Measuring social determinants of health in the All of Us Research Program.

To accelerate medical breakthroughs, the All of Us Research Program aims to collect data from over one million participants. This report outlines processes used to construct the All of Us Social Determinants of Health (SDOH) survey and presents the psychometric characteristics of SDOH survey measures in All of Us. A consensus process was used to select SDOH measures, prioritizing concepts validated in diverse populations and other national cohort surveys. Survey item non-response was calculated, and Cronbach's alpha was used to analyze psychometric properties of scales. Multivariable logistic regression models were used to examine associations between demographic categories and item non-response. Twenty-nine percent (N = 117,783) of eligible All of Us participants submitted SDOH survey data for these analyses. Most scales had less than 5% incalculable scores due to item non-response. Patterns of item non-response were seen by racial identity, educational attainment, income level, survey language, and age. Internal consistency reliability was greater than 0.80 for almost all scales and most demographic groups. The SDOH survey demonstrated good to excellent reliability across several measures and within multiple populations underrepresented in biomedical research. Bias due to survey non-response and item non-response will be monitored and addressed as the survey is fielded more completely.

Antecedents to and outcomes associated with teacher-child relationship perceptions in early childhood: Further evidence for child-driven effects.

Preschool teachers' perceptions about relationships with students (teacher-child relationships [TCRs]) predict children's subsequent social competence (SC) and academic progress. Why this is so remains unclear. Do TCRs shape children's development, or do child attributes influence both TCRs and subsequent development? Relations between TCRs and other measures were examined for 185 preschoolers (107 girls, 89 longitudinal, and ~75% European American). Teachers rated TCRs and child social/affective behaviors. Teacher-child interactions (TCIs) and children's affect expressiveness were observed. Child SC and receptive vocabulary were assessed. TCRs were significantly correlated with each type of outcome. TCIs, SC, expressed affect, and teacher-rated behaviors also predicted TCRs longitudinally. Results suggest that TCR ratings predict subsequent adaptation because they summarize children's behavioral profiles rather than on TCR quality per se.

Concurrent randomized control trials of the 1-year efficacy of two couple relationship education programs: ELEVATE and Couples Connecting Mindfully.

A long-standing university-community partnership used a longitudinal randomized control trial to implement and evaluate two couple relationship education (CRE) curricula, ELEVATE and Couples Connecting Mindfully (CCM), among an economically and racially diverse population of adult couples. Married and non-married couples (n = 929 couples) completed baseline surveys and were randomly assigned to either one of the two program groups or to the control group by implementation site. Follow-up surveys were collected at 2 months, 6 months, and 1 year after baseline. Using an intent-to-treat approach, growth curve modeling comparisons of trajectories indicated program effects at 1 year post-baseline in key outcome areas. Both the ELEVATE and the CCM group reported significant gains in couple relationship skills, couple quality, and family harmony over time compared to the control group that experienced either no change or declines. Further, the ELEVATE group also demonstrated positive program effects on measures of mental health and sleep quality. An assessment of the central premise of CRE indicated that the immediate post-program improvements in couple relationship skills predicted later couple quality for both program groups. This study indicates that both ELEVATE and CCM can be considered evidence-based CRE programs for use with a broad population of couples.

Una asociación duradera entre la universidad y la comunidad utilizó un ensayo controlado aleatorizado y longitudinal para implementar y evaluar dos currículos de educación sobre las relaciones de pareja, ELEVATE y Couples Connecting Mindfully (CCM), entre una población de parejas adultas económicamente y racialmente diversa. Parejas casadas y no casadas (n = 929 parejas) contestaron encuestas en el momento basal, y luego, en el lugar de implementación, se las distribuyó aleatoriamente a alguno de los dos grupos del programa o al grupo de referencia. Se recogieron encuestas de seguimiento dos meses, seis meses y un año después del momento basal. Utilizando un método por intención de tratar, las comparaciones de trayectorias del modelo de curva del crecimiento indicaron efectos del programa un año después del momento basal en áreas de resultado claves. Tanto el grupo de ELEVATE como el de CCM informaron beneficios significativos en las habilidades para las relaciones de pareja, la calidad de la pareja y la armonía familiar con el tiempo en comparación con el grupo de referencia, que no tuvo ningún cambio ni empeoramientos. Además, el grupo de ELEVATE también demostró efectos del programa en las medidas de salud mental y calidad del sueño. Una evaluación de la premisa fundamental de la educación sobre las relaciones de pareja indicó que las mejoras inmediatas después del programa en las habilidades para las relaciones de pareja predijeron una posterior calidad de la pareja para ambos grupos del programa. Este estudio indica que tanto ELEVATE como CCM pueden considerarse programas factuales de educación sobre las relaciones de pareja aptos para su uso con una amplia población de parejas.

Maternal use of physical and non-physical forms of discipline and preschoolers' social and literacy skills in 25 African countries.

OBJECTIVES: Little is known about associations between different forms of discipline and children's literacy, social skills, and behavior in low- and middle-income countries. This study examined maternal use of physical discipline, harsh physical discipline, psychological aggression, and nonphysical discipline and their relative associations with preschool-aged children's social and literacy skills and behavioral difficulty in 25 diverse African countries. We also explored whether belief in physical discipline and sociodemographic factors moderate the associations between different forms of discipline and childhood outcomes. METHODS: The participants were 32,817 biological mothers and their preschool-aged children from the UNICEF Multiple indicator Cluster Surveys. Information regarding belief in and use of physical and nonphysical forms of discipline and children's social and literacy skills and behavioral difficulty were obtained via questionnaires obtained from mothers in each household. RESULTS: Psychological aggression was negatively, and nonphysical discipline positively associated with children's literacy skills. Harsh physical discipline, physical discipline, and psychological aggression were positively, and nonphysical discipline negatively associated with behavioral difficulty in children. Psychological aggression, physical discipline, and nonphysical discipline were positively associated with and harsh physical discipline negatively associated with children's social skills. Maternal education, preschool enrollment, and household wealth variously moderated the associations between different modes of discipline and children's literacy and social skills and behavioral difficulty. CONCLUSIONS: Findings underline the negative consequences of harsh discipline on children's social and literacy skills and behavioral difficulty in African cultural communities.

Development and Validation of the Policies, Opportunities, Initiatives and Notable Topics (POINTS) Audit for Campuses and Worksites.

Background: Workplace or campus wellness/obesity-prevention policies and initiatives can improve health. Research tools to assess worksite or campus policies/initiatives are scarce. Thus, the aim of this research is to develop and validate the policies, opportunities, initiatives, and notable topics (POINTS) audit. Methods: POINTS was developed and refined via expert review, pilot-testing, and field testing. Trained researchers completed a web-based review from a student-focus or employee-focus regarding 34 health-promoting topics for colleges. Each topic was evaluated on a 0⁻2 scale: 0 = no policy/initiative, 1 = initiatives, 2 = written policy. When a written policy was detected, additional policy support questions (administered, monitored, reviewed) were completed. Results: Cronbach's Alpha for the student-focused POINTS audit was α = 0.787 (34 items, possible points = 65), and for the employee-focused POINTS audit was α = 0.807 (26 items, possible points = 50). A total of 115 student-focused and 33 employee-focused audits were completed. Although there was little evidence of policy presence beyond stimulant standards (smoking and alcohol), there were extensive examples of health initiatives. The student-focused POINTS audit was validated using the Healthier Campus Initiative's survey. Conclusions: POINTS is a web-based audit tool that is valid and useful for pre-assessment, advocacy, benchmarking, and tracking policies for health and well-being for students (campus) and employees (worksite).

Positive discipline, harsh physical discipline, physical discipline and psychological aggression in five Caribbean countries: Associations with preschoolers' early literacy skills.

Physical punishment has received worldwide attention because of its negative impact on children's cognitive and social development and its implications for children's rights. Using UNICEF Multiple Indicator Cluster Surveys 4 and 5 data, we assessed the associations between positive discipline, harsh physical punishment, physical punishment and psychological aggression and preschoolers' literacy skills in 5628 preschool-aged children and their caregivers in the developing nations of Belize, the Dominican Republic, Guyana, Jamaica and Suriname. Caregivers across countries used high levels of explanations and psychological aggression. There were significant country differences in the use of the four disciplinary practices. In the Dominican Republic and Guyana, physical punishment had negative associations with children's literacy skills, and in the Dominican Republic, positive discipline had a positive association with children's literacy skills. Findings are discussed with respect to the negative consequences of harsh disciplinary practices on preschoolers' early literacy skills in the developing world.

Multilevel Structural Equation Modeling of Students' Dietary Intentions/Behaviors, BMI, and the Healthfulness of Convenience Stores.

BACKGROUND: When dietary behaviors are habitual, intentions are low, and environmental cues, such as the consumer food environment, might guide behavior. How might intentions to eat healthily and ultimately actual dietary behaviors, be influenced by the consumer food environment (including the availability and affordability of healthy foods) in convenience stores? This study will determine pathways between the healthfulness of convenience stores and college students' dietary intentions/behaviors, and body mass index (BMI). METHODS: Through multilevel structural equation modeling, a comparison was made of students' healthful meal intentions (HMI); intake (fruits/vegetables, %kcal/fat, sugar-sweetened beverages (SSBs) and whole-grains); and measured BMI; as well as the healthfulness of convenience stores (fruits/vegetables availability/quality, healthy food availability/affordability). Data was collected on 1401 students and 41 convenience stores across 13 US college campuses. RESULTS: Controlling for gender, HMI was negatively associated with SSBs (ß = -0.859) and %kcal/fat (ß = -1.057) and positively with whole-grains (ß = 0.186) and fruits/vegetables intake (ß = 0.267); %Kcal/fat was positively (ß = 0.098) and fruits/vegetables intake (ß = -0.055) negatively associated with BMI. Campus level, fruits/vegetables availability were positively associated to HMI (ß = 0.214, ß = 0.129) and directly/negatively to BMI (ß = -2.657, ß = -1.124). CONCLUSIONS: HMI modifies dietary behaviors, with energy from fat and fruit/vegetable intake the most predictive of weight. Availability of fruit/vegetables in convenience stores make it easier for young adults to eat well.

The moderating role of relationship skills education on depressive symptoms in fathers with young children.

Drawing on couple-focused prevention intervention models that target family level processes, we used complier average causal effect (CACE) estimates to determine whether relationship skills education moderated the association between fathers' depressive symptoms assessed when their children were 15-months-old and again when their children were 36-months-old. The sample consisted of low-income Hispanic American, European American, and African American fathers (N = 2,540) from the Building Strong Families Study. Fathers from 8 sites across the United States were randomly assigned to either a treatment group who were offered relationship skills education or a control group. Paternal age and family residential stability predicted fathers' utilization of intervention services. Relationship skills education moderated the association between depressive symptoms at 15 months and depressive symptoms at 36 months. The impact of dosage of relationship skills education on depressive symptoms was inconsistent and dependent on percentage of receipt of relationship skills education classes. Data are interpreted in the context of the efficacy of intervention programs for tempering depressive symptoms in low-income fathers with young children. (PsycINFO Database Record