Patients receiving long-term opioid therapy for chronic pain and interested in tapering their opioid dose were randomly assigned to a 22-week taper support intervention (psychiatric consultation, opioid dose tapering, and 18 weekly meetings with a physician assistant to explore motivation for tapering and learn pain self-management skills) or usual care (N=35). Assessments were conducted at baseline and 22 and 34 weeks after randomization. Using an intention-to-treat approach, we constructed linear regression models to compare groups at each follow-up. At 22 weeks, adjusted mean daily morphine-equivalent opioid dose (MED) in the past week (primary outcome) was lower in the taper support group, but this difference was not statistically significant (adjusted mean difference = −42.9 mg; 95% CI: −92.42, 6.62; p= 0.09). Pain severity ratings (0–10 NRS) decreased in both groups at 22 weeks, with no significant difference between groups (adjusted mean difference = −0.68; 95% CI: −2.01, 0.64; p = 0.30). The taper support group improved significantly more than usual care in self-reported pain interference, pain self-efficacy, and prescription opioid problems at 22 weeks (all p-values <0.05). This taper support intervention is feasible and shows promise in reducing opioid dose while not increasing pain severity or interference. [ClinicalTrials.gov Identifier: NCT01883882]

Explanatory models of sexual aggression were examined among mainland Asian American (n=222), Hawaiian Asian American (n=127), and European American men (n=399). The Malamuth et al. (N. M. Malamuth, D. Linz, C. L. Heavey, G. Barnes, & M. Acker, 1995; N. M. Malamuth, R. J. Sockloskie, M. P. Koss, & J. S. Tanaka, 1991) confluence model of sexual aggression, which posits impersonal sex and hostile masculinity as paths to sexual aggression, was consistently supported. Culture-specific moderators of sexual aggression were also identified. Whereas loss of face was a protective factor against sexual aggression in the Asian American samples, it generally was not a protective factor among European Americans. These findings are not a function of actual or perceived minority status. An implication is that theoretical models may need to be augmented with cultural constructs for optimal application in certain ethnic group contexts.

This study evaluates the effectiveness of a theoretically based rape prevention intervention with college men who were at high or low risk to perpetrate sexually coercive behavior. Participants (N = 146) are randomly assigned to the intervention or control group. Outcomes include rape myth acceptance, victim empathy, attraction to sexual aggression, sex-related alcohol expectancies, and behavioral indicators, measured across three time points. Positive effects are found for rape myth acceptance, victim empathy, attraction to sexual aggression, and behavioral intentions to rape. Only rape myth acceptance and victim empathy effects sustain at the 5-week follow-up. High-risk men are generally unaffected by the intervention although low-risk men produced larger effects than the entire sample. Results suggest rape prevention studies must assess risk status moderation effects to maximize prevention for high-risk men. More research is needed to develop effective rape prevention with men who are at high risk to rape.

Objective To develop and implement a stepped collaborative care intervention targeting PTSD and related co-morbidities to enhance the population impact of early trauma-focused interventions. Method We describe the design and implementation of the Trauma Survivors Outcomes & Support Study (TSOS II). An interdisciplinary treatment development team was comprised of trauma surgical, clinical psychiatric and mental health services “change agents” who spanned the boundaries between front-line trauma center clinical care and acute care policy. Mixed method clinical epidemiologic and clinical ethnographic studies informed the development of PTSD screening and intervention procedures. Results Two-hundred and seven acutely injured trauma survivors with high early PTSD symptom levels were randomized into the study. The stepped collaborative care model integrated care management (i.e., posttraumatic concern elicitation and amelioration, motivational interviewing, and behavioral activation) with cognitive behavioral therapy and pharmacotherapy targeting PTSD. The model was feasibly implemented by front-line acute care MSW and ARNP providers. Conclusions Stepped care protocols targeting PTSD may enhance the population impact of early interventions developed for survivors of individual and mass trauma by extending the reach of collaborative care interventions to acute care medical settings and other non-specialty posttraumatic contexts.

EHR data quality assessment has been hampered by implementation of ad hoc processes. The architecture and implementation of DQe-c offer valuable insights for developing reproducible and scalable data science tools to assess, manage, and process data in clinical data repositories.