Behavior and Behavior Mechanisms Commons^™

Editorial: Individual Differences In Cognition And Affects In The Era Of Pandemic And Machine Learning, Andrea Vranic, Yang Jiang, Xiaopeng Zhao

Behavioral Science Faculty Publications

No abstract provided.

Short Chain Fatty Acids Taken At Time Of Thrombectomy In Acute Ischemic Stroke Patients Are Independent Of Stroke Severity But Associated With Inflammatory Markers And Worse Symptoms At Discharge, Nicholas Henry, Jacqueline A. Frank, Christopher J. Mclouth, Amanda L. Trout, Andrew J. Morris, Jianzhong Chen, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker

Behavioral Science Faculty Publications

Introduction: Short chain fatty acids (SCFA) are gut microbiota-derived metabolites that contribute to the gut-brain axis and may impact stroke outcomes following gut dysbiosis. We evaluated plasma SCFA concentrations against stroke severity parameters and identified SCFA-associated protein networks.

Methods: The Blood and Clot Thrombectomy Registry and Collaboration (BACTRAC), a continuously enrolling tissue bank, was used to obtain stroke samples. Arterial blood distal and proximal to the thrombus was obtained from Acute Ischemic Stroke (AIS) Patients (n=53) during thrombectomy. Patient demographics, stroke presentation and outcome parameters were reported. The SCFAs were isolated from proximal plasma via chemical derivatization UHPLC coupled tandem …

Esfuerzos Realizados En Puerto Rico Hacia La Consolidación De Políticas Públicas Para La Prevención De Cánceres Asociados Al Vph, Diana T. Medina-Laabes, Vivian Colón-López, Vilnery Rivera-Figueroa, Coralia Vázquez-Otero, Glizette O. Arroyo-Morales, Lara Arce-Cintrón, Paola Fernández-Rivera, Idamaris Vega, Roxana Soto-Abreu, Olga L. Díaz-Miranda, Ángel Rivera, Iris Cardona, Ana P. Ortiz, Lilliam Rodríguez Capó, Pamela C. Hull

Behavioral Science Faculty Publications

El propósito de este informe especial es describir cronológicamente los eventos que contribuyeron al desarrollo y aprobación de la legislación e implementación del requisito escolar de vacunación en Puerto Rico (PR), con el fin de prevenir el VPH y los cánceres asociados a este. A partir del 2010, PR inició las aprobaciones de políticas públicas con el objetivo de mejorar el registro de casos de los cánceres y la cobertura de la vacuna contra el VPH a través de los planes médicos en adolescentes de 11 a 18 años. En el 2014, los esfuerzos científicos y comunitarios lograron documentar la …

Parental Barriers Toward Seeking Mental Healthcare For Saudi Children At Risk Of Adhd, Amani Kappi

Theses and Dissertations--Nursing

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder commonly diagnosed in childhood. Underdiagnosis and undertreatment of ADHD can lead to the development of other mental illnesses and disruptions in social functioning in adulthood. Therefore, parents can play a crucial role in proactively seeking mental healthcare for children who are at risk for or who have a clear diagnosis of ADHD. Studies in the United Kingdom and the United States highlight many barriers that prevent parents from seeking mental healthcare for their children, such as negative attitudes towards the mental healthcare system and stigma towards mental illnesses.

Cultural differences …

Social Media Use And Mental Health: An Educational Intervention To Reduce Depression And Anxiety In Adolescents, Natalie Catlett

DNP Projects

Background: Most adolescents spend a great deal of their time using various social media platforms. However, excessive and maladaptive social media use is correlated with worsening symptoms of depression and anxiety among adolescents.

Objective: This project aimed to determine whether an educational intervention could help decrease overall time spent using social media and improve mood and mental health outcomes among adolescents with depression or anxiety disorders.

Methods: This was a quasi-experiment with a pretest and posttest design. An educational intervention about the relationship between social media use and symptoms of depression and anxiety among adolescents and strategies to minimize risk …

A Pilot Randomized Controlled Trial Of Smoking Cessation Induction Treatment For Rural, Underserved Cancer Survivors Across The Continuum Of Motivation To Quit, William Bowling

Theses and Dissertations--Psychology

The United States’ smoking prevalence has decreased substantially, but this public health improvement is unevenly distributed across the population. A promising individual-level approach to cancer control equity is to develop more acceptable and efficacious interventions that are widely disseminated to rural and other disadvantaged cancer survivors. Smoking cessation induction focuses not on long-term abstinence, but on engaging people in the process of making quit attempts and may be ideal for hard-to-reach populations. The aim of this pilot randomized controlled trial was to evaluate the feasibility and acceptability of a smoking cessation induction intervention designed for rural cancer survivors. The treatment …

Digital Stress Management In Cancer: Testing Stressproffen In A 12-Month Randomized Controlled Trial, Elin Børøsund, Shawna L. Ehlers, Matthew M. Clark, Michael A. Andrykowski, Milada Cvancarova Småstuen, Lise Solberg Nes

Behavioral Science Faculty Publications

BACKGROUND: Cognitive-behavioral stress management interventions are associated with improved psychological well-being for cancer survivors. The availability of, access to, and outreach of these in-person interventions are limited, however. The current study, therefore, evaluated the efficacy of StressProffen, a digital application (app)-based stress management intervention for cancer survivors, in a 12-month randomized controlled trial.

METHODS: Cancer survivors 1 year or less after their treatment (N = 172) were randomized to the StressProffen intervention (n = 84) or a usual-care control group (n = 88). The intervention was delivered in a simple blended care model: 1) 1 in-person introduction session, 2) 10 …

Overcoming The Covid-19 Pandemic For Dementia Research: Engaging Rural, Older, Racially And Ethnically Diverse Church Attendees In Remote Recruitment, Intervention And Assessment, Lisa Kirk Wiese, Ishan C. Williams, Nancy E. Schoenberg, James E. Galvin, Jennifer Lingler

Behavioral Science Faculty Publications

Background: Access to cognitive screening in rural underserved communities is limited and was further diminished during the COVID-19 pandemic. We examined whether a telephone-based cognitive screening intervention would be effective in increasing ADRD knowledge, detecting the need for further cognitive evaluation, and making and tracking the results of referrals.

Method: Using a dependent t-test design, older, largely African American and Afro-Caribbean participants completed a brief educational intervention, pre/post AD knowledge measure, and cognitive screening.

Results: Sixty of 85 eligible individuals consented. Seventy-percent of the sample self-reported as African American, Haitian Creole, or Hispanic, and 75% were female, with an average …

Understanding Parents' Views Toward The Newly Enacted Hpv Vaccine School Entry Policy In Puerto Rico: A Qualitative Study, Vivian Colón-López, Diana T. Medina-Laabes, Roxana Soto Abreu, Olga L. Díaz Miranda, Ana P. Ortiz, María E. Fernández, Pamela C. Hull

Behavioral Science Faculty Publications

BACKGROUND: The Human papillomavirus vaccine (HPV) is an essential tool for the prevention of HPV-related cancers. In Puerto Rico, the Secretary of Health established a school entry requirement of at least one dose of HPV vaccination in girls and boys aged 11 and 12 years, taking effect in August 2018. Our study aimed to examine parents' and guardians' views of unvaccinated children about the process of implementation of the new HPV vaccination school entry policy in Puerto Rico and identify potential barriers and facilitators related to the implementation of this requirement.

METHODS: During April through November 2019, we conducted three …

Prescribers' Satisfaction With Delivering Medications For Opioid Use Disorder, Hannah K. Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Jee-Seon Kim, Hanna Kim, Lynn M. Madden, Eric Haram, Todd Molfenter

Behavioral Science Faculty Publications

BACKGROUND: Expanding access to medications for opioid use disorder (MOUD), such as buprenorphine and extended release (XR) naltrexone, is critical to addressing the US opioid epidemic, but little is known about prescriber satisfaction with delivering these two types of MOUD. The current study describes the satisfaction of prescribers delivering buprenorphine and XR-naltrexone while examining whether satisfaction is associated with current patient census and organizational environment.

METHODS: As part of a cluster randomized clinical trial (RCT) focused on expanding access to medication for opioid use disorder, 41 MOUD prescribers in Florida, Ohio, and Wisconsin completed a web-based survey. The survey included …

The Impact Of The Human Papillomavirus Vaccine On High-Grade Cervical Lesions In Urban And Rural Areas: An Age–Period–Cohort Analysis, Jaimie Z. Shing, Alicia Beeghly-Fadiel, Marie R. Griffin, Rachel S. Chang, Staci L. Sudenga, James C. Slaughter, Manideepthi Pemmaraju, Edward F. Mitchel, Pamela C. Hull

Behavioral Science Faculty Publications

Disparities in human papillomavirus (HPV) vaccination exist between urban (metropolitan statistical areas (MSAs)) and rural (non-MSAs) regions. To address whether the HPV vaccine’s impact differs by urbanicity, we examined trends in cervical intraepithelial neoplasia grades 2 or 3 and adenocarcinoma in situ (collectively, CIN2+) incidence in MSAs and non-MSAs among Tennessee Medicaid (TennCare)-enrolled women aged 18–39 years and among the subset screened for cervical cancer in Tennessee, United States. Using TennCare claims data, we identified annual age-group-specific (18–20, 21–24, 25–29, 30–34, and 35–39 years) CIN2+ incidence (2008–2018). Joinpoint regression was used to identify trends over time. Age–period–cohort Poisson regression models …

Resilience-Focused Hiv Care To Promote Psychological Well-Being During Covid-19 And Other Catastrophes, L. Lauren Brown, Erika G. Martin, Hannah K. Knudsen, Heather J. Gotham, Bryan R. Garner

Behavioral Science Faculty Publications

The COVID-19 pandemic has adversely affected people with HIV due to disruptions in prevention and care services, economic impacts, and social isolation. These stressors have contributed to worse physical health, HIV treatment outcomes, and psychological wellness. Psychological sequelae associated with COVID-19 threaten the overall well-being of people with HIV and efforts to end the HIV epidemic. Resilience is a known mediator of health disparities and can improve psychological wellness and behavioral health outcomes along the HIV Continuum of Care. Though resilience is often organically developed in individuals as a result of overcoming adversity, it may be fostered through multi-level internal …

Content Analysis Of Digital Media Coverage Of The Human Papillomavirus Vaccine School-Entry Requirement Policy In Puerto Rico, Vivian Colón-López, Vilnery Rivera-Figueroa, Glizette O. Arroyo-Morales, Diana T. Medina-Laabes, Roxana Soto-Abreu, Manuel Rivera-Encarnación, Olga L. Díaz-Miranda, Ana P. Ortiz, Katelyn B. Wells, Coralia Vázquez-Otero, Pamela C. Hull

Behavioral Science Faculty Publications

BACKGROUND: In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11-12 years old. Evidence suggests that the content of media coverage may impact people's perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR.

METHODS: A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix …

Intracranial Vcam1 At Time Of Mechanical Thrombectomy Predicts Ischemic Stroke Severity, Benton Maglinger, Madison Sands, Jacqueline A. Frank, Christopher J. Mclouth, Amanda L. Trout, Jill M. Roberts, Stephen Grupke, Jadwiga Turchan-Cholewo, Ann M. Stowe, Justin F. Fraser, Keith R. Pennypacker

Behavioral Science Faculty Publications

BACKGROUND: Emergent large vessel occlusion (ELVO) strokes are devastating ischemic vascular events for which novel treatment options are needed. Using vascular cell adhesion molecule 1 (VCAM1) as a prototype, the objective of this study was to identify proteomic biomarkers and network signaling functions that are potential therapeutic targets for adjuvant treatment for mechanical thrombectomy.

METHODS: The blood and clot thrombectomy and collaboration (BACTRAC) study is a continually enrolling tissue bank and registry from stroke patients undergoing mechanical thrombectomy. Plasma proteins from intracranial (distal to clot) and systemic arterial blood (carotid) were analyzed by Olink Proteomics for N=42 subjects. Statistical …

Obstetric Patients And Healthcare Providers Perspectives To Inform Mobile App Design For Physical Activity And Weight Control During Pregnancy And Postpartum In A Rural Setting, Rachel Tinius, Cathryn Duchette, Sia Beasley, Maire Blankenship, Nancy Schoenberg

Behavioral Science Faculty Publications

Background: Mobile health technology offers the opportunity for women to engage with physical activity promotion programs without many of the barriers commonly associated with exercise during and after pregnancy (eg, childcare concerns, rigid schedules, fear of doing harm to fetus or self, access to fitness facilities, uncomfortable with body in front of others) which may be particularly useful in under-resourced rural environments. We conducted the first known study on perspectives of pregnant women, postpartum women, and obstetric healthcare providers in a rural setting on needs related to the development of a mobile app designed to increase physical activity during pregnancy …

Modifications To The Healing Communities Study In Response To Covid-19 Related Disruptions, Scott T. Walters, Redonna K. Chandler, Thomas Clarke, Nabila El-Bassel, Lashawn M. Glasgow, Rebecca D. Jackson, Emmanuel A. Oga, Jeffery H. Samet, Sharon L. Walsh, Gary A. Zarkin

Behavioral Science Faculty Publications

No abstract provided.

Rural Residents' Perspectives On An Mhealth Or Personalized Health Coaching Intervention: Qualitative Study With Focus Groups And Key Informant Interviews, Nancy Schoenberg, Madeline Dunfee, Hannah Yeager, Matthew Rutledge, Angela Pfammatter, Bonnie Spring

Behavioral Science Faculty Publications

BACKGROUND: Compared with national averages, rural Appalachians experience extremely elevated rates of premature morbidity and mortality. New opportunities, including approaches incorporating personal technology, may help improve lifestyles and overcome health inequities.

OBJECTIVE: This study aims to gather perspectives on whether a healthy lifestyle intervention, specifically an app originally designed for urban users, may be feasible and acceptable to rural residents. In addition to a smartphone app, this program-Make Better Choices 2-consists of personalized health coaching, accelerometer use, and financial incentives.

METHODS: We convened 4 focus groups and 16 key informant interviews with diverse community stakeholders to assess perspectives on this …

Adaptation Of A Standard Extended-Release Naltrexone (Xr-Ntx) Protocol For Rural Re-Entering Offenders With Oud, Michele Staton, Hannah K. Knudsen, Sharon L. Walsh, Carrie B. Oser, Erika Pike, Michelle R. Lofwall

Behavioral Science Faculty Publications

BACKGROUND: Despite a growing body of empirical support for the effectiveness of extended-release naltrexone (XR-NTX) to reduce opioid relapse among people with opioid use disorder (OUD) transitioning from a correctional facility to the community, continuity of care following release remains challenging. This paper describes a research-based adaptation of a state's standard of care XR-NTX protocol using the ADAPT-ITT framework for delivery in a non-traditional, non-treatment, community criminal justice setting (P&P office), as well as the expansion of services by a local Federally Qualified Health Center (FQHC) provider who would, for the first time, be going to the jail and P&P …

Memory-Related Frontal Brainwaves Predict Transition To Mild Cognitive Impairment In Healthy Older Individuals Five Years Before Diagnosis, Yang Jiang, Juan Li, Frederick A. Schmitt, Gregory A. Jicha, Nancy B. Munro, Xiaopeng Zhao, Charles D. Smith, Richard J. Kryscio, Erin L. Abner

Behavioral Science Faculty Publications

BACKGROUND: Early prognosis of high-risk older adults for amnestic mild cognitive impairment (aMCI), using noninvasive and sensitive neuromarkers, is key for early prevention of Alzheimer's disease. We have developed individualized measures in electrophysiological brain signals during working memory that distinguish patients with aMCI from age-matched cognitively intact older individuals.

OBJECTIVE: Here we test longitudinally the prognosis of the baseline neuromarkers for aMCI risk. We hypothesized that the older individuals diagnosed with incident aMCI already have aMCI-like brain signatures years before diagnosis.

METHODS: Electroencephalogram (EEG) and memory performance were recorded during a working memory task at baseline. The individualized baseline neuromarkers, …

Sex Differences And Psychological Stress: Responses To The Covid-19 Pandemic In China, Shiyan Yan, Rui Xu, Terry D. Stratton, Voyko Kavcic, Dan Luo, Fengsu Hou, Fengying Bi, Rong Jiao, Kangxing Song, Yang Jiang

Behavioral Science Faculty Publications

BACKGROUND: About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals' "normal" daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored - in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents.

METHODS: In late February (2020), an anonymous …

The Role Of Alexithymia And Affective Lability In Disordered Eating Behaviors, Anna Marie Lilia Ortiz

Theses and Dissertations--Psychology

Affective distress may influence eating disorder behaviors in multiple ways. Affective lability refers to the tendency to experience frequent and striking fluctuations in mood. There is considerable evidence that it predicts eating disorder symptoms. Further, alexithymia is characterized by difficulties identifying and describing feelings and an externally oriented thinking style. Alexithymia has also been implicated in the development and maintenance of eating disorders. To date, these risk factors have been studied separately. Given the evidence that both alexithymia and affective lability are affective components associated with eating disordered behaviors, it may be important to examine possible relationships among alexithymia, affective …

Identification Of Infant Feeding Practices In Eastern Kentucky And Southern West Virginia That Correlate With High Weight-For-Length, Havilah R. Adkins

DNP Projects

Background: Approximately 20% of children in the United States are obese. West Virginia and Kentucky rank in the top 10 for obesity rates in children as young as 2-4 years old. Obesity increases the risk for numerous short-term health problems and impacts long-term health, development, quality of life, and life expectancy. Research indicates that obesogenic behaviors can be addressed prior to the development of obesity or significant health problems to prevent, rather than treat. Interventions targeting caregivers of infants younger than 2-years can promote early development of healthy feeding habits that persist through the developmental stages of nutrition. Before a …

Experimental Manipulations To Test Theory-Driven Mechanisms Of Cognitive Behavior Therapy, Matthew W. Southward, Shannon Sauer-Zavala

Psychology Faculty Publications

Despite decades of randomized-controlled trials demonstrating the efficacy of cognitive-behavior therapy (CBT), the mechanisms by which CBT achieves its effects remain unclear. Here, we describe how one adaptive intervention, the sequential multiple assignment randomized trial (SMART), can be used to randomize patients at multiple decision points in treatment to draw stronger causal claims about mechanisms unfolding in the course of CBT. We illustrate this design using preliminary data and case examples from an ongoing SMART in which we are testing the role of aversive reactions to negative emotions as a hypothesized mechanism of change in the Unified Protocol. Finally, we …

E-Cigarette Availability, Price Promotions And Marketing At The Point-Of Sale In The Contiguous United States (2014-2015): National Estimates And Multilevel Correlates, Heather D'Angelo, Shyanika W. Rose, Shelley D. Golden, Tara Queen, Kurt M. Ribisl

Behavioral Science Faculty Publications

Electronic cigarette (e-cigarette) sales and use have increased rapidly, yet point-of-sale e-cigarette availability and marketing is understudied. We estimated changes in e-cigarette availability and marketing among tobacco retailers in the U.S., and associations with neighborhood characteristics. A national sample of tobacco retailers in the Contiguous U.S. was audited in 2014 and 2015 (n = 1,905 and n = 2,126, respectively) to observe e-cigarette availability and marketing (signs, ads, displays and promotions) and generate national prevalence estimates. Store, neighborhood and state level correlates of 2015 e-cigarette availability, price promotions and exterior advertising were analyzed using multilevel mixed-effects generalized linear models. E-cigarettes …

A Web-Based, Positive Emotion Skills Intervention For Enhancing Posttreatment Psychological Well-Being In Young Adult Cancer Survivors (Empower): Protocol For A Single-Arm Feasibility Trial, John M. Salsman, Laurie E. Mclouth, Michael Cohn, Janet A. Tooze, Mia Sorkin, Judith T. Moskowitz

Behavioral Science Faculty Publications

BACKGROUND: Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations but have not been routinely tested in AYAs.

OBJECTIVE: The aim of this protocol is to (1) test the feasibility and acceptability of a Web-based positive emotion skills intervention for posttreatment AYAs called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) and (2) examine proof of concept for reducing psychological distress and enhancing psychological well-being.

METHODS: The intervention development and testing are …

Substance Use Prevention Services In Juvenile Justice And Behavioral Health: Results From A National Survey, Rodney Funk, Hannah K. Knudsen, Larkin S. Mcreynolds, John P. Bartkowski, Katherine S. Elkington, Ellen H. Steele, Jessica M. Sales, Christy K. Scott

Behavioral Science Faculty Publications

BACKGROUND: This study examined the national availability of substance use prevention (SUP) within juvenile justice (JJ) and their primary behavioral health (BH) providers, and the relationships between the availability of SUP and agency-level measures of organizational structure, staffing, and youth characteristics. A three-stage national probability sampling process was used to select participants for a national survey that included, among other facets of community supervision (CS) and BH practices, questions on agency characteristics, youth characteristics, whether the agency/provider directly provided SUP services, and whether the agency/provider directly provided substance use and/or mental health treatment. This paper focuses on SUP services along …

Development And Psychometrics Of The English Version Of The Itch Cognitions Questionnaire, Carolyn J. Heckman, Christina Schut, Mary Riley, Anke Ehlers, Rodrigo Valdes-Rodriguez, Jörg Kupfer, Uwe Gieler, Jerod L. Stapleton

Health, Behavior & Society Faculty Publications

BACKGROUND: The aim of this study was to validate the English version of the Itch Cognition Questionnaire in a sample of patients with chronic itch due to psoriasis or atopic dermatitis. An English-language version of an instrument assessing itch-related cognitions is needed since cognitions can contribute to a worsening of itch, and chronic itch is prevalent in English-speaking counties and internationally.

METHODS: The German Itch Cognitions Questionnaire was translated into English, and cognitive interviewing was conducted to finalize item wording. Internal and test-retest reliability, item discrimination, responsiveness to change, and construct, convergent, and discriminant validity were assessed in a national …

Measuring The Effects Of Lobinaline-N-Bioxide (419) On Alcohol Consumption, Nicotine Locomotor Sensitization, And Conditioned Place Preference In Mice And Rats, Cocanut M. Suhail

Theses and Dissertations--Medical Sciences

Objective: Novel drug 419 was examined to see the effect it has in vivo mice and rats on alcohol consumption, nicotine locomotor sensitization, and conditioned place preference (CPP) models regarding behavioral tests on dopamine transporter activity.

Methods: Mice and rats were used to see how they react to the drug 419 and control vehicle, in each of the models. The animals were assessed to pre- and post- drug administration of novel drug 419. We examined each model to see the association between how drug 419 will help with treating drug abuse.

Results: We found that in alcohol consumption model the …

Escalation And Reinstatement Of Fentanyl Self-Administration In Male And Female Rats, Samantha G. Malone

Theses and Dissertations--Psychology

Escalation of intake and craving are two DSM-5 hallmark symptoms of opioid use disorder (OUD). Objectives: This study determined if escalation measured by long access (LgA) self-administration and craving measured by reinstatement are related. Adult male and female Sprague-Dawley rats were trained to self-administer (SA) fentanyl across 7 daily 1-h sessions, followed by 21 SA sessions of either 1- or 6-h duration. Assignment to short access (ShA) and long access (LgA) groups was randomly determined for both males and females. Following 14 1-h extinction sessions, Experiment 1 assessed reinstatement induced by either fentanyl (10 or 30 μg/kg) or yohimbine (1 …

The Importance Of Shared Language In Rural Behavioral Health Interventions: An Exploratory Linguistic Analysis, Michele Staton, Jennifer Cramer, Robert Walker, Claire Snell-Rood, Athena Kheibari

Behavioral Science Faculty Publications

A focus on the use of shared language to enhance congruence in interventionist-client dialogue is missing from traditional research on evidence-based practices and rural behavioral health. This study incorporates qualitative interactional sociolinguistics, which includes discourse analysis (typically written or audio recordings of face-to-face encounters with 11 clients and a study interventionist), to describe those speech patterns in a broad sense (dialect), as well as more specific use of communicative strategies to increase parity in the interaction between a rural interventionist delivering an evidence-based practice in the context of a research study with rural women opioid users in a non-therapeutic context. …