Partner-Involved Financial Incentives for Smoking Cessation in Dual-Smoker Couples: A Randomized Pilot Trial.

INTRODUCTION: Members of dual-smoker couples (in which both partners smoke) are unlikely to try to quit smoking and are likely to relapse if they do make an attempt. The purpose of this study was to investigate the feasibility, tolerability, and preliminary outcomes of dyadic adaptations of financial incentive treatments (FITs) to promote smoking cessation in dual-smoker couples. AIMS AND METHODS: We enrolled 95 dual-smoker couples (N = 190) in a three-arm feasibility RCT comparing two partner-involved FITs (single vs. dual incentives) against a no-treatment control condition. Participants in all conditions were offered nicotine replacement and psychoeducation. A 3-month follow-up provided information about retention, tolerability (ie, self-reported benefits and costs of the study), and preliminary efficacy (ie, program completion, quit attempts, point-prevalent abstinence, and joint quitting). RESULTS: Results suggest dyadic adaptations were feasible to implement (89% retention rate) and highly tolerable for participants (p < .001). Neither feasibility nor tolerability varied across the treatment arm. Preliminary efficacy outcomes indicated partner-involved FITs have promise for increasing smoking cessation in dual-smoker couples (OR = 2.36-13.06). CONCLUSIONS: Dyadic implementations of FITs are feasible to implement and tolerable to participants. IMPLICATIONS: The evidence that dyadic adaptations of FITs were feasible and tolerable, and the positive preliminary efficacy outcomes suggest that adequately powered RCTs formally evaluating the efficacy of dyadic adaptations of FITs for dual-smoker couples are warranted.

RACIAL DISCRIMINATION AND THE WEATHERING OF NONMARITAL RELATIONSHIPS.

Objective: The purpose of this study was to assess the impact of perceived racial discrimination on the satisfaction and dissolution of different-gender, nonmarital relationships among African American young adults. Background: Racial discrimination has proven detrimental to relationship quality among married couples. Racial disparities in relationship processes begin long before marriages form, however. Racial discrimination may also weather and disrupt nonmarital relationships earlier in the life course. Method: Survey data from African American young adult couples (N = 407) from the Family and Community Health Study were used to assess the associations between each partner's experience of racial discrimination, relationship satisfaction, and relationship dissolution using structural equation modeling. Results: Results support a stress spillover perspective in that racial discrimination experienced by both men and women increased the likelihood of relationship dissolution through reduced satisfaction. No support was found for a stress buffering perspective. Conclusion: Racial discrimination appears to distress and, ultimately, disrupt nonmarital relationships among African American young adult couples. Implications: Given the role of relationship quality and stability in promoting health and well-being, understanding how discrimination impacts the unfolding of relationships, or linked lives, across the life course is essential to untangling and addressing the "chains of disadvantage" identified by Umberson et al. (2014) as central to racial disparities in health and well-being.

Neighborhood disadvantage is associated with biological aging: Intervention-induced enhancement of couple functioning confers resilience.

The accelerated pace of biological aging predicts mortality and morbidity later in life. The current study examines whether a change in supportive couple functioning buffers accelerated aging associated with stressful community environments among Black Americans who live in rural, Southern, disadvantaged neighborhoods. We examined 348 Black American middle-aged adults assigned randomly to receive the Protecting Strong African American Families (ProSAAF) intervention or a control condition. The program was designed to enhance supportive couple functioning among Black Americans. We used DunedinPoAm to quantify the methylation pace of aging and employed the Area Deprivation Index at the census block group level to measure neighborhood disadvantage. Neighborhood disadvantage was associated with the accelerated pace of aging. Further, participation in ProSAAF enhanced supportive couple functioning, and improvement in couple functioning protected participants from the harmful effects of neighborhood disadvantage on the accelerated pace of aging. These findings supported mediated moderation and suggested that family-based prevention programs that enhance couple support may decrease the erosive effects of neighborhood disadvantage and improve prospects for healthy aging among rural, Southern, Black Americans living in difficult circumstances. This may provide a supplemental strategy for decreasing health disparities due to neighborhood disadvantage by enhancing family systems.

Shifts in lifestyle and socioeconomic circumstances predict change-for better or worse-in speed of epigenetic aging: A study of middle-aged black women.

BACKGROUND: While numerous studies have documented the power of new generation epigenetic clocks to predict morbidity and mortality, research regarding the causes of variation in speed of epigenetic aging is in the early stages. To the extent that these epigenetic clocks are robust measures of biological aging, they should be sensitive to various nutritional, behavioral, ecological, and social factors that have been shown to affect health. OBJECTIVE: Investigate over an 11-year period the extent to which changes in socioeconomic stress and lifestyle predict changes in speed of epigenetic aging among a sample of middle-aged African American women. METHODS: Using data from the Family and Community Health Study, we investigated whether changes in socioeconomic stress, diet, smoking, exercise, alcohol consumption, and relationship status predict changes in speed of biological aging assessed with 3 s-generation epigenetic clocks: AccelGrimAge, DunedinPoAm, and AccelPhenoAge. The study was able to avoid the challenges associated with self-reports of diet and smoking by employing recently developed epigenetic measures. RESULTS: Changes in socioeconomic stress and diet were associated with changes in speed of biological aging as assessed by all three epigenetic clocks, and changes in smoking was related to changes in AccelGrimAge and DunedinPoAm. Analyses controlling for cell-type indicated that in large measure diet exerts its effect on aging through its impact on the immune system. CONCLUSIONS: These findings suggest that adoption of a healthy diet and reduction in the use of tobacco are related to a decrease in epigenetic aging, whereas increased pressure relating to income, housing and economic independence are associated with an increase in the speed of aging. These effects were especially strong for the two epigenetic clocks AccelGrimAge and DunedinPoAm. Overall, the results indicate that stress and lifestyle changes may, for better or worse, influence the "biological weathering" often experienced by middle-aged African American women.

Racial discrimination and health among two generations of African American couples.

The current study extends research on the detrimental health implications of racial discrimination by examining how these implications reverberate across romantic relationships. Using two generations of different-gender romantic couples from the Family and Community Health Study, we examined how racial discrimination experienced by a romantic partner was associated with poor health among Black adults, independent of one's own level of racial discrimination. Results from the actor-partner interdependence model showed that beyond the effects of socioeconomic status, health behavior, relationship satisfaction, and own experiences of racial discrimination, a romantic partner's experiences of discrimination were associated with increased psychological distress for both the middle/older-age generation and the young-adult generation. Further, in the middle/older-age generation, partners' experiences of racial discrimination were associated with increased cardiovascular disease risk, particularly for men. These results reiterate recent findings that researchers may underestimate the impact of racial discrimination on health when we fail to consider linked lives. Further, they indicate that there may be gender and generational differences in the individual and relational implications of racial discrimination on health.

Feasibility, tolerability, and potential advantages of a dyadic financial incentive treatment for smoking cessation among dual-smoker couples: A pilot study.

As of 2019, 34.1 million adults in the United States smoke cigarettes. People who smoke and who are partnered with other smokers (i.e., dual-smoker couples [DSCs]) represent an estimated two-thirds of U.S. smokers. DSCs face unique obstacles to quitting, are less likely to try to quit, and are more likely to relapse during a quit attempt. Although joint quit attempts hold promise for DSCs' abstinence, few DSCs report trying to quit together. Financial incentive treatments [FITs]-where individuals receive monetary incentives for quitting and maintaining abstinence-increase motivation to quit, and so may help DSCs engage in joint quit attempts. We tested the feasibility and tolerability of adapting a financial incentive treatment to a dyadic context (N = 14 DSCs), in which both individuals of a smoking couple are offered incentives for attendance in a smoking cessation program ($100 USD) and abstinence at follow-up ($100 USD). Ten DSCs (71.4%) completed the follow-up session. Seven participants had biochemically verified abstinence at the follow-up session; of these, six of the seven (86%) were members of DSCs in which both partners were abstinent. Among participants who completed the follow-up session, cravings to smoke and tobacco withdrawal symptom severity were reduced over the study period. Participants rated the study as highly tolerable and listed many benefits and few costs from participation. The present study demonstrates the feasibility, tolerability, and potential advantages of implementing a dyadic financial incentive treatment for smoking cessation for DSCs in the U.S. over the course of 2 months. Public Health Significance: This pilot study demonstrates the feasibility, tolerability, and potential advantages of implementing a dyadic financial incentive treatment for smoking cessation for people who smoke who are coupled with other smokers (dual-smoker couples). The majority of participants (86%) who were abstinent at 2-month follow-up were in a relationship with another smoker who was abstinent at follow-up, suggesting advantages of a dyadic financial incentive treatment to promote joint quit attempts among dual-smoker couples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Relationship intervention indirectly buffers financial strain's effect on biological aging among Black adults.

Black adults in the rural South experience elevated financial strain and other contextual stressors, increasing their risk for poor health. Supportive relationships, particularly positive romantic relationships, have been shown to offset these risks. The present study aims to provide experimental evidence of the buffering effect of supportive relationships by testing whether participation in a relationship enhancement program (ProSAAF) that improves couple functioning (Barton, Beach, Wells, et al., 2018) subsequently buffers the effect of cumulative financial strain on biological aging (weathering). Postintervention financial strain was assessed four times. Deoxyribonucleic acid (DNA) was extracted from peripheral whole blood collected 6 years after baseline (n = 348 individuals), and patterns of methylation were used to index accelerated pace of aging. Couple functioning was treated as a latent construct comprising four self-report indicators: effective communication, relationship confidence, relationship satisfaction, and perceived partner support. Results indicated that cumulative financial strain was associated with accelerated pace of aging with a medium to large effect size. This effect was moderated by change in couple functioning such that individuals with greater improvement in couple functioning showed less epigenetic aging in response to cumulative financial strain. Additionally, there was a significant indirect buffering effect of ProSAAF on the association between cumulative financial strain and accelerated pace of aging. This is the first study to demonstrate that a couple-focused preventive intervention can reduce the impact of financial strain on rate of aging by enhancing couple functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Neighborhood structural disadvantage and biological aging in a sample of Black middle age and young adults.

OBJECTIVES: Research on the social determinants of health has suggested that neighborhood disadvantage may undermine healthy aging and is particularly relevant for understanding health disparities. Recently, this work has examined deoxyribonucleic acid methylation (DNAm)-based measures of biological aging to understand the risk factors for morbidity and mortality. However, it is unknown whether neighborhood disadvantage is related to different indices of DNAm-based aging among Black Americans and whether such neighborhood effects vary as a function of age or gender. METHODS: Our analyses of a Black American sample included 448 young adults and 493 middle-aged adults. We measured neighborhood disadvantage using the Area Deprivation Index at the census block group level. DNAm-based accelerated aging indices were measured using established procedures. Regressions with clustered standard errors were used for the analysis. RESULTS: Neighborhood disadvantage was independently associated with acceleration in PhenoAge, GrimAge, and DunedinPoAm, among young and middle-aged adults. Further, there was no evidence that gender conditioned the effects of neighborhood disadvantage on the aging indices. CONCLUSIONS: Regardless of age groups or gender, accelerated biological aging among Black Americans is partly rooted in differences in neighborhood disadvantage. From a policy standpoint, our findings suggest that programs that decrease neighborhood disadvantage are likely to increase healthy aging, especially among Black Americans.

COVID-19 Stress and the Health of Black Americans in the Rural South.

Black Americans have been disproportionately affected by the COVID-19 pandemic. To better understand changes in and predictors of their mental and physical health, in the current study, we used three waves of data (two prepandemic and a third during summer 2020) from 329 Black men and women in the rural South. Results indicated that health worsened after the onset of the pandemic, including increased depressive symptoms and sleep problems and decreased self-reported general health. Greater exposure to COVID-19-related stressors was significantly associated with poorer health. Prepandemic stressors (financial strain, racial discrimination, chronic stress) and prepandemic resources (marital quality, general support from family and friends) were significantly associated with exposure to COVID-19-related stressors and with health during the pandemic. Findings underscore how the pandemic posed the greatest threats to Black Americans with more prepandemic psychosocial risks and highlight the need for multifaceted interventions that address current and historical stressors among this population.

Family-centered prevention buffers the effect of financial strain on parenting interactions, reducing youth conduct problems in African American families.

OBJECTIVE: This study examined whether a family-focused prevention program for African American families could buffer the negative effect of perceived financial strain on protective parent-child interactions and thereby reduce the indirect effect of financial strain on youth conduct problems. METHOD: Three hundred and forty-six African American couples with an early adolescent child (M age = 10.9 years at Wave 1 [W1]) participated. Families were randomly assigned to the Protecting Strong African American Families (ProSAAF) prevention program or to a no-treatment control condition and provided data prerandomization (W1) and postintervention, Wave 2 (W2), 9.4 months after W1. Youth and both parents reported family financial strain at W1 and protective parent-child interactions at W1 and W2. Youth reported their conduct problems at W1 and W2. Hypotheses were tested using moderated mediation analyses. RESULTS: ProSAAF significantly moderated the negative effect of youth-reported financial strain on changes in protective parenting interactions such that financial strain was not significantly associated with changes in protective parenting among the intervention group, thus reducing the indirect effect of financial strain on increases in youth conduct problems among this group. Parent-reported financial strain was not significantly associated with changes in protective parenting in either condition, precluding the potential for stress buffering intervention effects. CONCLUSIONS: The ProSAAF prevention program buffered the negative effect of youth-reported financial strain on protective parenting interactions and reduced its indirect effect on youth conduct problems. These findings suggest that family-focused prevention has the potential to promote resilience among African American youth perceiving family financial strain. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Race and prostate specific antigen surveillance testing and monitoring 5-years after definitive therapy for localized prostate cancer.

BACKGROUND: Prostate-specific antigen (PSA) surveillance testing is a cornerstone of prostate cancer survivorship because patients with biochemical recurrence often have no symptoms. However, the investigation of guideline-concordant PSA surveillance across racial groups is limited. We examined racial differences in PSA surveillance testing 5-years post-definitive treatment for localized prostate cancer. METHODS: We created a population-based retrospective cohort from the Surveillance, Epidemiology, and End Results-Medicare linked database for men diagnosed with prostate cancer between the years 2007 to 2011 with Medicare claims through 2016 (N = 21,372). Multivariable log-binomial regression models were used to examine the effect of race on the likelihood of not receiving at least one PSA surveillance test annually 5-years post-definitive treatment. RESULTS: Black men had 90%, 71%, 44%, 34%, and 23% increased risk of not receiving at least one PSA surveillance test annually in the first, second, third, fourth, and fifth years of post-definitive treatment follow-up, respectively. The adjusted relative risk [ARR] for Black men compared to White men were 1.68 (95% Confidence Interval [CI], 1.37-2.07), 1.52 (95% CI, 1.32-1.75), 1.32 (95% CI, 1.17-1.48), and 1.16 (95% CI, 1.05-1.29) in the first, second, third, and fourth year of post-definitive treatment, respectively. CONCLUSION: Black men were more likely not to receive guideline-concordant PSA surveillance testing following definitive treatment for localized prostate cancer during the first 4 years post-treatment. This study suggest room for improvement in defining survivorship care plans for Black men to increase use of PSA surveillance testing.

Racial Discrimination, Inflammation, and Chronic Illness Among African American Women at Midlife: Support for the Weathering Perspective.

It is widely accepted that socioeconomic status (SES) is a fundamental cause of health inequality. There is evidence, however, that race is also a fundamental cause of disparities in health. Based on this idea, the weathering hypothesis developed by Geronimus and her colleagues views the elevated rates of illness and disability seen among Black Americans as a physiological response to the structural barriers, daily slights, and other threats to identity that comprise the Black experience. The current study tests the weathering hypothesis using chronic inflammation as an indicator of biological weathering. Specifically, we examine the extent to which persistent exposure to racial discrimination predicts elevated inflammation and, in turn, diagnosed chronic illness, after taking into account SES and several control variables. This mediation model was tested using zero-inflated Poisson path modeling with five waves of data collected from 391 African American women participating in the Family and Community Health Study (FACHS). A 13-item index was used to assess exposure to racial discrimination across 8 years. ELISA blood assays of seven cytokines central to the inflammatory response were used to construct an inflammatory index. Respondents reported their diagnosed chronic diseases. Consonant with the weathering hypothesis, persistent exposure to discrimination predicted inflammation which, in turn, predicted number of chronic diseases. This indirect effect was statistically significant. SES predicted having a chronic disease and the various controls showed no effect. The findings support the idea that race, like SES, is a fundamental cause of health inequalities.

Childhood adversity is linked to adult health among African Americans via adolescent weight gain and effects are genetically moderated.

Identifying the mechanisms linking early experiences, genetic risk factors, and their interaction with later health consequences is central to the development of preventive interventions and identifying potential boundary conditions for their efficacy. In the current investigation of 412 African American adolescents followed across a 20-year period, we examined change in body mass index (BMI) across adolescence as one possible mechanism linking childhood adversity and adult health. We found associations of childhood adversity with objective indicators of young adult health, including a cardiometabolic risk index, a methylomic aging index, and a count of chronic health conditions. Childhood adversities were associated with objective indicators indirectly through their association with gains in BMI across adolescence and early adulthood. We also found evidence of an association of genetic risk with weight gain across adolescence and young adult health, as well as genetic moderation of childhood adversity's effect on gains in BMI, resulting in moderated mediation. These patterns indicated that genetic risk moderated the indirect pathways from childhood adversity to young adult health outcomes and childhood adversity moderated the indirect pathways from genetic risk to young adult health outcomes through effects on weight gain during adolescence and early adulthood.

The effects of social adversity, discrimination, and health risk behaviors on the accelerated aging of African Americans: Further support for the weathering hypothesis.

BACKGROUND: The weathering hypothesis views the elevated rates of illness, disability, and mortality seen among Black Americans as a physiological response to the structural barriers, material hardships, and identity threats that comprise the Black experience. While granting that lifestyle may have some significance, the fundamental explanation for heath inequalities is seen as race-related stressors that accelerate biological aging. OBJECTIVE: The present study tests the weathering hypothesis by examining the impact on accelerated aging of four types of adversity frequently experienced by Black Americans. Further, we investigate whether health risk behaviors mediate the effect of these conditions. METHOD: Our analyses utilize data from 494 middle-age, African American men and women participating in the Family and Community Healthy Study. The newly developed GrimAge index of accelerated aging is used as an indicator of weathering. Education, income, neighborhood disadvantage, and discrimination serve as the independent variables. Three health risk behaviors - diet, exercise, and alcohol consumption - are included as potential mediators of the four types of adversity. Marital status and gender are entered as controls. RESULTS: Multivariate analyses indicated that the four types of adversity predicted acceleration whereas marriage predicted deceleration in speed of aging. Males showed greater accelerated aging than females, but there was no evidence that gender conditioned the effect of adversity. The health risk behaviors were unrelated to accelerated aging and did not mediate the effect of the stressors. CONCLUSION: Modern medicine's emphasis on life style as the primary explanation for race-based health disparities ignores the way race-related adversity rooted in structural and cultural conditions serves to accelerate biological decline, thereby increasing risk of early onset of illness and death. Importantly, these social conditions can only be addressed through social policies and programs that target institutional racism and promote economic equity.

Array-Based Epigenetic Aging Indices May Be Racially Biased.

Epigenetic aging (EA) indices are frequently used as predictors of mortality and other important health outcomes. However, each of the commonly used array-based indices has significant heritable components which could tag ethnicity and potentially confound comparisons across racial and ethnic groups. To determine if this was possible, we examined the relationship of DNA methylation in cord blood from 203 newborns (112 African American (AA) and 91 White) at the 513 probes from the Levine PhenoAge Epigenetic Aging index to ethnicity. Then, we examined all sites significantly associated with race in the newborn sample to determine if they were also associated with an index of ethnic genetic heritage in a cohort of 505 AA adults. After Bonferroni correction, methylation at 50 CpG sites was significantly associated with ethnicity in the newborn cohort. The five most significant sites predicted ancestry with a receiver operator characteristic area under the curve of 0.97. Examination of the top 50 sites in the AA adult cohort showed that methylation status at 11 of those sites was also associated with percentage European ancestry. We conclude that the Levine PhenoAge Index is influenced by cryptic ethnic-specific genetic influences. This influence may extend to similarly constructed EA indices and bias cross-race comparisons.

Peer influence, Frontostriatal connectivity, and delay discounting in African American emerging adults.

Prior research has demonstrated the importance of delay discounting in adverse health behaviors, such as addiction, attention deficit hyperactivity disorder, risk taking, and obesity. Nevertheless, the functional connectivity of neural circuitry associated with delay discounting and the ways in which the social environment may influence frontostriatal connectivity remain largely unknown, particularly in African Americans. Building on recent literature implicating frontostriatal connectivity during active delay discounting decision making and at rest, we used functional magnetic resonance imaging to assess the association between delay discounting and frontostriatal resting state connectivity (rsFC). We also examined the capacity of social relationships with parents and peers to longitudinally predict frontostriatal rsFC. The study cohort was composed of 91 rural African American emerging adults followed over a 6-year period. Greater (i.e., more positive) frontostriatal rsFC was associated with decreased delay discounting (i.e., less impulsive decision making). In addition, peer relationships at ages 20 and 21 significantly predicted frontostriatal rsFC at age 25 above and beyond parental influence. A significant indirect effect of peer affiliation on delay discounting through frontostriatal rsFC also emerged. These results indicate a role of frontostriatal connectivity in delay discounting decision making and highlight peers' unique influence on decision making behaviors through frontostriatal rsFC during emerging adulthood.

Life Course Patterns of Concurrent Trajectories of BMI and Affective Symptoms of Rural Mothers: Socioeconomic Antecedents and Disease Outcomes in Later Life.

OBJECTIVES: The current study, using prospective data over 25 years (1991-2015), concurrently investigates patterns of body mass index (BMI) and affective symptom trajectories in middle-aged mothers and the socioeconomic antecedents and disease outcomes of these patterns. METHOD: Growth mixture modeling was used to identify latent classes of conjoint health risk trajectories (BMI, depressive symptoms, and anxiety symptoms) from 1991 to 2001. For each latent class, we identified mean trajectories of each health risk. Then, analyses were conducted identifying how these conjoint health risk classes were associated with respondents' socioeconomic background profiles in 1991 and subsequent chronic health problems in 2015. RESULTS: Socioeconomic background profiles were significantly associated with initially high-risk trajectories. There was a statistically significant association between membership in certain classes of conjoint trajectories and physical health outcomes in later years. Consistent patterns of association with changes in different health outcomes including onset of diseases were observed when classes of conjoint risk trajectories are examined. DISCUSSION: The identification of members of various conjoint risk trajectory groups provides a potentially useful prognostic tool for early preventive intervention efforts, treatment, and policy formation. Such interventions should promote and develop resiliency factors, thereby aiding in the redirection of middle-aged women's adverse risk trajectories.

Testing Life Course Models Whereby Juvenile and Adult Adversity Combine to Influence Speed of Biological Aging.

The present study extends prior research on the links between social adversity and aging by employing more comprehensive measures of adversity and a new gene expression index of aging. Hierarchical regression and 20 years of data from a sample of 381 black Americans were used to test models regarding the impact of social adversity on speed of aging. Consistent with the early life sensitivity model, early adversity continued to predict accelerated aging after controlling for adult adversity. Contrary to the pathway model, adult adversity was not related to aging following controls for early adversity. The cumulative stress model received partial support as high adversity during adulthood amplified the effect of early adversity on aging. Finally, consonant with the social change model, low adversity during adulthood buffered the effect of early adversity on aging. These findings held after controlling for health behaviors such as smoking, diet, and exercise.

The effect of early discrimination on accelerated aging among African Americans.

OBJECTIVE: This study examined the role of depressive symptoms in mediating the relationship between early life experiences of racial discrimination and accelerated aging in adulthood for African Americans (i.e., prediction over a 19-year period, from ages 10 to 29) after adjusting for gender and health behaviors. METHOD: Longitudinal self-report data over 7 waves of data collection from the Family and Community Health Study were utilized. The sample included 368 African Americans with usable gene expression data to compute accelerated aging, as well as complete data on all self-report variables including racial discrimination (Schedule of Racist Events) and depression (Diagnostic Interview Schedule for Children-Version 4). Blood was collected by antecubital blood draws from participants at age 29. The proposed model was tested by path analysis. RESULTS: Findings revealed that high discrimination at ages 10-15 was associated with depression at ages 20-29 (ß = .19, p = .001), controlling for depression at ages 10-15, which, in turn, was related to accelerated cellular-level aging (ß = .11, p = .048) after controlling for gender, alcohol consumption, and cigarette use. The indirect effect of racial discrimination on aging through depression at ages 20-29 was significant (ß = .021, 95% confidence interval [.001, .057]), accounting for 32.3% of the total variance. CONCLUSION: These findings support research conceptualizations that early life stress due to racial discrimination lead to sustained negative affective states continuing into young adulthood that confer risk for accelerated aging and possibly premature disease and mortality in African Americans. These findings advance knowledge of potential underlying mechanisms that influence racial health disparities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Perceived relationship support moderates the association of contextual stress with inflammation among African Americans.

We followed 402 African American young adults from ages 24 to 29, a period of emerging committed relationships, to examine the association of contextual stress (CS), for example, experiences of financial strain, victimization, and racial discrimination, with inflammation, and to test predictions that greater perceived relationship warmth and support (PRWS) at age 29 would moderate the association between earlier CS and inflammation, using a multiplex assessment of cytokines to construct an index of the ratio between predominantly proinflammatory cytokines versus predominantly anti-inflammatory cytokines. CS experienced at age 24 was associated with greater inflammation at age 29 in the full sample (b = .112, p = .004). PRWS at age 29 moderated the association of earlier CS with inflammation (b = -.114, p = .011), but there was no significant main effect of PRWS (b = -.053, p = .265). Finally, using an internal moderator approach, we compared the association of CS with inflammation among those not in a committed relationship to those in more or less supportive relationships, showing a significant and stronger association of CS with inflammation for those with low PRWS (-1 SD; b = .182, p < .001), a weaker and nonsignificant association of CS with inflammation among those with higher PRWS (+1 SD; b = -.002, p = .975), and an intermediate and nonsignificant association of CS with inflammation among those with no committed romantic relationship (b = .077, p = .227). Results were robust to number of cytokines included in the inflammation index. (PsycINFO Database Record (c) 2019 APA, all rights reserved).