This study examines how a 2013 Arizona law on shared parenting would affect living arrangements, and thus mental health measures. There were two hypotheses. According to the Law Change Hypothesis, it was hypothesized that parenting time in Arizona would be more equal following the 2013 Arizona law change while there would be no change in parenting time in other states following the 2013 Arizona law change. It was further hypothesized that child mental health would be better after the law change in Arizona with no change being seen in other states. Results of this study were almost completely inconsistent with the hypothesis. According to the Law Reflect Hypothesis, the law is actually reflecting the behavior of the community and their thoughts on equal parenting time becoming more favorable, and therefore a change towards more equal parenting time would be found prior to 2013 in Arizona with no change seen in other states. Furthermore, as the Arizona community’s behavior changed, child mental health would be better with no change being seen in other states. Regressions found that a small change toward more equal parenting and closeness with father was prior to 2013 for Arizona students, compared to out-of-state students, although it did not find that the year of divorce resulted in less anxiety, stress, and depression. This partially agrees with past research that the 2013 law is working as intended, even if it started working earlier than we thought. This does not agree with previous research stating there is a connection between equal parenting and better mental health. This is important because this study questions the efficacy of an important and controversial policy. If future studies are consistent with this one, the effectiveness of the Arizona 2013 law change on mental health will need to be further evaluated.

Purpose: This qualitative research aimed to create a developmentally and gender-appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents. <br/>Background: Ranking as the most common sexually transmitted infection, about 80 million Americans are currently infected by HPV, and it continues to increase with an estimated 14 million new cases yearly. Certain types of HPV have been significantly associated with cervical, vaginal, and vulvar cancers in women; penile cancers in men; and oropharyngeal and anal cancers in both men and women. Despite HPV vaccination being one of the most effective methods in preventing HPV-associated cancers, vaccination rates remain suboptimal in adolescents. Game-based intervention, a novel medium that is popular with adolescents, has been shown to be effective in promoting health behaviors. <br/>Methods: Sample/Sampling. We used purposeful sampling to recruit eight adolescent-parent dyads (N = 16) which represented both sexes (4 boys, 4 girls) and different racial/ethnic groups (White, Black, Latino, Asian American) in the United States. The inclusion criteria for the dyads were: (1) a child aged 11-14 years and his/her parent, and (2) ability to speak, read, write, and understand English. Procedure. After eligible families consented to their participation, semi-structured interviews (each 60-90 minutes long) were conducted with each adolescent-parent dyad in a quiet and private room. Each dyad received $50 to acknowledge their time and effort. Measure. The interview questions consisted of two parts: (a) those related to game design, functioning, and feasibility of implementation; (b) those related to theoretical constructs of the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB). Data analysis. The interviews were audio-recorded with permission and manually transcribed into textual data. Two researchers confirmed the verbatim transcription. We use pre-developed codes to identify each participant’s responses and organize data and develop themes based on the HBM and TPB constructs. After the analysis was completed, three researchers in the team reviewed the results and discussed the discrepancies until a consensus is reached.<br/>Results: The findings suggested that the most common motivating factors for adolescents’ HPV vaccination were its effectiveness, benefits, convenience, affordable cost, reminders via text, and recommendation by a health care provider. Regarding the content included in the HPV game, participants suggested including information about who and when should receive the vaccine, what is HPV and the vaccination, what are the consequences if infected, the side effects of the vaccine, and where to receive the vaccine. The preferred game design elements were: 15 minutes long, stories about fighting or action, option to choose characters/avatars, motivating factors (i.e., rewards such as allowing users to advance levels and receive coins when correctly answering questions), use of a portable electronic device (e.g., tablet) to deliver the education. Participants were open to multiplayer function which assists in a facilitated conversation about HPV and the HPV vaccine. Overall, the participants concluded enthusiasm for an interactive yet engaging game-based intervention to learn about the HPV vaccine with the goal to increase HPV vaccination in adolescents. <br/>Implications: Tailored educational games have the potential to decrease the stigma of HPV and HPV vaccination, increasing communication between the adolescent, parent, and healthcare provider, as well as increase the overall HPV vaccination rate.

The COVID-19 pandemic has generated alarming increases in psychological distress and alcohol use behaviors and has caused the greatest increases in depression and anxiety symptoms among college students. Prior studies have examined the impact of COVID-19 broadly on mental health and alcohol use outcomes; however, few studies have examined these impacts in college students. Previous studies have examined individual factors that could moderate the relation between COVID-19 related stressors and mental health and alcohol use outcomes, but knowledge is lacking regarding the role of emotion regulation. The present study aimed to examine the role of emotion regulation in the relation between both COVID-19 stressful experiences and COVID-19 related worry and mental health and alcohol use outcomes, and to explore racial/ethnic differences in their associations. Four hierarchical multiple regression models were conducted to assess main effects of COVID-19 stressors and emotion regulation, as well as moderation of the effect of emotion regulation on depression symptoms, anxiety symptoms, alcohol consumption, and alcohol use disorder (AUD) symptoms during the past year. COVID-19 related worry was associated with greater symptoms of both mental health outcomes, whereas COVID-19 related stressful experiences were associated with both mental health outcomes, more alcohol consumption, and more AUD symptoms. Difficulties in emotion regulation had significant main effects on mental health outcomes and AUD symptoms, but not alcohol consumption. Hispanic/Latinx students reported higher experiences of both COVID-19 related stressors, but consumed less alcohol than did White/European students. This study provides further insight into the nature of COVID-19 related stressors and their subsequent impacts. Implications for prevention and intervention on college campuses are discussed.

Purpose: The purpose of this project was to examine if a relationship existed between the changes in attitude and knowledge of a mental health care provider, before and after an educational intervention was given on how to identify sex trafficking victims.

Background: According to the National Trafficking Hotline (2017), last year there were over 5,000 cases of sex trafficking reported. Lederer & Wetzel (2014) discuss that more than 88% of victims interact with a health care provider while being trafficked at least once. A majority of cases, mental health care providers were informed that their patient was a sex trafficking victim through collaboration of other services. Without this collaboration, many providers would have never
known that they had interacted with a victim (Domoney, Howard, Abas, Broadben, & Oram, 2015).

Methods: The participant population consisted of psychiatrists, psychiatric nurse practitioners and psychologists working in acute and out patient settings.
A pre survey was given to identify the participant’s knowledge of sex trafficking and their awareness of available resources and tools to help screen as well as treat victims of sex trafficking. After completion, the participants viewed an educational voice over presentation that educated them on how to identify current sex trafficking victims, what screening tools are available, the mental health risk factors and how to protect both the victim and provider from potential danger from the alleged trafficker. A post survey was then given to assess their knowledge after the presentation intervention, how much they retained and their confidence in being able to assess and treat sex trafficking victims. All surveys and the presentation were available online for participant convenience via a private link.

Results: The knowledge posttest score was higher than the pretest (Z=-2.694, p<0.007).
The confidence score on treating sex trafficking victims was higher posttest (Z=-2.251, p<0.024) No significant change in attitudes for advocating for sex trafficking victim care. All providers agreed that this high-risk vulnerable population needs advocates (Z=4.67, p<0.707).

Conclusion: All providers agreed for the need to advocate for victim care prior to the educational intervention. The results suggest that mental health providers are more knowledgeable posttest about risk factors, have a higher level of confidence in treating sex trafficking victims and have a higher confidence in their ability to protect victims and provide adequate care.