[Note: This article has been accepted and is in press, scheduled to be published in 2021.] Background: College students are a priority population for health insurance literacy interventions. Yet, there are few psychometric studies on measuring health insurance knowledge-a core construct of health insurance literacy. Methods: We administered a health insurance survey to 2,250 college students. We applied Classical Test Theory and Item Response Theory methods to estimate psychometric properties of the Kaiser Family Foundation’s 10-item health insurance knowledge quiz. Results: The scale is unidimensional, and a two-parameter logistic model best fit the data. IRT estimates indicated varying item discriminations (a range: 0.717 to 2.578) and difficulties (b range: -0.913 to 1.790). Precision of measurement was maximized for students half a standard deviation below the mean (θ = -0.686) health insurance knowledge ability. Conclusions: This scale can be used to identify gaps in health insurance knowledge among college students and be applied in clinical and community health education practice.

Over the past two decades there has been increasing recognition of the importance and merits of increasing representation of historically underrepresented minorities in the health professions. However, people with disabilities are less discussed in these efforts. Over one-in-four of U.S. Americans have a disability; yet, it seems these individuals are less represented in the field of health education. This commentary discusses the merits of increasing representation of people with disabilities in the health education/promotion profession and calls for preparation programs and professional organizations to reduce systemic barriers and facilitate increased representation.

Background. Deaf American Sign Language (ASL) users represent an understudied linguistic/cultural minority group experiencing social disenfranchisement leading to a myriad of health inequities. Community-engaged and community-based participatory research is a best practice when working with Deaf ASL-users; yet, prior research using large funding mechanisms from governmental organizations is mostly unattainable by community organizations. The purpose of this study was to conduct a pilot survey assessing the feasibility of community-engagement methods to administer a low cost, community-oriented, accessible health survey among Deaf ASL-users in Florida. Methods. We established a community advisory workgroup of representatives from major Deaf-serving organizations and higher density localities. The community-academic partnership developed an accessible health survey available in ASL and English. The pilot survey was administered over a three-month period in summer 2018 using convenience sampling strategies including in-person recruitment at community events, and advertisements through Facebook and community e-mail lists. Results. Our recruitment strategy yielded 92 eligible, and diverse, respondents from across the state of Florida. We provide lessons learned from our strategy including considerations for including community members as translation reviewers; recruiting participants across a large geographic area with limited time; and, informed consent strategies. Conclusions. Limited resource environments are pervasive in public health practice and in the communities we serve. Using data from this pilot survey, we identified recommendations for future study methodology to improve community-orientation and participant recruitment among this priority population.

Background. Higher problem severity contraindicates moderation drinking in treatment samples, but has not been well investigated in natural recovery samples with more prevalent moderation outcomes, nor have single studies assessed multiple severity indicators. Therefore, we integrated five prospective studies of recent natural recovery attempts to identify multi‐indicator profiles that distinguished moderation from abstinence or unstable resolution involving relapse. The study evaluated whether moderation was distinguished by a generalized lower severity profile, or whether more complex profiles better differentiated outcomes. Methods. Community‐dwelling problem drinkers in the Southeastern U.S. (N = 616, 67% male, 65% white, mean age = 46.5 years) enrolled soon after stopping alcohol misuse without treatment were followed prospectively for a year. Outcome predictors assessed at enrollment included pre‐resolution drinking practices, alcohol‐related problems, alcohol dependence, and a behavioral economic measure of the reward value of drinking based on pre‐resolution spending on alcohol vs. saving for the future. Results. Latent profile analysis of severity indicators supported a four‐profile solution: (1) global low risk on all indicators, (2) global high risk on all indicators, (3) high risk limited to drinking practices only, and (4) high risk limited to alcohol dependence and alcohol‐related problems only. Outcomes differed by profile membership (p < .01). Multinomial logistic regression analyses showed that the global low risk and heavy drinking risk only profiles were associated with stable moderation during the one‐year follow‐up. The high dependence‐alcohol problems risk profile was associated with both abstinence and relapse during the follow‐up (ps < .05). Conclusions. Consistent with prior research, moderation was associated with lower alcohol dependence, problems, and reward value. Participants who simply drank heavily and did not have elevated risk on other indicators also had a higher probability of moderation. Results support using multi‐dimensional severity indicators that encompass functional variables in addition to drinking practices to predict outcomes.