UNASSIGNED: The COVID-19 pandemic has caused psychological problems among nurses worldwide. However, their willingness to seek professional help is relatively low, due to perceived barriers that have remained unknown.
UNASSIGNED: This study analysed the potential barriers and influencing factors of psychological help-seeking among nurses participating in community COVID-19 epidemic prevention work.
UNASSIGNED: Five variables - depression, anxiety, post-traumatic stress syndrome, social support and mental health literacy - were measured from a sample of 667 nurses. Latent class analysis identified homogeneous classes about psychological help-seeking barriers and multinomial logistic regression identified factors associated with potential grouping outcomes.
UNASSIGNED: Three categories were identified: major barriers (N = 17, 2.5%), stigma and accessibility barriers (N = 132, 21.2%) and low barriers (N = 518, 76.4%). Mental health literacy was significantly correlated with the \'low barriers\' class (OR = 0.953, B = -0.047, p = 0.03), whereas depression (OR = 1.091, B = 0.085, p = 0.011) had a slightly positive effect on being in the \'stigma and accessibility barriers\' class.
UNASSIGNED: During pandemics or other social health crises, nurses may experience psychological barriers to help seeking. Communities and hospitals should consider increasing the resources available for psychological counselling services, improving mental health awareness and literacy that may help reduce depression levels and promote mental health.

BACKGROUND: The purpose of this study includes: 1) identifying classes of substance-related needs among Black women, and 2) examining the effect of substance-related need classes and culturally-relevant factors on Black women\'s use of substance use disorder (SUD) treatment and mutual support groups.
METHODS: As part of a longitudinal cohort study, Black women were recruited in prison nearing release, on probation, and in the community without involvement in the criminal legal system (CLS, n=565) and followed-up at 18-months. We conducted a baseline latent class analysis of substance-related needs among Black women. Logistic regression models adjusted for culturally-relevant factors to predict the use of treatment and frequency of mutual support group participation over 18-months among Black women who use drugs.
RESULTS: Four classes by level of needs were found: low, daily marijuana use, high mental health, and high comorbidity. During the 18-month follow-up, women characterized by the high comorbidity need class and with higher scores of religious well-being were more likely to frequently participate in mutual support groups. Non-CLS-involved women were less likely to engage with both treatment and mutual support groups than women from the prison sample at 18-months.
CONCLUSIONS: This study highlights four distinct classes of substance-related needs among Black women, highlighting the complex patterns of behavior and within-racial group differences among Black women. Black women with high comorbidity needs were more likely to participate in mutual support groups, but the latent classes did not predict SUD treatment indicating other non-medical and social contextual need factors may be at play.

UNASSIGNED: This study aimed to identify the behavioural pattern of psychological distress (PD) in the population of 18 to 65 years old people in Mashhad, Iran, using latent class regression and evaluate the related factors. PD is a unique emotional state with suffering in response to a stressor or specific need that leads to temporary or permanent impacts. Due to its negative effects on several features of life like the quality of life, health, performance and productivity of individuals, PD and its consequences are considered a public health priority.
UNASSIGNED: A cross-sectional study was performed on 425,286 individuals aged 18 to 65, who were referred to health centres in Mashhad, northeastern Iran in the first half of 2018. The information required for this study, including a checklist of demographic information and the six-item Kessler Psychological Distress Scale (K-6), was obtained from the Sina System.
UNASSIGNED: Latent class regression identified three latent patterns of PD in answering the questions of the K-6 questionnaire, including severe PD (14%), low PD distress (40%) and no PD (46%). Statistical variables of this study due to the results are considered as the following: women, illiterate people, unemployed and divorced people, individuals aged between 50 and 59 years and people with low weight were more likely to be in the severe PD class than in the no PD class.
UNASSIGNED: Although a small percentage of people were classified as severely disturbed, the findings showed a high rate of symptoms of distress and sadness even in the no PD class.

BACKGROUND: Patterns of utilization of numerous smoking cessation methods among pregnant women amidst the increasing popularity of vaping (use of e-cigarettes) remains unknown.
METHODS: This study included 3,154 mothers who self-reported smoking around the time of conception and delivered live births in 2016-2018 in seven US states. Latent class analysis was used to identify subgroups of smoking women based on their utilization of 10 surveyed quitting methods and vaping during pregnancy.
RESULTS: We identified four subgroups of smoking mothers with different utilization patterns of quitting methods during pregnancy: 22.0% reported \"not trying to quit\"; 61.4% tried to \"quit on my own\" without any behavioral or pharmacological assistance; 3.7% belonged to the \"vaping\" subgroup; and 12.9% utilized \"wide-ranging methods\" with higher use rate of multiple approaches, such as quit line and nicotine patch. Compared to mothers \"not trying to quit,\" the subgroup trying to \"quit on my own\" were more likely to be abstinent (adjusted OR 4.95, 95% CI 2.82-8.35) or to reduce the number of cigarettes smoked daily (adjusted OR 2.46, 95% CI 1.31-4.60) in late pregnancy, and these improvements lasted into early postpartum. We did not observe a measurable reduction in smoking among the \"vaping\" subgroup or women trying to quit with \"wide-ranging methods\".
CONCLUSIONS: We identified four subgroups of smoking mothers with different utilization patterns of eleven quitting methods during pregnancy. Pre-pregnancy smokers who tried to \"quit on my own\" were most likely to be abstinent or to reduce smoking amount.

Bodily Distress Syndrome (BDS) represents a new research concept for adult patients with various functional somatic syndromes. We evaluated the utility of the BDS research concept and the associated BDS-25-checklist as a screening tool for diverse functional somatic symptoms (FSS) in adolescence by investigating: 1) the psychometric and factorial structures of the checklist, 2) symptom cluster patterns and 3) illness classification and associations with emotional psychopathology and sociodemographic factors.
This cross-sectional study obtained data from the 16/17-year follow-up (N = 2542) of the general population Copenhagen Child Cohort 2000 (CCC2000). We used self-reported questionnaires to assess physical symptoms (the BDS-25 checklist), overall health (KidScreen), emotional psychopathology (Spence Children\'s Anxiety Scale; The Mood and Feelings Questionnaire), and illness worry (Whiteley-6 Index), and utilized data from Danish national registers to assess sociodemographic factors.
The BDS-25 checklist items displayed satisfactory psychometric data quality. Factor analyses revealed a similar four-factor model as reported in adults (factor loadings λ ≥0.5), representing distinct BDS symptom clusters: cardio-pulmonary, gastro-intestinal, musculoskeletal and general symptoms. Latent class analyses revealed a model with three latent classes, i.e. probable no to mild BDS, probable moderate, single-organ BDS and probable severe, multi-organ BDS, displaying acceptable class quality (Entropy = 0.904). Trend analyses revealed sociodemographic group differences across latent classes. Increased emotional psychopathology was associated with more pronounced BDS symptoms.
Our findings support the BDS concept with four symptom clusters and three illness severity groups (no BDS, single- organ and multi-organ BDS) to screen for FSS in adolescence.

This study aimed to examine reclassification rates among classes of chronic obstructive pulmonary disease (COPD) patients based on their distinct symptom experiences and to assess how these subgroups differed in symptom scores and health-related quality of life (HRQoL) outcomes over one year. Moreover, we wished to assess how these subgroups differed in demographic and clinical characteristics at 12 months.
This is a follow-up study of 267 patients with moderate, severe, and very severe COPD. Based on their distinct symptom experiences using the Memorial Symptom Assessment Scale (MSAS), three subgroups (i.e., \"high\", \"intermediate\", and \"low\") were identified at baseline. In the present study, transitions between the subgroups at three, six, nine, and 12 months were investigated and calculated as reclassification rates. Differences among the subgroups in symptom scores and HRQoL at each time point and demographic and clinical characteristics at 12 months were evaluated using analysis of variance with post hoc comparisons.
Almost 65% were still in the \"high\" class after 12 months. At 12 months, pairwise comparisons for respiratory function measurements were not significantly different. Compared to the \"intermediate\" and \"low\" class, patients in the \"high\" class were more likely to be women and had significantly more comorbidities, reported a significantly higher number of symptoms at all time points, and worse HRQoL scores.
Our findings suggest that the pattern of a high symptom burden in COPD is consistent over time. The patients\' individual symptom experiences should be the primary focus of treatment.

Review studies increasingly emphasize the importance of the role of parenting in interventions for preventing overweight in children. The aim of this study was to examine typologies regarding how consistently parents apply energy-balance related behavior rules, and the association between these typologies and socio-demographic characteristics, energy balance-related behaviors among school age children, and the prevalence of being overweight.
For this cross-sectional study, we had access to a database managed by a Municipal Health Service Department in the Netherlands. In total, 4,865 parents with children 4-12 years of age participated in this survey and completed a standardized questionnaire. Parents classified their consistency of applying rules as \"strict\", \"indulgent\", or \"no rules\". Typologies were identified using latent class analyses. We used regression analyses to examine how the typologies differed with respect to the covariates socio-demographic characteristics, children\'s energy balance-related behaviors, and weight status.
We identified four stable, distinct parental typologies with respect to applying dietary and sedentary behavior rules. Overall, we found that parents who apply \"overall strict EBRB rules\" had the highest level of education and that their children practiced healthier behaviors compared to the children of parents in the other three classes. In addition, we found that parents who apply \"indulgent dietary rules and no sedentary rules\" had the lowest level of education and the highest percentage of non-Caucasians; in addition, their children 8-12 years of age had the highest likelihood of being overweight compared to children of parents with \"no dietary rules\".
Parents\' consistency in applying rules regarding dietary and sedentary behaviors was associated with parents\' level of education and ethnic background, as well as with children\'s dietary and sedentary behaviors and their likelihood of becoming overweight. Our results may contribute to helping make healthcare professionals aware that children of parents who do not apply sedentary behavior rules are more likely to become overweight, as well as the importance of encouraging parents to apply strict dietary and sedentary behavior rules. These results can serve as a starting point for developing effective strategies to prevent overweight among children.

The usual method for assessing the reliability of survey data has been to conduct reinterviews a short interval (such as one to two weeks) after an initial interview and to use these data to estimate relatively simple statistics, such as gross difference rates (GDRs). More sophisticated approaches have also been used to estimate reliability. These include estimates from multi-trait, multi-method experiments, models applied to longitudinal data, and latent class analyses. To our knowledge, no prior study has systematically compared these different methods for assessing reliability. The Population Assessment of Tobacco and Health Reliability and Validity (PATH-RV) Study, done on a national probability sample, assessed the reliability of answers to the Wave 4 questionnaire from the PATH Study. Respondents in the PATH-RV were interviewed twice about two weeks apart. We examined whether the classic survey approach yielded different conclusions from the more sophisticated methods. We also examined two ex ante methods for assessing problems with survey questions and item nonresponse rates and response times to see how strongly these related to the different reliability estimates. We found that kappa was highly correlated with both GDRs and over-time correlations, but the latter two statistics were less highly correlated, particularly for adult respondents; estimates from longitudinal analyses of the same items in the main PATH study were also highly correlated with the traditional reliability estimates. The latent class analysis results, based on fewer items, also showed a high level of agreement with the traditional measures. The other methods and indicators had at best weak relationships with the reliability estimates derived from the reinterview data. Although the Question Understanding Aid seems to tap a different factor from the other measures, for adult respondents, it did predict item nonresponse and response latencies and thus may be a useful adjunct to the traditional measures.

BACKGROUND: Few studies have assessed patterns of substance use among Canadian adolescents. This cross-sectional study examined substance use classes among Canadian secondary school students and associations with anxiety and depression.
METHODS: This study used data from Year 6 (2017/18) of the COMPASS study. Students (n = 51 767) reported their substance use (alcohol, cannabis, cigarette and e-cigarette use) and anxiety and depression symptoms. We employed latent class analysis to identify substance use classes and multinomial logistic regression to examine how anxiety and depression were associated with class membership.
RESULTS: Overall, 40% of students indicated having anxiety and/or depression (50% in females; 29% in males) and 60% of students reported substance use (60% in females; 61% in males). We identified three substance use classes: poly-use, dual use, and non-use. Females with both anxiety and depression had the highest odds of being in the poly-use class compared to the non-use class (odds ratio [OR] = 4.09; 95% confidence interval [CI]: 3.59-4.65) followed by females with depression only (OR = 2.65; 95% CI: 2.31-3.04) and males with both anxiety and depression (OR = 2.48; 95% CI: 2.19-2.80). Symptomatology was also associated with belonging to the dual use class except among males with anxiety only (OR = 1.13; 95% CI: 0.94-1.37).
CONCLUSIONS: Canadian secondary school students are engaging in dual and poly-substance use, and anxiety and depression were associated with such use. Females had a higher prevalence of anxiety and depression and should be a priority population for mental health programming.
BACKGROUND: Peu d’études ont évalué les habitudes de consommation de substances chez les adolescents canadiens. Cette étude transversale porte sur les catégories de consommation de substances chez les élèves du secondaire au Canada et leurs associations avec l’anxiété et la dépression.
UNASSIGNED: Cette étude repose sur des données de l’année 6 (2017-2018) de l’étude COMPASS. Les élèves (n = 51 767) ont fait état de leur consommation de substances (alcool, cannabis, cigarettes et cigarettes électroniques) et de leurs symptômes d’anxiété et de dépression. Nous avons utilisé une analyse par classes latentes pour créer les catégories de consommation de substances et une analyse de régression logistique multinomiale pour examiner la manière dont l’anxiété et la dépression étaient associées à l’appartenance à une catégorie.
UNASSIGNED: Dans l’ensemble, 40 % des élèves ont indiqué souffrir d’anxiété ou de dépression (50 % des filles et 29 % des garçons) et 60 % des élèves ont fait état d’une consommation de substances (60 % des filles et 61 % des garçons). Nous avons établi trois catégories de consommation de substances : la polyconsommation, la double consommation et la non-consommation. Les plus susceptibles d’appartenir à la catégorie de polyconsommation plutôt qu’à la catégorie de non-consommation étaient les filles souffrant à la fois d’anxiété et de dépression (rapport de cote [RC] = 4,09; intervalle de confiance [IC] à 95 % : 3,59 à 4,65]), suivies des filles souffrant de dépression uniquement (RC = 2,65; IC à 95 % : 2,31 à 3,04) et des garçons souffrant à la fois d’anxiété et de dépression (RC = 2,48; IC à 95 % : 2,19 à 2,80). La symptomatologie a également été associée à l’appartenance à la catégorie de double consommation, sauf pour les garçons souffrant d’anxiété uniquement (RC = 1,13; IC à 95 % : 0,94 à 1,37).
CONCLUSIONS: Les élèves du secondaire au Canada s’adonnent à une double consommation et à une polyconsommation de substances, et on a pu associer l’anxiété et la dépression à ces types de consommation. Les filles affichent une prévalence plus élevée d’anxiété et de dépression et devraient, de ce fait, constituer une priorité en matière de programmation en santé mentale.
40% of students indicated anxiety and/or depression and 60% of students reported substance use. Females had a higher prevalence of anxiety and/or depression (50% vs. 29%). Overall, anxiety and/or depression were associated with dual use and poly-substance use. Females with both anxiety and depression had the highest odds of being in the poly-substance use class.
40 % des élèves ont fait état de symptômes d’anxiété ou de dépression et 60 % d’une consommation de substances. Les filles affichaient une prévalence plus élevée d’anxiété ou de dépression (50 % contre 29 %). De manière générale, l’anxiété et la dépression étaient associées à la double consommation et à la polyconsommation de substances. Les filles souffrant à la fois d’anxiété et de dépression étaient les plus susceptibles de relever de la catégorie de polyconsommation de substances.

Introduction: Long-standing disparities in colorectal cancer (CRC) outcomes and survival between Whites and Blacks have been observed. A person-centered approach using latent class analysis (LCA) is a novel methodology to assess and address CRC health disparities. LCA can overcome statistical challenges from subgroup analyses that would normally impede variable-centered analyses like regression. Aim was to identify risk profiles and differences in malignant CRC survivorship outcomes. Methods: We conducted an LCA on the Surveillance, Epidemiology, and End Results data from 1975 to 2016 for adults ≥18 (N = 525,245). Sociodemographics used were age, sex/gender, marital status, race, and ethnicity (Hispanic/Latinos) and stage at diagnosis. To select the best fitting model, we employed a comparative approach comparing sample-size adjusted BIC and entropy; which indicates a good separation of classes. Results: A four-class solution with an entropy of 0.72 was identified as: lowest survivorship, medium-low, medium-high, and highest survivorship. The lowest survivorship class (26% of sample) with a mean survival rate of 53 months had the highest conditional probabilities of being 76-85 years-old at diagnosis, female, widowed, and non-Hispanic White, with a high likelihood with localized staging. The highest survivorship class (53% of sample) with a mean survival rate of 92 months had the highest likelihood of being married, male with localized staging, and a high likelihood of being non-Hispanic White. Conclusion: The use of a person-centered measure with population-based cancer registries data can help better detect cancer risk subgroups that may otherwise be overlooked.