Behavior and Behavior Mechanisms Commons^™

A Single Administration Of Psilocybin Is Ineffective In Reversing Ptsd-Like Sequelae In A Rat Model Of Stress-Enhanced Fear Learning, Kylie M. King, Marisa J. Savini, Noelle M. Molnar, Evelynn J. Schneider, Savannah E. Straub, Joe Parker, Lillianna P. Puppel, Aleece K. Al-Olimat, Allison M. Bach, Phillip R. Zoladz

ONU Student Research Colloquium

Single treatments with psychedelics produce rapid, long-lasting antidepressant effects. Psychedelics may also exert anxiolytic effects and be useful in treating more complex psychiatric conditions, such as PTSD. However, less is known about the impact of these agents on PTSD-related symptoms. Thus, we aimed to determine whether a single administration of psilocybin could reverse PTSD-like sequelae induced by stress-enhanced fear learning in rats. Sprague-Dawley rats were placed in Context A (circular, white conditioning box) and exposed to several uncontrollable footshocks (Stress) or no footshocks (No Stress). The next day, the rats were placed in Context B (square conditioning box with clear …

Psilocybin And The Related Tryptamine, Norbaeocystin, Exert Acute Anxiogenic Effects That Depend On Sex, Marisa J. Savini, Kylie M. King, Noelle M. Molnar, Evelynn J. Schneider, Savannah E. Straub, Joe Parker, Lillianna P. Puppel, Aleece K. Al-Olimat, Allison M. Bach, Andrew Jones, Phillip R. Zoladz

ONU Student Research Colloquium

Single treatments with psychedelics have demonstrated rapid, long-lasting antidepressant effects. However, psychedelics often produce unfavorable psychoactive effects that could worsen existing psychological distress. Thus, we compared the effects of psilocybin and the related tryptamine, norbaeocystin, on anxiety-like behavior in male and female rats. In Experiment 1, rats were treated with 1 mg/kg psilocybin (PSIL), 1 mg/kg norbaeocystin (NOR), or vehicle 30 min before a 5-min trial on an elevated plus maze (EPM) or in an open field test (OFT). On the EPM, PSIL led to decreased open arm time and fewer arm entries in males and females. NOR led to …

Out-Of-Pocket Costs And Antihypertensive Medication Use Among Veterans: A Natural Experiment, Alexander R. Zheutlin, Alexander Chaitoff, Daniel Addo, Joshua A. Jacobs, Catherine G. Derington, Eric L. Stulberg, Peter A. Glynn, Bernardo Modenesi, Jordana B. Cohen, Adam P. Bress

Department of Neurology Faculty Papers

BACKGROUND: Blood pressure (BP) control remains suboptimal in the United States despite available low-cost antihypertensive medications. Even small out-of-pocket medication costs may contribute to adherence. We determined whether $0 versus >$0 out-of-pocket costs for antihypertensive medications is associated with differences in adherence, discontinuation, BP control, and cardiovascular outcomes.

METHODS: We included veterans with newly diagnosed hypertension who initiated antihypertensive medication in the Veterans Health Administration from 2004 to 2022. A fuzzy regression discontinuity design with 2-stage residual inclusion leveraged differences in medication copay policy at a 50% service-connected disability threshold (≥50% service-connected disability: $0 out-of-pocket cost versus < 50%: $8 monthly cost). Outcomes included 1-year medication nonadherence (proportion of days covered < 80%), 1-year medication discontinuation (no medication in the final 90 days of the study year), 1-year BP control (systolic BP/diastolic BP < 140/90 mm Hg and < 130/80 mm Hg) and cardiovascular disease events (myocardial infarction, coronary revascularization, peripheral artery disease, or stroke).

RESULTS: Among 417 …

The Impact Of A Mindfulness Meditation Program On Phq-9 Scores In Eskd Clients At The Dialysis Center, Christi Collins Weaver

Student Scholarly Projects

Practice Problem: Patients undergoing hemodialysis for end-stage kidney disease (ESKD) experience high rates of untreated depressive symptoms, which negatively impact quality of life, treatment adherence, and therefore increased hospitalization and higher mortality rates.

PICOT: In adult patients receiving in-center hemodialysis (P), how does the implementation of a structured mindfulness meditation program (I), compared to usual care (C), affect depressive symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9) (O) over an eight-week period (T)?

Evidence: Current literature demonstrates that depression is highly prevalent among individuals with ESKD and is associated with increased morbidity and decreased treatment adherence. Evidence supports mindfulness …

Drd2 Rs6276 Polymorphism And Trait Impulsivity In Individuals With Mixed Behavioral And Substance Addictions, Gabriela Zdunek, Remigiusz Recław, Aleksandra Suchanecka, Krzysztof Chmielowiec, Dariusz Larysz, Patryk Ilków, Kinga Łosińska, Jolanta Chmielowiec, Łukasz Jaworski, Anna Grzywacz

Baltic Journal of Health and Physical Activity

Background/Objectives: Impulsivity is a key transdiagnostic trait linked to dysregulated reward processing in both behavioral and substance-related addictions, as recognized in DSM-5. Dopaminergic genes, including DRD2, may modulate individual differences in impulsivity, particularly under conditions of increased addiction vulnerability. This study examined whether the DRD2 Exon 8 rs6276 polymorphism predicts impulsivity levels in men with mixed addictive behaviors compared with healthy controls. Methods: A total of 328 males (128 with mixed behavioral and substance addictions and 200 controls) were assessed. Diagnoses were confirmed using the MINI interview, and impulsivity was measured with the Barratt Impulsiveness Scale (BIS-11). Genotyping of …

Efficacy, Acceptability, And Feasibility Of Stayquit For Sustaining Smoking Abstinence After Psychiatric Hospitalization: A Pilot Study, Corinne N. Kacmarek, Hannah C. Smith, Alicia Lucksted, Lan Li, Laché Wilkins, Gabriella Coakley, Peter Phalen, Deborah Medoff, Faith Dickerson, Julie Kreyenbuhl, Melanie E. Bennett

Journal of Patient-Centered Research and Reviews

Purpose: Veterans with mental illness have high rates of tobacco use and psychiatric hospitalization in the Veterans Health Administration (VA). VA is smoke-free, and guidelines recommend that smoking cessation medication and counseling be delivered during and one month after hospitalization to sustain abstinence. Little is known about how patients experience this intervention. This pilot study evaluated the acceptability, feasibility, and efficacy of an evidence-informed, novel smoking intervention, StayQuit, for psychiatric inpatients.

Methods: Participants were recruited from an inpatient VA psychiatric unit. Changes in self-reported cigarettes smoked per day, nicotine dependence, and abstinence self-efficacy were evaluated between baseline and 12-week follow …

Heroes Of Medicine In The Rio Grande Valley: Documentary Interview With Dr. Cynthia Cavazos Gonzalez, Cynthia Cavazos Gonzalez, Raquel Elena Orellana

Heroes of Medicine in the Rio Grande Valley

Cynthia Cavazos Gonzalez PhD is an Associate Professor of Clinical Practice at UTRGV in Edinburg, Texas and she is the clinic director of the UTRGV Psychology training clinic. She completed a doctoral degree in Clinical Psychology from California School of Professional Psychology in Fresno, California. Her doctoral degree is in Clinical Psychology with a major specialization in Neuropsychology and minor specialization in Health Psychology. She completed an APA-accredited pre-doctoral internship at UTMB in Galveston with a major emphasis in hospital consultation, outpatient psychotherapy, and psychological and neuropsychological evaluations with diverse populations. She completed an informal neuropsychology post-doctoral residency in Texas …

The Role Of Loneliness On College Freshmen Retention, Amy Berg

Libraries Undergraduate Research Award (LURA) Winners

What factors contribute to student retention, dropout, and success within the first semester? We hypothesized that persistent feelings of loneliness across the semester play a major role in a student’s intentions to continue enrollment, and a lack of social connection to the university mediates this relationship. We assessed this in a sample of n = 30 first semester freshman enrolled in a university success seminar across the Fall 2025 semester, of whom n = 8 completed Wave 1 and Wave 4 surveys of a four-wave study spanning the whole semester. We used the 20- item UCLA Loneliness Scale, the 24-item …

Adverse Childhood Experiences And Proactive Coping: Impacts On College Adjustment And Risky Behavior, Saige A. Imm, Jisook Park, Will Stutterheim

SACAD: Scholarly Activities

Numerous studies have examined the enduring impact of Adverse Childhood Experiences (ACEs) on individuals’ capacity to manage stress and effectively navigate challenges in the rigors of the university environment. Exposure to negative life events has shown to interfere with individuals’ psychological maturation, heightening an inclination to engage in risky behaviors, especially during pivotal developmental transitions like the start of college. Thus, investigating the impact of ACEs on college students is crucial as it could impair their societal well-being and increase mental health concerns and maladaptive behaviors in college (Schafer, 2021; King et al., 2024). The current research examines the role …

Evaluating Sensory Sensitivities Among Children With Autism Spectrum Disorder In An Adaptive Gymnastics Program, Aicha Kaouss, Bradley Eppinger, Austin Ebbrecht, Kailash Ram, Kaitlin P. Hardy Md

Knowledge and Creativity Expo

Introduction: Children with autism spectrum disorder (ASD) participate in physical activity at lower rates than their neurotypical peers1. Sensory sensitivities, reported in approximately 75–95% of children with ASD, may contribute to this disparity2. Gymnastics environments involve bright lighting and loud noise, which can precipitate sensory overload. The impact of specific sensory features on participation in adaptive gymnastics remains underexplored.

Methods: A cross-sectional study recruited caregivers of children aged 3–12 years with an ASD diagnosis enrolled in the EVMS Adaptive Gymnastics Program. Caregivers completed the Sensory Experiences Questionnaire–Third Edition (SEQ-3)3 and supplemental survey items on Redcap which assessed environmental triggers and …

Potency-Related Effects Of Smoked Cannabis On Simulated Driving Performance: A Randomized, Controlled Crossover Trial, Bruna Brands, Adam Zaweel, Madison Wright, Patricia Di Ciano, Christine M. Wickens, Justin Matheson, Andrew Fares, Omer S. M. Hasan, Marcos Sanches, Beth Sproule, Marilyn A. Huestis, Timothy L. Brown, Bernard Le Foll

Institute of Emerging Health Professions Faculty Papers

Given the increasing availability of high-potency Δ9-tetrahydrocannabinol (Δ9-THC) products, understanding potency-related effects of Δ9-THC on driving performance is an important public safety issue. This randomized, double-blind, placebo-controlled, within-subjects trial examined the effects of smoked cannabis with varying Δ9-THC concentrations on simulated driving. Adults aged 19–45 who regularly used cannabis and held valid driver’s licenses completed simulated driving tasks after smoking placebo, or cannabis containing low (6.25%/47 mg Δ9-THC), medium (12.5%/94 mg Δ9-THC), or high (22%/165 mg Δ9-THC) Δ9-THC levels. The primary outcome was mean speed (km/h); secondary measures included maximum speed, standard deviation of lateral position (SDLP), reaction time (RT), …

Impact Of Acute Flight Training Stress On Cardiovascular Health, Toni Butler, Noah Robbins, Sophia Vaden, Bryan Hinton

Student Research Symposium (SRS)

Student pilots face a unique set of stressors that are a part of their flight training. These acute stressors can have immediate and long-term impacts on their physiological and psychological well-being. Using near-infrared spectroscopy (NIRS) to measure vascular endothelial function (a marker of cardiovascular health), this investigation will help us understand how the stressors involved in acute flight training affects the cardiovascular health of student pilots. We will test the hypothesis that acute flight training stress obtained from a single bout of flight training reduces cardiovascular function as shown by a reduced post-occlusive reactive hyperemic (PORH) response. Cardiovascular health will …

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

Requesting Less, Winning More: A Plaintiff Strategy To Eliminate Low-Value Anchors, Emily V. Shaw, Jade E. Larson

Mercer Law Review

Picture this: You are a plaintiffs’ lawyer representing a permanently injured client in a high-stakes lawsuit. You think you can earn millions of dollars for your client based on their injuries—but something is holding you back: your client’s past medical bills. To date, she has only had to pay around $20,000. You worry that this fact might make your request for several million dollars in non-economic damages seem excessive to a jury. So, you make a plan: on the eve of trial, you withdraw your request for economic damages and stick to only requesting non-economic damages in the millions. There …

Addressing Health Inequities For People With Intellectual And Developmental Disabilities In The Hospital Through Partnerships In Nurse Training, Suzannah Iadarola, Amanda Laprime, Samantha Hochheimer, Tabby Anvari, Carrie Baker, Jacqueline Goodman

Developmental Disabilities Network Journal

People with intellectual/developmental disabilities (IDD) deserve the same access to quality healthcare yet are at increased risk of medical and/or psychiatric conditions as compared to the general population. Patients with IDD have less health satisfaction, shorter life expectancy, less access to preventative care, higher chronic health conditions, overuse of certain medications, and increased mortality. This population and their caregivers report high levels of dissatisfaction with emergency/inpatient care. Nurses also express frustration with lack of training, limited resources, and competing priorities.

We developed the Advancing Supportive Care through Education for Nurses on Disability (ASCEND) Program, to build the capacity of inpatient/Emergency …

Sociodemographic Influences On Student-Athlete Eating Disorder Risk And Treatment-Seeking Behavior In The National College Health Assessment, Savannah Hughbanks, Andrew W. Froehle, Brian A. Edwards

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Objective: The present study was developed to explicate attributes associated with increased likelihood of disordered eating behaviors and treatment avoidance and help practitioners better-identify and assist high-risk individuals.

Participants: Varsity athletes (n=51,882) who completed the National College Health Assessment (NCHA) between 2011 and 2019.

Methods: Data was collected from survey responses to questions related to disordered eating behaviors. Disorders were cross-sectioned into eight predictors: year in school, gender, sexual-orientation, race/ethnicity, school-type, international-student, history of mental health illness, and anxiety of impending academic performance.

Results: Two percent of the student-athletes self-reported an ED diagnosis, and within those two percent 65.9% reported …

Affect Regulation In The Context Of Sexual And Gender Minority Stress: A Scoping Review Protocol, Daphne Y. Liu, Benjamin A. Swerdlow, Shao Yuan Chong, Nadia Kako, Alex Rubin, Nicholas S. Perry

Psychology: Faculty Scholarship

Objective

To provide a broad, comprehensive picture of affect regulation in the context of sexual and gender minority stress, this scoping review aims to identify and synthesize methods, methodologies, and available evidence pertinent to emotion regulation and coping in the context of minority stress among sexual and gender minority (SGM) people.

Introduction

SGM people face disproportionately high rates of mental health problems due to experiences of minority stress and lack of social safety. Theories and growing evidence suggest that affect regulation plays a critical role in SGM people’s well-being in the face of minority stress. Researchers have largely studied emotion …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

Gritty Residents: Starting Residency With Resiliency, R Levi Sundermeyer, Brock Cardon

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Implementing A “Naloxone Hub With Many Spokes” Model In Kentucky: Partner Agency Perspectives On Implementation Strategies, Hannah K. Knudsen, Michael Goetz, Shaquita Andrews-Higgins, Sandra Back-Haddix, Olivia A. Davis, Patricia R. Freeman, Douglas R. Oyler, Sharon L. Walsh

Behavioral Science Faculty Publications

Background: Overdose education and naloxone distribution (OEND) is a vitally important evidence-based practice for addressing the ongoing opioid epidemic. During the HEALing Communities Study in Kentucky, OEND was dramatically scaled up in eight counties using a “hub with many spokes” model and multifaceted implementation strategies. This aim of this manuscript is to describe qualitative perspectives of partner organizations regarding the utility of the implementation strategies used to expand OEND.   Method: Twenty small-group and 24 individual qualitative interviews were conducted with staff from 44 agencies that implemented OEND through partnerships with the study team. Interviews were conducted 6–8 months after the …

Derivation Of An Intrinsic Brain Activity Biomarker For The Earliest Prediction Of Cognitive Decline, Leslie S. Prichep, Syed N. Zaidi, Kara Brink, Saloni Kanakia, Bo Liang, Yang Jiang, Ruben Armañanzas

Behavioral Science Faculty Publications

Early identification of cognitive decline in the elderly is essential for timely and effective intervention. Current neuroimaging and clinical biomarkers have largely focused on patients with mild cognitive impairment (MCI) and dementias, and though effective, have not been demonstrated to be sensitive to the earliest signs of functional abnormalities. The electroencephalogram (EEG), with a millisecond time base, allows a precise exploration of synaptic dysfunction even at the initial stages of the damage. This study introduces a novel non-invasive EEG-based biomarker to predict cognitive decline of participants showing only subjective cognitive impairment (SCI). Baseline EEG recordings from 88 SCI participants who …

Toward A Predictive Model Of Success In Contingency Management: A Proof Of Concept Study Utilizing Behavioral Economic, Clinical Severity, And Alcohol Use Severity Measures, Haily K. Traxler, Christopher T. Franck, Mikhail N. Koffarnus

Behavioral Science Faculty Publications

As contingency management (CM) moves from research to practice, researchers have a responsibility to outline the minimum procedural necessities that lead to an effective, sustainable treatment that can be implemented as a mainstream therapy for substance use disorders. To begin identifying the minimum requirements, the purpose of the current study was to provide framework and a first step toward building a risk calculator that predicts treatment outcomes in CM, and can predict the optimal incentive size to prescribe by evaluating behavioral economic factors, demographic variables, and use severity measures in individuals who completed CM treatment for alcohol use. Participants were …

Felt Ambivalence Weakens The Attitude-Intention Pathway For Regular Leisure-Time Physical Activity In Chinese Adolescents: A Three-Wavee Prospective Study, Yaogang Han, Yubing Wang, Pan Li, Guohua Zheng

Human Movement Studies & Special Education Faculty Publications

Background: Favorable attitudes toward regular leisure-time physical activity may not always translate into intention if adolescents feel ambivalent about the behavior. This study tested whether felt ambivalence weakens the prospective attitude–intention association and the indirect effect of attitude on later behavior through intention. Methods: Chinese adolescents (N = 1714; Grades 7–12; mean age = 15.0 years) completed a three-wave survey at approximately two-week intervals. Wave 1 assessed attitudes toward regular leisure-time moderate-to-vigorous physical activity, felt ambivalence, and physical activity habit; Wave 2 assessed intention; and Wave 3 assessed leisure-time physical activity. Moderated mediation was tested in a structural equation model …

Suicidality, Self-Neglect, And Medical Refusal In Advanced Illness: An Ethical Case Report, Austin Supak, Sarah Greene, Madeline Adelman, Whitney Snyders

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Pillpetz: A Smarter Way To Encourage Medication Adherence In Children, John H. Begley

CMC Senior Theses

Medication adherence is usually framed as a problem of patient behavior, but this thesis argues that it is equally a problem of design. Children who take daily medication face barriers that adults often do not: developing executive function, dependence on caregivers, shifting school and home routines, privacy concerns, and stigma around being perceived as different. The standard prescription bottle, by contrast, was designed primarily for dispensing efficiency, safety, and accidental ingestion prevention—not for sustained daily use by a developing child.

This thesis proposes PillPetz, a smart pill case and digital companion that uses routine, play, dose confirmation, and caregiver-connected support …

Mindfulness Matters: Reducing Anxiety In Prelicensure Undergraduate Nursing Students Using Virtual Reality Meditation Prior To High Fidelity Simulation., Lindsey K. Hildreth

Honors Theses and Capstones

Abstract:

The aim of this study was to evaluate the effectiveness of a 5-minute virtual reality (VR) meditation intervention in reducing self-reported anxiety among prelicensure nursing students immediately prior to their participation in a high-fidelity clinical simulation. Anxiety levels were measured using a Visual Analog Scale (VAS) and compared between students who participated in the VR meditation intervention and those in a control group receiving standard prebrief, and no VR meditation. It was hypothesized that students who engage in VR meditation would demonstrate a reduction in anxiety compared to students in the control group.

Clinical And Demographic Characteristics Of Participants In A Hepatitis C Treatment Trial In Rural Kentucky: How Policies Around Treatment Access May Impact Elimination Efforts In The United States, Jennifer R. Havens, Brittney D. Williams, Takako Schaninger, Virginia A. Shepherd-Tackett, Michelle R. Lofwall, Michele Staton, Sharon L. Walsh, Hannah K. Knudsen

Behavioral Science Faculty Publications

Introduction: The advent of curative direct acting antiviral (DAA) drugs to treat those actively infected with the hepatitis C virus (HCV) has allowed for discussion around HCV elimination. Restrictive state-by-state policies for the coverage of DAAs for Medicaid recipients may hamper elimination efforts in the United States by limiting access to these curative treatments. Methods: The purpose of the current analysis was to examine the sociodemographic, drug use and clinical characteristics of participants in the Kentucky Viral Hepatitis C Treatment (KeY Treat) study in the context of Medicaid policies in the United States. The goal of KeY Treat was to …

The Interaction Of Tobacco Retailer Density And Rurality With Tobacco Use Prevalence In Kentucky, Shyanika W. Rose, W. Jay Christian, Judy Van De Venne, Delvon T. Mattingly, Bethany Shorey Fennell, Saber Feizy, Mary Kay Rayens

Behavioral Science Faculty Publications

Purpose: Tobacco retailer density is a key correlate of tobacco use prevalence in the United States, but this relationship has typically been examined in urban areas. We examined the relationship between retailer density and tobacco use across Kentucky counties, a state with high smoking rates and a substantial rural population.

Methods: We obtained a list of tobacco retailers from the 2021 Kentucky Synar program, used for minor’s access inspections. We merged these data with county-level prevalence estimates for cigarette and smokeless tobacco use for each county in Kentucky, calculated using pooled 3-year estimates (2017-2019) of Kentucky Behavioral Risk Factor Surveillance …

Acceptability And Appropriateness Of Harm Reduction Vending Machines Compared To Syringe Service Programs In Appalachian Kentucky, Hannah K. Knudsen, Jennifer R. Havens, April M. Young

Behavioral Science Faculty Publications

Objective:

Many rural people who inject drugs do not use syringe service programs (SSPs). In addition, people who use drugs but do not inject may perceive that SSPs are not intended for their use. Harm reduction vending machines (HRVMs) may be preferred by some individuals. This study examines attitudes and preferences regarding HRVMs to consider possibilities for enhancing the reach of harm reduction services. Method:

Structured surveys were conducted with 712 people who use drugs in two rural Appalachian counties in Kentucky. Participants rated the acceptability/appropriateness of SSPs and HRVMs; HRVM preference was the difference between the two scales. Linear …

Perceived Neighborhood Disadvantage And Current Nicotine Pouch Use Among U.S. Youth, Delvon T. Mattingly, Meman Diaby, Jing Zhang, Juhan Lee, Melinda J. Ickes

Behavioral Science Faculty Publications

Introduction: Nicotine pouches (NPs) are emerging nicotine products that appeal to youth due to their discreet use, tobacco-free formulation, and flavor availability. However, given their recent introduction to the market, little is known about how neighborhood environments may influence US youth NP use.

Methods: We imputed cross-sectional data from the 2023 National Youth Tobacco Survey (n = 22,069, ages 9 + years) and developed a neighborhood risk score (range: 1–4) by averaging 10 items related to neighborhood disorder, safety, and disadvantage. To estimate associations between the risk score and current (past 30-day) NP use, we fit logistic regression models adjusted …