Study Objective-Produce Girl Talk, a free smartphone application containing comprehensive sexual health information, and determine the application's desirability and appeal among teenage girls.Design, Setting and Participants-39 girls ages 12-17 from Rhode Island participated in a two-phase prospective study. In Phase I, 22 girls assessed a sexual health questionnaire in focus groups. In Phase 2, 17 girls with iPhones® used Girl Talk for two weeks and answered the revised sexual health questionnaire and interview questions before and after use.Main Outcome Measures-Participants' responses to the sexual health questionnaire, interviews and time viewing the application were used to determine feasibility and desirability of Girl Talk.Results-Girl Talk was used on average for 48 minutes during participants' free time on weekends for 10-15 minute intervals. Reported usefulness of Girl Talk as a sexual health application increased significantly from baseline to follow-up (35.3% vs. 94.1%; p < .001). Knowledge improved most in topics related to Anatomy and Physiology (4.2%), Sexuality and Relationships (3.5%) and STI Prevention (3.4%). Most participants (76.5%) were exposed to sexual health education prior to using Girl Talk, but 94.1% of participants stated that the application provided new and/or more detailed information than health classes. Conclusion-GirlTalk can potentially connect teenage girls to more information about sexual health versus traditional methods, and participants recommended the application as a valuable resource to learn about comprehensive sexual health.

Study Objective Produce Girl Talk, a free smartphone application containing comprehensive sexual health information, and determine the application’s desirability and appeal among teenage girls. Design, Setting and Participants 39 girls ages 12–17 from Rhode Island participated in a two-phase prospective study. In Phase I, 22 girls assessed a sexual health questionnaire in focus groups. In Phase 2, 17 girls with iPhones® used Girl Talk for two weeks and answered the revised sexual health questionnaire and interview questions before and after use. Main Outcome Measures Participants’ responses to the sexual health questionnaire, interviews and time viewing the application were used to determine feasibility and desirability of Girl Talk. Results Girl Talk was used on average for 48 minutes during participants’ free time on weekends for 10–15 minute intervals. Reported usefulness of Girl Talk as a sexual health application increased significantly from baseline to follow-up (35.3% vs. 94.1%; p < .001). Knowledge improved most in topics related to Anatomy and Physiology (4.2%), Sexuality and Relationships (3.5%) and STI Prevention (3.4%). Most participants (76.5%) were exposed to sexual health education prior to using Girl Talk, but 94.1% of participants stated that the application provided new and/or more detailed information than health classes. Conclusion Girl Talk can potentially connect teenage girls to more information about sexual health versus traditional methods, and participants recommended the application as a valuable resource to learn about comprehensive sexual health.

Background The impacts of opioid use disorder and opioid-involved overdose are known, but less is known about the contexts in which people first misuse opioids, and the motivations for continued misuse. Methods In-depth interviews with 26 individuals in Allegheny County, Pennsylvania with current or past histories of opioid misuse were conducted. Narratives were analyzed to understand the circumstances and influences contributing to initial and continued misuse of opioids. Results Participants described social and familial contexts that normalized or accepted opioid misuse—this often included their own use of other illicit substances prior to initiating opioids. Participants also described initial use of opioids as related to efforts to cope with physical pain. They also described recognizing and then seeking psychological/emotional benefits from opioids. All three of these themes often overlapped and intersected in these stories of starting opioid misuse. Conclusions Opioid misuse stemmed from complex interacting influences involving coping with physical and psychological pain, perception that opioids are needed to feel “normal”, and acceptance or normalization of opioid use. This suggests a multi-pronged approach to both prevention and treatment are needed.

Background Certain communities in the United States experience greater opioid-involved overdose mortality than others. Interventions to stem overdose benefit from contextual understandings of communities’ needs and strengths in addressing the opioid crisis. This project aims to understand multiple stakeholder perspectives on the opioid epidemic in communities disproportionately affected by opioid-involved overdose mortality. Methods We performed a rapid-cycle qualitative assessment study utilizing in-depth interviews with community stakeholders and observations of community meetings in eight communities in Allegheny County, Pennsylvania, USA, disproportionately impacted by opioid-involved overdose mortality. Stakeholder categories included: current and past illicit users of opioids; medical and social service providers; emergency medical services; law enforcement; spouse or other family members of illicit users/former users of opioids; government officials; school officials; community members. Content analysis was utilized to identify themes and answer study questions. Regular feedback to stakeholders was provided to support targeted interventions. Results We performed semi-structured, in-depth interviews with 130 community stakeholders and 29 community meeting observations in 2018–2019. Participants perceived similar economic and social determinants as origins of the opioid overdose epidemic including lack of economic resources, loss of jobs, transient populations and dilapidated housing. However, they differed in their awareness of and attention to the epidemic. Awareness was dependent on the visibility of opioid use (presence of paraphernalia litter, location of drug users, media coverage, and relationship to users). Overall, there was good knowledge of naloxone for opioid overdose reversal but less knowledge about local syringe services programs. Perceptions of harm reduction efforts were ambivalent. Conclusions Members of communities impacted by the opioid epidemic perceived that economic downturn was a major factor in the opioid overdose epidemic. However, the varied beliefs within and between communities suggest that interventions need to be tailored according to the cultural norms of place.