The Impact of Temporary Assistance for Needy Families Benefit Requirements and Sanctions on Maternal Material Hardship, Mental Health, and Parental Aggravation.

INTRODUCTION: Temporary Assistance for Needy Families requirements can be stress-inducing, difficult for families to complete, and may be detrimental during early life. We assessed the impact of TANF requirements on primary caregiving mothers' experiences of material hardship, anxiety, depression, and parental aggravation in the first year of a child's life. METHODS: Survey responses were selected from mothers in the Future of Families and Childhood Wellbeing Study, who received TANF in the first year of their child's life (N = 1085). RESULTS: Survey-weighted regression models showed associations between: presence of any requirements and increased material hardship, work requirements and increased material hardship, requirement to name the father of their child and increased depression, benefit cuts and increased parental aggravation, and benefit cuts and increased material hardship. DISCUSSION: Federal and state policies should revise requirement programs to increase program accessibility and support the mental health and financial stability of mothers applying for TANF to facilitate sustainable movement into employment.

Abortion Trends in Georgia Following Enactment of the 22-Week Gestational Age Limit, 2007-2017.

Objectives. To measure trends before, during, and after implementation of Georgia House Bill 954, a limit on abortion at 22 or more weeks of gestation passed in 2012, in total abortions and abortions by gestational age and state residence.Methods. We analyzed aggregate year-level induced termination of pregnancy data from the Georgia Department of Public Health from 2007 to 2017. We used linear regression to describe annual trends in the number of abortions and χ2 analyses to describe changes in proportions of abortions by gestational age (< 20 weeks, 20-21 weeks, and > 21 weeks) across policy implementation periods (before, partial, and full implementation) for Georgia residents and nonresidents.Results. Although the total number of abortions and abortions at 21 weeks or less remained stable from 2007 to 2017, the number of abortions at more than 21 weeks declined (P = .02). The decline in number of abortions at more than 21 weeks was steeper for nonresidents (31/year; Β = -31.3; P = .02) compared with Georgia residents (14/year; Β = -13.9; P = .06).Conclusions. Findings suggest that implementation of Georgia's 22-week gestational age limit has effectively limited access to needed abortion services in Georgia and beyond. (Am J Public Health. Published online ahead of print May 21, 2020: e1-e5. doi:10.2105/AJPH.2020.305653).

Implementation of Evidence-Based HIV Interventions for Gay, Bisexual, and Other Men Who Have Sex with Men.

The Centers for Disease Control and Prevention provides trainings to support implementation of five evidence-based HIV prevention interventions (EBIs) for men who have sex with men (MSM): d-up: Defend Yourself!; Many Men, Many Voices; Mpowerment; Personalized Cognitive Counseling; and Popular Opinion Leader. We evaluated trainees' implementation of these EBIs and, using multivariable logistic regression, examined factors associated with implementation. Approximately 43% of trainees had implemented the EBIs for which they received training. Implementation was associated with working in community-based organizations (vs. health departments or other settings); acquiring training for Mpowerment or Popular Opinion Leader (vs. Personalized Cognitive Counseling); having ≥3 funding sources (vs. one); and having (vs. not having) sufficient time and necessary EBI resources. Findings suggest that implementation may vary by trainee characteristics, especially those related to employment setting, EBI training, funding, and perceived implementation barriers. Efforts that address these factors may help to improve EBI implementation among trainees.

Pathways to adolescent childbearing among Kaqchikel women in Guatemala.

One-in-five children in Guatemala is born to a mother aged 15-19 years, which poses social, economic and health risks to both mother and child. In Guatemala, adolescent childbearing is directly associated with education, ethnicity and poverty, which increases vulnerability among Indigenous young women living in poverty. This study examines the context and experiences of adolescent childbearing from the perspectives of young mothers in the Kaqchikel Indigenous ethnic group of Sololá, Guatemala. Data were collected in 19 qualitative in-depth interviews with women who had given birth to one or more children when aged 15 to 19 years. Grounded theory and narrative analysis were used to develop a conceptual framework of the process and influences on childbearing. Four distinct pathways were identified, which were influenced by gender expectations, limited communication about sex and stigma around sex. The study identifies key sociocultural influences that lead to adolescent childbearing and reveals variability within these. Identifying distinct pathways to early childbearing and their influences enables a clearer understanding of potential opportunities to interrupt these pathways with culturally relevant policies and programmes, in particular those that promote gender equality and intergenerational communication about sex.

"Nos apoyamos mutuamente": Strategies to supporting community health workers addressing the emergency and chronic needs of Latinx families.

Community health workers (CHWs) have established pathways to implementing effective, sustainable, and cost-effective health programs among underserved populations. Despite the significant role of CHWs, there is limited literature describing the needs of CHWs, specifically in times of health emergencies and crises. Thus, we explored the challenges and sources of support among CHWs providing services to Latinx families. Participants were recruited from a Latinx community-based organization in metro Atlanta, working to strengthen family relationships using evidence-based programming. Fifteen semistructured interviews were conducted among CHWs. Interviews were conducted primarily in Spanish, recorded, transcribed, and translated into English for analysis. Following a thematic analysis, data were double-coded, and codes were described and compared for themes. Participants identified as Latinx (n = 15), were between the ages of 29 and 69 years, and had worked as CHWs between 1 month to 4 years. Two themes and seven subthemes were identified in the data. Theme 1 highlighted barriers and strategies employed by CHWs to address clients' preexisting and emerging needs, and Theme 2 focused on responding to client needs during the COVID-19 pandemic, which introduced new challenges and barriers that provoked adaptive organizational strategies to promote worker resilience. Addressing the needs of vulnerable communities in times of crisis to improve the working conditions for CHWs will require a multifaceted approach that prioritizes the removal of structural barriers. Barriers can be mitigated by prioritizing cultural assets, adopting flexible and equitable work policies, and enacting policies at the federal level that promote health justice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"I Can Never Feel Safe": Latinx Youth Voices on Psychosocial Impacts of 287(g) in Georgia.

Increasingly, immigration policies are understood as structural determinants, rooted in racism, nativism, and ethnocentrism, which raise serious public health concerns for Latinx adolescents' mental health. Our objective was to examine how immigration policy enforcement affects mental health of Latinx youth raised in a county with an aggressive interior immigration enforcement program. From 2009 to 2021, Gwinnett County, GA, led the nation in deportations under the 287(g) program as a "universal enforcement model," where local law enforcement were deputized to detain undocumented immigrants, primarily through traffic violations. From June to July 2022, we followed a participatory action research approach with two groups of Latinx youth who grew up in Gwinnett County. In total, 10 youth took photos related to the research question, and engaged in facilitated dialogue using photovoice guide SHOWED/VENCER for four, 2-hour sessions that were audio-recorded and transcribed. Transcripts were analyzed following grounded theory principles to arrive at a conceptual model codeveloped and validated by youth. Youth described how 287(g) led to policing and deportation in their communities, fueling stereotypes, and discrimination that criminalized Latinx immigrants. Youth linked immigration enforcement policies like 287(g) to exclusionary systems that contributed to fear, marginalization, and loss in their communities, bringing experiences of sadness, grief, isolation, hopelessness, and low self-worth. From youth-driven research, we identified mental health implications of the 287(g) program among Latinx youth. The cascading harms of immigration enforcement policies highlight the need to address these policies and identify immediate strategies to promote Latinx youth mental health.

Immigration Enforcement Climate in Georgia and the Mental Health of Latinx Immigrants.

INTRODUCTION: Immigrant-related social policies and immigration enforcement contribute to a sociopolitical environment that affects immigrants' health. This exploratory study in six metro-Atlanta counties examined associations among immigrants' perceived vulnerability to harmful immigrant-related social policies and county-level 287(g) agreements (which facilitate cooperation between local law enforcement and federal immigration authorities), county-level immigration enforcement levels (arrests, community arrests, detainers, and removals), and immigrants' mental health. METHODS: Using data from a 2020 study among Latinx parents who were undocumented or members of mixed-status families (N = 140), we merged data on individuals' perceived policy vulnerability and depressive and anxiety symptoms with county 287(g) status and immigration enforcement levels. RESULTS: Perceived policy vulnerability was not associated with county-level 287(g) status or immigration enforcement levels. Greater policy vulnerability and Immigration and Customs Enforcement arrests were associated with higher depressive and anxiety symptoms, but 287(g) status was associated with lower depressive and anxiety symptoms. CONCLUSION: Perceived policy vulnerability, 287(g) status, and immigration enforcement levels do not always align and can have different associations with mental health.

Facing a dual threat: Pandemic stress and immigration policy vulnerability on mental health among Latinx immigrant parents.

BACKGROUND: Exclusionary immigration policies rooted in structural racism threaten the wellbeing of Latinx families, increasing stress, anxiety, depression, and distress among immigrant parents. The COVID-19 pandemic has had devastating and disproportionate impacts on communities of color with unique impacts on Latinx immigrant parents in mixed-status families. AIMS: From a syndemic theory lens, we explored the convergence of structural racism and the COVID-19 pandemic to explore if the stress of the COVID-19 pandemic may compound harmful immigration-related policies. METHODS: Our community-based participatory research cross-sectional study administered 145 surveys among Latinx immigrant parents in mixed-status families in Georgia. We examined the relationship of pandemic stress and perceived statewide immigration policy vulnerability to depressive, anxiety, and PTSD symptoms. We conducted multiple linear regression analyses to test these relationships and their interaction. RESULTS: We found that that greater perceived policy immigration vulnerability and reported pandemic stress were associated with higher symptoms of depression. Increased PTSD symptoms were also associated with immigration policy vulnerability, but not pandemic stress. Tests to assess if pandemic stress strengthened the relationship between policy vulnerability on depressive, anxiety, and PTSD symptoms revealed no statistically significant interactions. CONCLUSION: Our findings suggest that stress of the COVID-19 pandemic and longstanding anti-immigrant policies in Georgia were salient for and related to the mental health of these Latinx immigrant parents.

Depressive Symptoms in Relation to Adverse Childhood Experiences, Discrimination, Hope, and Social Support in a Diverse Sample of College Students.

BACKGROUND: Young adulthood is a critical transitory period, with various factors impacting mental health and longer-term health outcomes, particularly among racial/ethnic minorities. Drawing from minority stress theory, this study examined correlates of depressive symptoms, specifically adverse childhood experiences (ACEs), racial/ethnic discrimination, hope, social support, and their interactive effects, among a diverse sample of college students. METHODS: We analyzed data from 666 racial/ethnic minority college students (57% Black, 22% Latinx, 21% Asian) attending seven colleges and universities in the state of Georgia. Depressive symptoms were assessed using the Patient Health Questionnaire-9 Item (PHQ-9). Multivariable linear regressions included ACEs, racial/ethnic discrimination, hope, and social support, adjusting for sex, race/ethnicity, parent education, nativity, and age. We tested two-way interaction terms in four separate models to examine the potential buffering effect of social support and hope on the association between ACEs and discrimination. RESULTS: Participants were on average 20.56 years old (SD = 1.93) and 30% were male. The mean PHQ-9 score was 3.89 (SD = 4.91); 56% reported at least one ACE; 70% experienced racial/ethnic discrimination. ACEs and racial/ethnic discrimination correlated with higher levels of depressive symptoms; higher social support and hope correlated with decreased depressive symptoms. While hope and social support did not moderate the relationships between ACEs or discrimination and depressive symptoms among the full sample, racial/ethnic subgroup analyses indicated that, among Asian students, the positive association between discrimination and depressive symptoms was significantly weaker for those perceiving greater hope. CONCLUSIONS: Eliminating racial/ethnic disparities in mental health requires concerted efforts to prevent and/or reduce ACEs and discrimination and identifying protective factors that can mitigate their relationship to depressive symptoms.

Women's Lived Experiences with Temporary Assistance for Needy Families (TANF): How TANF Can Better Support Women's Wellbeing and Reduce Intimate Partner Violence.

Women experiencing poverty are more likely to face intimate partner violence (IPV), poor health, and stigma. IPV survivors are overrepresented among those who receive Temporary Assistance for Needy Families (TANF), a conditional cash program serving families experiencing poverty. More generous TANF policies may be protective against IPV, but a greater insight into TANF's effect could be gleaned through a contemporaneous study that examines intersecting determinants of wellbeing and engages community interpretation of findings. Using an adapted Family Stress Model framework and analyzing data through an intersectional and community-based lens, we explore the impact of TANF on women's wellbeing through in-depth, semi-structured interviews during the COVID-19 pandemic with 13 women who had TANF experience in three U.S. states. Data were analyzed using thematic analysis in MAXQDA and researchers facilitated three member-checking events to enhance validity of result interpretation. Four themes emerged: (1) Low cash and conditional benefits provided limited short-term "relief" but contributed to poverty and hard choices; (2) TANF benefit levels and conditions increased women's dependence on others, straining relationships; (3) Women undertook extraordinary measures to access TANF, largely to fulfill their roles as mothers; and (4) TANF stigma creates psychological stress, differentially experienced by African Americans. Increasing TANF cash benefits and other cash transfers for those experiencing poverty, adopting solely state funded TANF programs, increasing funding for TANF administration, addressing TANF stigma and racialized narratives, and allowing optional child support participation or a larger "pass-through" of child support are important steps toward making TANF more protective against IPV.

Racial and Ethnic Abortion Disparities Following Georgia's 22-Week Gestational Age Limit.

INTRODUCTION: Georgia's 2012 House Bill 954 (HB954) prohibiting abortions after 22 weeks from last menstrual period (LMP) has been associated with a significant decrease in abortions after 22 weeks. However, the policy's effects by race or ethnicity remain unexplored. We investigated whether changes in abortion numbers and ratios (per 1,000 live births) in Georgia after HB954 varied by race or ethnicity. METHODS: Using Georgia Department of Public Health induced terminations of pregnancy data from 2007 to 2017, we examined changes in number of abortions and abortion ratios (per 1,000 live births) by race and ethnicity following HB954 implementation. RESULTS: After full implementation of HB954 in 2015, the number of abortions and abortion ratios at or after 22 weeks (from last menstrual period) decreased among White (bNumber = -261.83, p < .001; bRatio = -3.31, p < .001), Black (bNumber = -416.17, p < .001; bRatio = -8.84, p < .001), non-Hispanic (bNumber = -667.00, p = .001; bRatio = -5.82, p < .001), and Hispanic (bNumber = -56.25, p = .002; bRatio = -2.44, p = .002) people. However, the ratio of abortions before 22 weeks increased for Black people (bLessThan22Weeks = 44.06, p = .028) and remained stable for White (bLessThan22Weeks = -6.78, p = .433), Hispanic (bLessThan22Weeks = 21.27, p = .212), and non-Hispanic people (bLessThan22Weeks = 26.93, p = .172). CONCLUSION: The full implementation of HB954 had differential effects by race/ethnicity and gestational age. Although abortion at 22 weeks or more decreased for all groups, abortion at less than 22 weeks increased among Black people. Additional research should elucidate the possible causes, consequences, and reactions to differential effects of abortion restrictions by race and ethnicity.

Translating cultural assets research into action to mitigate adverse childhood experience-related health disparities among African American youth.

Adverse childhood experiences (ACEs) including trauma exposure, parent mental health problems, family dysfunction, and community-level adversities put individuals at risk for a host of negative health outcomes. The effects of cumulative ACEs are numerous, diverse, and can predispose an individual to cognitive, emotional, behavioral, and physical health problems as well as premature death. African American youth experience disproportionate exposure to ACEs in the context of racism that increases risk for allostatic load and hinders systems of care responses resulting in physical and mental health disparities. To maximize efforts to mitigate these disparities it is imperative that we translate research into action to respond to ACEs in the context of racism. This article synthesizes African American cultural assets research within a resilience after trauma framework to provide a foundation for translating research into action to mitigate ACE-related disparities among African American youth. We present task shifting and youth-partnered advocacy as two strategies supported by this framework and describe their application to responding to ACEs in the context of racism. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The effect of increased minimum wage on child externalizing behaviors.

The Family Stress Model (FSM) has been used to show the relationship between socioeconomic disadvantage and child externalizing behaviors and suggests that interventions promoting economic security may be a promising approach to reduce child externalizing behavior. Using longitudinal data from the Fragile Families and Child Wellbeing study from 2002 to 2010 we examined the effect of minimum wage laws on child externalizing behaviors through a difference in difference in differences (DDD) study design. Externalizing behavior was assessed with the Child Behavior Checklist (CBCL) using the rule breaking, attention problems, and violence subscales. DDD analyses suggest a $1 increase in the minimum wage was associated with a 2% reduction in violent behaviors (ß = -1.90, 95%CI[-3.12, -0.68], p = 0.003) for the most vulnerable families headed by a primary caregiver with less than a high school education. The study results suggest that increases in the minimum wage are associated with reductions in the most severe and costly externalizing behaviors among children. Study results contribute to a growing body of literature showing that increased family incomes have positive impacts on child development, and that minimum wage policy is potentially an effective mechanism for the primary prevention of violence.