were collected from both patients and therapists. Results revealed that gender-matched dyads reported higher alliances and were more likely to complete treatment. Racial matching predicted greater retention but not patient-rated alliance. However, therapists in mismatched dyads rated significantly lower alliances. Results suggest that, although multicultural training remains critical, training emphasis should also be placed on understanding how gender and racial differences affect therapeutic processes.

Fast-food marketing to children is considered a contributor to childhood obesity. Effects of marketing on parents may also contribute to childhood obesity. The authors explore relevant hypotheses with data from caregivers of 2-to 12-year-old children in medically underserved communities. The results have implications for obesity-related public policies and social marketing strategies.

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT INTERNALIZED WEIGHT STIGMA MODERATES EATING BEHAVIOR 2 ! Abstract 36Weight stigma is a significant socio-structural barrier to reducing health disparities and 37 improving quality of life for higher weight individuals. The aim of this study was to examine the 38 impact of internalized weight stigma on eating behaviors after participating in a randomized 39 controlled trial comparing the health benefits of a weight-neutral program to a conventional 40 weight-management program for 80 community women with high body mass index (BMI > 30, 41 age range: 30-45). Programs involved 6 months of facilitator-guided weekly group meetings 42 using structured manuals. Assessments occurred at baseline, post-intervention (6 months), and 43 24-months post-randomization. Eating behavior outcome measurements included the Eating 44Disorder Examination-Questionnaire and the Intuitive Eating Scale. Intention-to-treat linear 45 mixed models were used to test for higher-order interactions between internalized weight stigma, 46 group, and time. Findings revealed significant 3-way and 2-way interactions between 47 internalized weight stigma, group, and time for disordered and adaptive eating behaviors, 48 respectively. Only weight-neutral program participants with low internalized weight stigma 49 improved global disordered eating scores. Participants from both programs with low internalized 50 weight stigma improved adaptive eating at 6 months, but only weight-neutral program 51 participants maintained changes at follow-up. Participants with high internalized weight stigma 52 demonstrated no changes in disordered and adaptive eating, regardless of program. In order to 53 enhance the overall benefit from weight-neutral approaches, these findings underscore the need 54 to incorporate more innovative and direct methods to reduce internalized weight stigma for 55 women with high BMI. 56Key Words: internalized weight stigma, disordered eating, intuitive eating, obesity, 57 health at every size, conventional weight-management 58 obesity is a pervasive stigmatization of people with a higher weight statusÑa stigmatization that 63 is on the rise among adults and children (Andreyeva, Puhl, & Brownell, 2008; Harriger, 64 Calogero, Witherington, & Smith, 2010;Latner & Stunkard, 2003). Indeed, weight 65 discrimination has been well-documented in educational, workplace, and healthcare settings 66 (e.g., Giel, Thiel, Teufel, Mayer, & Zipfel, 2010;Neumark-Sztainer, Story, & Harr...

Breastfeeding is associated with improved developmental and social outcomes for an infant. Despite these health benefits, only 54% of women breastfeed in the early postpartum period. Although an understanding of socio-demographic characteristics, breastfeeding intent, and breastfeeding attitudes can facilitate breastfeeding initiatives, these factors have not been characterized particularly for urban and immigrant mothers. The objectives of this study are to provide a descriptive analysis of the socio-demographic characteristics, breastfeeding intent, and breastfeeding attitudes of primiparas presenting to an inner city prenatal clinic and determine if breastfeeding attitudes are associated with breastfeeding intent and socio-demographic variables. Of 100 primiparas, 79 reported the intent to breastfeed. Breastfeeding intent was associated with 1) positive breastfeeding attitudes, 2) higher household incomes, 3) being born outside the US, 4) being Afro-Caribbean as opposed to African American, 5) having family, peer, and partner support for breastfeeding, 6) attending breastfeeding classes, and 7) greater years of education. These findings suggest that targeting breastfeeding initiatives towards low-income, less educated, US born mothers who lack breastfeeding support from their loved ones may improve breastfeeding rates among urban primiparas.