Survival Analysis and Socio-Cognitive Factors in the Timing of COVID-19 Vaccination Among Mexican-Origin Youth.

OBJECTIVE: The COVID-19 pandemic disproportionately affected ethnic minority populations and exacerbated preexisting health disparities. The current study aims to promote vaccine uptake among Mexican-origin youth from immigrant families by examining their time to COVID-19 vaccine uptake and assessing the influence of demographic, cognitive, and social factors on the incidence of COVID-19 vaccination. METHODS: The study conducted Survival Analysis using a Cox proportional hazards model based on a sample of 202 Mexican-origin youth (61.39% female; Mage = 20.41) with data collected from August 2021 to January 2023 in central Texas. RESULTS: The results show a critical time period for vaccine uptake (i.e., in the first six months after the vaccines were publicly available), evidenced by a surge decrease in COVID-19 unvaccination probability. In addition, more positive attitudes toward the COVID-19 vaccine (Hazard ratio/HR = 1.89, 95% Confidence Interval/CI = [1.64, 2.18]), greater motivation (HR = 2.29, 95% CI = [1.85, 2.85]), higher education levels (HR = 1.52, 95% CI = [1.24, 1.86]), and fewer general barriers to COVID-19 vaccine knowledge (HR = 0.75, 95% CI = [0.60, 0.94]) were associated with greater incidences of receiving COVID-19 vaccines at any given time point during the pandemic. CONCLUSION: The findings suggest that COVID-19 vaccine uptake among Mexican-origin youth occurred primarily within the initial months of vaccines being publicly distributed. To encourage vaccination among Mexican-origin youth, sustained COVID-19 vaccine promotion efforts are needed by targeting their motivation and positive attitudes and reducing barriers to vaccine information, particularly for youth with lower education levels.

Factors Contributing to Non-Concordance Between End-of-Life Care and Advance Care Planning.

CONTEXT: Despite making do-not-resuscitate or comfort care decisions during advance care planning, terminally ill patients sometimes receive life-sustaining treatments as they approach end of life. OBJECTIVES: To examine factors contributing to nonconcordance between end-of-life care and advance care planning. METHODS: In this longitudinal retrospective cohort study, terminally ill patients with a life expectancy shorter than six months, who had previously expressed a preference for do-not-resuscitate or comfort care, were followed up after palliative shared care intervention. An instrument with eight items contributing to non-concordant care, developed through literature review and experts' consensus, was employed. An expert panel reviewed electronic medical records to determine factors associated with non-concordant care for each patient. Statistical analysis, including descriptive statistics and the chi-square test, examines demographic characteristics, and associations. RESULTS: Among the enrolled 7871 patients, 97 (1.2%) received non-concordant care. The most prevalent factor was "families being too distressed about the patient's deteriorating condition and therefore being unable to let go" (84.5%) followed by "limited understanding of medical interventions among patients and surrogates" (38.1%), and "lack of patient participation in the decision-making process" (25.8%). CONCLUSIONS: This study reveals that factors related to relational autonomy, emotional support, and health literacy may contribute to non-concordance between advance care planning and end-of-life care. In the future, developing an advance care planning model emphasizes respecting relational autonomy, providing emotional support, and enhancing health literacy could help patients receiving a goal concordant and holistic end-of-life care.

"Some people will tell jokes to you; some people be racist:" A mixed-method examination of racist jokes and adolescents' well-being.

This study examined how adolescents make meaning of racist jokes and their impact on daily well-being using a sequential mixed-methods research design with interview (N = 20; 60% girls, 5% gender-nonconforming; 45% Asian American, 40% Latina/o/x, 10% Black, 5% biracial/multiethnic) and daily diary data (N = 168; 54% girls; 57% Latina/o/x, 21% biracial/multiethnic, 10% Asian American, 9% White, 4% Black). Qualitative results revealed that racist jokes were common, distinct from other overt forms of discrimination, and perceived as harmless when perpetrated by friends. Quantitatively, approximately half of adolescents reported hearing at least one racist joke during the study period, and racist jokes by friends were associated with higher daily angry, anxious, and depressed moods and stress. Racist jokes by known others and strangers were also significantly associated with poorer well-being, although less consistently. Findings highlight the hidden harmful effects of racist jokes on adolescents' daily mood and stress.

Language brokering profiles of Mexican-origin adolescents in immigrant communities: Social-cultural contributors and developmental outcomes.

This study examines social-cultural contributors and developmental outcomes of language brokers. From 2012 to 2020, three waves of data were collected from 604 Mexican-origin adolescent language brokers (Mage = 12.92, SD = 0.92, 54% girls). The study (1) identified four distinct subgroups of language brokers (efficacious, conservative, nonchalant, and burdened) who translated for mothers and fathers, after incorporating objective bilingual proficiency along with multiple dimensions of language brokering; (2) showed that early adolescents' Mexican, rather than U.S., cultural values and orientation were related to later language brokering profiles; and (3) showed that the efficacious group was the most resilient while burdened was the most vulnerable to developmental problems. Preservation of Mexican culture may facilitate language brokering experiences related to more positive developmental outcomes.

Peer-based discrimination and adolescent emotional and sleep health: A daily examination of direct and buffering associations.

Using 10-day daily diary data collected in 2019 from 10th grade students in southern U.S. (N = 161, 57% Latina/x/o, 21% Biracial, 10% Asian, 9% White, 4% Black; 55% female, Mage = 15.51), this study examined various forms of peer-based discrimination in adolescents' everyday lives. Results showed that personally experienced discrimination, peer racial teasing, and vicarious discrimination were frequent and impactful events. Results also provided strong evidence for the protective role of psychological resilience and some evidence for the protective-reactive roles of peer support and school climate in moderating the link between peer-based discrimination and daily well-being. The findings highlight the necessity to eliminate peer-based discrimination and shed light on interventions to reduce the harmful effects of peer-based discrimination on adolescents' daily well-being.

Age Disparities in Prevalence of Anxiety and Depression Among US Adults During the COVID-19 Pandemic.

Importance: High levels of anxiety and depression were documented shortly after the arrival of the COVID-19 pandemic and were more prevalent in younger adults than in older adults. Knowing whether these age disparities persisted throughout multiple years of the COVID-19 pandemic and identifying associated factors will help guide health policy. Objective: To investigate age disparities in anxiety and depression during the COVID-19 pandemic. Design, Setting, and Participants: This cross-sectional study consisted of a nationally representative online survey administered between April 2020 and August 2022 and included US adults who were not incarcerated. Data were analyzed between March and September 2022. Exposures: The first 27 months of the COVID-19 pandemic included wide variation in infection rates, turbulence in US political and social life, and geopolitical instability. Primary exposures include individuals' age and economic precarity and pandemic-related events (eg, weekly state-level case counts and individual vaccination status). Main outcomes and measures: Symptoms of anxiety and depression were assessed via responses to 2-item screeners (Generalized Anxiety Disorder 2-item for anxiety and Patient Health Questionnaire-2 for depression). An individual's symptoms were identified as clinically elevated if scores exceeded validated thresholds. Results: This study included 3 028 923 respondents (mean [SD] age, 48.9 [17.0] years; 1 567 603 [51.8%] female). In multiple regression analyses that include state fixed effects and survey-week fixed effects, likely anxiety and depressive disorders among 291 382 (40%) and 238 505 (33%) of adults aged 18 to 39 years, respectively, compared with 357 820 (31%) and 274 534 (24%) of adults aged 40 to 59 years and 225 295 (20%) and 183 695 (16%) adults aged 60 years and older. Levels declined throughout the pandemic period for those aged 40 years and older but remained elevated for younger adults. Analyses identified several associated factors of these age disparities. Younger adults' anxiety and depression increased more than older adults' after surges in COVID-19 case counts but decreased less following vaccination against the virus. Additionally, approximately one third of the age gap among individuals with depression and anxiety was attributed to economic precarity, to which younger adults are disproportionately exposed. Conclusions and relevance: In this cross-sectional study of anxiety and depression during the COVID-19 pandemic, economic precarity was associated with high anxiety and depression among younger adults in the US compared with older adults in the US. These findings suggest a need for greater mental health care and economic policies targeted toward younger adults.

Short-term cortisol adaption to discrimination and Mexican-origin adolescents' mental and sleep health.

Discrimination experiences are a salient contributor to the health disparities facing Latina/x/o youth. The biopsychosocial model of minority health posits that discrimination influences health through wear and tear on the biological stress responses, including the hypothalamic-pituitary-adrenal (HPA) axis, which is a primary stress response system in the body. Emerging evidence suggests that discrimination alters the secretion of cortisol, the end product of the HPA axis, yet, whether the daily processes between discrimination and diurnal cortisol response influence mental and sleep health remains unanswered. This study integrated daily diary and post-diary survey data to examine whether daily diurnal cortisol responses to discrimination influence adolescents' mental (depressive symptoms, anxiety) and sleep (sleep quality, duration) health in a sample of Mexican-origin youth (N = 282; M age = 17.10; 55% female). Results showed that adolescents who experienced more discrimination across the four-day diary period exhibited steeper diurnal cortisol slopes and lower evening cortisol; however, such physiological responses tended to be associated with poorer adolescents' mental and sleep health. The current study underscores the potential adaptation cost associated with short-term cortisol adaptation in the face of discrimination.

Change patterns of mother-adolescent perceived parenting and the corresponding trajectories in their internalizing symptoms.

Adolescence is a challenging and sensitive developmental period in which mothers and adolescents may be vulnerable to internalizing symptoms. The current study aimed to understand how patterns of changes in mother-adolescent perceived parenting (i.e., mother-adolescent perceived parenting transition profiles) corresponded with trajectories of mothers' and adolescents' internalizing symptoms from early to late adolescence. The current study utilized a three-wave longitudinal data set of 604 adolescents (54% female, Mage = 12.92, SD = 0.92) and 595 mothers (Mage = 38.89, SD = 5.74) from Mexican-origin immigrant families and adopted mother-adolescent perceived parenting transition profiles from a previous study. Multiple group analyses showed that mother-adolescent dyads who agreed on high levels of positive parenting across the course of adolescence (i.e., Stable Both High) experienced the lowest levels of internalizing symptoms, whereas dyads that showed an inconsistent pattern of mixed profile typologies over time (i.e., Fluctuated) experienced high levels of internalizing symptoms. For mother-adolescent dyads that consistently showed a pattern in which mothers reported more positive parenting compared to their adolescent children (i.e., Stable Mother High), mothers experienced low levels of (and even a decrease in) internalizing symptoms, while adolescents experienced considerably high levels of internalizing symptoms over time. The results for the other two parenting transition profiles (i.e., Change to Both High and Change from Both High) are also discussed. The findings highlight the importance of developing separate adaptive interventions to reduce internalizing symptoms for mothers and children by considering their change patterns of perceived parenting during the course of adolescence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Perceived Parenting Discrepancy Profiles, Feelings about Language Brokering, and Internalizing Symptoms among Mexican-origin Adolescents in Immigrant Families.

While different patterns of perceived parenting discrepancy among mother-adolescent dyads have been shown to be associated with adolescent internalizing symptoms, little is known about the pathway underlying such associations, particularly among immigrant families. The current study considered one culturally salient form of mother-adolescent communication, language brokering (i.e., adolescents translating and interpreting between host and heritage languages for mothers), in order to investigate its mediating role based on two waves of longitudinal data on Mexican-origin immigrant families. Wave 1 included 604 adolescents (54% female; Mage = 12.92, SD = 0.92) and 595 mothers (Mage = 38.89, SD = 5.74); Wave 2 was collected one year later with data from 483 adolescents. Perceived parenting discrepancy patterns at Wave 1 were captured by three profiles based on the levels of both mothers' and adolescents' perceived positive parenting (i.e., Mother High, Adolescent High, and Both High). Compared to the other two profiles, adolescents who reported much lower positive parenting than mothers at Wave 1 (i.e., Mother High) experienced more negative feelings about brokering at Wave 2, relating to more anxiety. Being in the Mother High (vs. Both High) group was also directly related to more depressive symptoms one year later. This study highlights the importance of considering culturally salient forms of communication, such as language brokering, when designing family-level interventions to reduce adolescents' internalizing symptoms by building agreement on high positive parenting among mother-adolescent dyads from immigrant families.

Mother-Adolescent Perceived Parenting Profiles and Mexican-origin Adolescents' Academic Performance.

Mothers and adolescents often perceive parenting differently, but it is unclear how different profiles of mother-adolescent perceived parenting and developmental transitions of such profiles would influence adolescent academic performance longitudinally. The current study adopted a three-wave dataset of 604 Mexican-origin adolescents (54% female; Mwave1.age = 12.92 years) and 595 mothers. Adolescents who agreed on high levels of positive parenting with their mothers in early adolescence (i.e., the Both High group) and stayed in the Both High group demonstrated the best academic performance in late adolescence. However, adolescents who changed from the Both High group in early adolescence and ended with discrepancies in perceived parenting or an agreement on low positive parenting with mothers in late adolescence had the worst academic performance. The findings suggest the plasticity of mother-adolescent relationships during adolescence, which can be an intervention target to improve Mexican-origin adolescent academic performance.

Reconsidering the "Acculturation Gap": Mother-Adolescent Cultural Adaptation Mis/Matches and Positive Psychosocial Outcomes among Mexican-Origin Families.

Previous studies have linked parent-child cultural adaptation mismatches with adolescents' maladjustment without addressing how intergenerational mis/matches are related to positive aspects of adolescent development and parental outcomes. Using data from 604 Mexican-origin families (adolescent sample:54%female, Mage = 12.41, range = 11 to 15), response surface analysis was conducted to investigate how mother-child mis/matches in cultural adaptation (acculturation, enculturation, English and Spanish proficiency) are associated with adolescents' and mothers' resilience and life meaning. Adolescents and mothers reported greater resilience and meaning when they matched at higher, versus lower, levels of acculturation, enculturation and English proficiency; adolescents reported more resilience when they were more acculturated than mothers. The findings provide a strengths-based understanding of parent-child cultural adaptation mis/matches and elucidate how Mexican-origin families thrive in the cultural adaptation process.

Mexican-origin youths' language brokering for fathers and mothers: Daily experiences and youths' diurnal cortisol slopes.

This study examined the associations of language brokering stress intensity and exposure with Mexican-origin youths' cortisol responses when brokering for fathers and mothers, and the moderating role of youths' brokering efficacy in these relations. Participants were 289 adolescents (Mage  = 17.38, SD = .94, 52% girls) in immigrant families. When brokering for mothers, stress exposure was related to flatter (less healthy) same-day diurnal slopes in youth. When brokering for fathers, daily brokering efficacy buffered the detrimental link between stress intensity and youths' same-day cortisol slopes. When brokering for fathers/mothers, stress intensity and exposure were related to flatter (less healthy) next-day diurnal slopes. Although daily brokering stress can relate to youth physiologic functioning, feeling efficacious about brokering may buffer the negative ramifications of stress.

Invisibly Oppressed: Individual and Ecological Correlates of Chinese American Adolescents' Perceived Discrimination.

Despite being portrayed as model minorities, Chinese American adolescents still face challenges of discrimination. Using data from 444 Chinese American adolescents (Mage = 13.04, 54% female), this study examined the independent and joint influence of individual cultural characteristics (adolescents' acculturation and enculturation) and contextual factors (parental discrimination experiences, neighborhood disadvantage, and ethnic concentration) on Chinese American adolescents' perception of discrimination experiences. Results showed that acculturation was associated with fewer discrimination experiences; yet, higher levels of neighborhood disadvantage were related to more youth discrimination. Mothers' discrimination experiences were associated with adolescents' discrimination experiences when adolescents retained more of their Chinese culture. The findings of the study highlight the importance of considering the interplay between contextual and individual factors in influencing adolescents' development.

Working Harder than Others to Prove Yourself: High-Effort Coping as a Buffer between Teacher-Perpetrated Racial Discrimination and Mental Health among Black American Adolescents.

High-effort coping (feeling like one must work harder than others to succeed due to anticipated discrimination) is an understudied concept in adolescence. The current study examined among Black American adolescents surveyed in eighth and 11th grade (N = 630, 49% female) how high-effort coping moderated the relations between teacher-perpetrated racial discrimination and psychological distress across time, and whether the buffering role of high-effort coping varied by adolescent gender and socioeconomic status. Experiencing racial discrimination from teachers in eighth grade was positively related with depressive symptoms, anger, and suicidal ideation in 11th grade. High-effort coping buffered against teacher discrimination for suicidal ideation among low socioeconomic status youth, as well as for anger among high socioeconomic status youth. Findings underscore the harmful influence of racial discrimination on Black American adolescents' mental health, as well as suggest that among certain subpopulations, high-effort coping may be one psychologically protective resource through which Black American youth retain positive feelings that are undermined by racial discrimination, and thus promote mental well-being.

Daily Experiences of Discrimination and Ethnic/Racial Minority Adolescents' Sleep: The Moderating Role of Social Support.

Using data from a 14-day diary study of 95 ethnic/racial minority adolescents, this study examined the within-person effect of daily discrimination tied to multiple social identities on adolescents' daily sleep quality and duration and whether daily support from important others (i.e., friends, parents, and teachers) would moderate these links. We found that daily discrimination was a low-frequency, but high-impact event associated with shorter sleep duration. Results pointed to the nuanced roles of daily support. Support from friends was negatively related to sleep duration, whereas support from parents appeared to be promotive to sleep quality. Support from teachers protected adolescents from the negative effects of discrimination on sleep duration. Implications for future interventions targeting sleep disturbances associated with discrimination are discussed.

Cultural stressors, internalizing symptoms, and parent-child alienation among Mexican-origin adolescents.

Objective: The current study investigated the relation of various cultural stressors, parent-child alienation, and Mexican-origin adolescents' internalizing symptoms at both between- and within-person levels across the course of adolescence. Background: Positive parent-child relationships can be a critical buffer against cultural stressors for Mexican-origin adolescents. However, it is unclear whether low levels of parent-child alienation (a) buffer the negative effects of different types of cultural stressors on internalizing symptoms and (b) function at the individual level more generally or during specific periods when adolescents experience high cultural stressors. Method: The current study used a three-wave longitudinal dataset of 604 Mexican-origin adolescents (Wave 1: Mage = 12.41, SD = 0.97, 54% female, 75% born in the United States) and conducted multilevel regression analysis. Results: At the between-person level, overall low parent-child alienation buffered the adverse effects of ethnic discrimination on anxiety and cultural misfit on depressive symptoms. There were no significant within-person-level interactions of parent-child alienation and cultural stressors on adolescent internalizing symptoms. Implication: The findings suggest that interventions should aim to reduce parent-child alienation throughout the course of adolescence to alleviate the impact of cultural stressors on internalizing symptoms among Mexican-origin adolescents.

Culturally relevant stressors as moderators of intergenerational transmission of mother-adolescent executive function in Mexican immigrant families.

The intergenerational transmission of executive function may be enhanced or interrupted by culturally salient environmental stressors that shape the practice of executive function in the family. Building upon past research, the current study tests whether culturally relevant stressors such as economic stress and foreigner stress have a direct effect on adolescent executive function, as well as whether they modify the intergenerational transmission of mother-child executive function (i.e., working memory, inhibitory control, and shifting) in low-income Mexican immigrant families. The sample consists of 179 Mexican American adolescents (Mage = 17.03 years; SDage = 0.83; 58% females) and their Mexico-born mothers (Mage = 43.25 years; SDage = 5.90). Results show that mothers' perceived economic stress is associated with poor inhibitory control in adolescents. Low levels of mothers' perceived foreigner stress related to a stronger association between mothers' and adolescents' working memory, while high levels of mothers' perceived foreigner stress related to enhanced intergenerational transmission of poor shifting ability. Study findings demonstrate the prominence of perceived foreigner stress as a contextually relevant factor moderating the intergenerational transmission of mother-child executive function in low-income Mexican immigrant families.

Language Brokering-Stress Transition Profiles and Marijuana Use in Mexican-Origin Adolescents.

Although Mexican-origin adolescents experience multiple contextual stressors (e.g., discrimination, economic stress, and foreigner stress) that may result in increased marijuana use, they actively engage in cultural practices (e.g., language brokering) that may protect them from adverse developmental outcomes. Yet, the joint influence of contextual stressors and language brokering on marijuana use has rarely been studied from a developmental perspective. Using a sample of 604 Mexican-origin adolescent brokers (54% female, Mage.Wave1 = 12.41), we examined how stability and change of language brokering-contextual stress (i.e., broker-stress) profiles across three waves are related to adolescent marijuana use. We hypothesized that adolescents with positive brokering experiences and lower contextual stress across three waves (i.e., those in the Stable Protective profile) would be the least likely to use marijuana. For brokering for mothers, the Stable Protective and the Change to Protective groups were less likely than other groups to use marijuana. For brokering for fathers, the Stable Protective group was the least likely to use marijuana and the Change to Protective group was less likely than the Risk at Any Wave group to use marijuana. Interventions could foster brokering-related positive feelings across the course of adolescence to reduce marijuana use among Mexican-origin adolescents.

Antecedents and Consequences of Discrepant Perceptions of Racial Socialization between Parents and Adolescents within Mexican-Origin Families.

Parents and adolescents often have different views regarding parental racial socialization practices; however, studies documenting such discrepancies remain scarce. Using a person-centered approach, this study investigated patterns of parent-adolescent discrepant views on racial socialization (i.e., cultural socialization, bias coping, bias awareness) as well as antecedents and consequences of the discrepancy profiles. Participants were 604 adolescents (54% female, Mage = 12.41, Rangeage = 11-15) and their mothers and fathers. The results showed distinct discrepancy patterns and suggested that more maternal/paternal warmth was associated with profiles that have smaller discrepancies or profiles in which adolescents reported higher socialization than parents. Adolescents who reported higher or similar socialization as parents demonstrated better adjustment. Implications for interventions aimed at strengthening parent-child relationships and communication about race and culture are discussed.

The effect of racial discrimination on mental and physical health: A propensity score weighting approach.

RATIONALE: The preponderance of research documents the negative consequences of racial discrimination for the mental and physical well-being across several racial/ethnic groups including Black Americans, Hispanic Americans, and Asian Americans. Despite this large body of research, few studies have attempted to evaluate racial discrimination as a casual factor of worse health among racial minority groups. The current study utilized nationally representative data to estimate the causal effect of racial discrimination on cardiovascular disease (CVD), self-rated physical health (SRH), body mass index (BMI), depression disorder, and substance use disorder. In addition, we examined whether the effect of racial discrimination on health was moderated by socio-demographic characteristics (i.e., age, race/ethnicity, sex, socioeconomic status, marital status, geographic location, and health insurance coverage). METHODS: Data were from the combined National Survey of American Life and the National Latino and Asian American Study. We applied a propensity score weighting approach to estimate the differences between individuals who reported ever (N = 4358) or never (N = 1836) experiencing racial discrimination on a list of health outcomes (e.g., CVD, SRH, BMI, depression disorder, and substance use disorder). RESULTS: Participants who reported ever experiencing racial discrimination were about 5 % higher CVD risk, had 0.12 points lower SRH, a 3 % higher probability of a depression disorder, and a 2 % higher probability of a substance use disorder. Moderation effects by race/ethnicity, sex, socioeconomic status, geographic region, and health insurance coverage were found. CONCLUSION: Our study represents one of the first attempts to apply a propensity score weighting approach to causally link racial discrimination to worse health for racial minority individuals. This study adds to a larger body of research documenting the negative association between racial discrimination and health.