Depressive Symptom Trajectories Across Adolescence and Adulthood Among Individuals With Asthma.

OBJECTIVE: Individuals with asthma experience increased depressive symptoms, which is associated with deleterious health outcomes. No studies have examined depressive symptom trajectories among individuals with asthma despite increased risk. This study expanded prior literature by identifying the following: (1) depressive symptoms trajectories for individuals with and without asthma and (2) predictors of baseline levels and changes in symptoms across time for individuals with asthma. METHODS: Adolescents with (N = 965) and without (N = 7,392) asthma self-reported on depressive symptoms (CESD-9) across development. Covariates included: demographics and persistence of asthma. Latent growth curve modeling (LGCM) was used to identify depressive symptom trajectories and their predictors. RESULTS: A multigroup LCGM identified no significant differences between depressive symptom trajectories of individuals with and without asthma. Depressive symptoms followed a quadratic shape across time for individuals with asthma (Mintercept = 5.73, p < .00; Mlinear = -0.38,p < .001; Mquad = 0.03, p < .001), with a linear deceleration in depressive symptoms during adolescence and an acceleration of symptoms into adulthood. Next predictors of depressive trajectories among individuals with asthma were examined. Female sex (B = 0.58, p < .001), lower parent education (B = -0.57, p < .001), older age (B = 0.19, p < .001), and identifying as Black (B = 0.31, p = .04) were associated with greater baseline depressive symptoms. Older individuals exhibited faster linear symptom decelerations (B = -0.56, p < .001) and faster symptom accelerations (B = 0.73, p < .001). American Indian (AIAN) individuals exhibited faster linear symptom decelerations (B = -1.98, p = .005) and faster quadratic accelerations (B = 3.33, p = .007). DISCUSSION: Our results suggest that the depressive symptom trajectories of individuals with asthma are curvilinear and similar to individuals without asthma. When examining predictors of depressive symptom trajectories for those with asthma, socioeconomic disadvantage and racial marginalization were associated with greater baseline depressive symptoms. Although AIAN youth demonstrated more favorable trajectories in adolescence, they also exhibited worse trajectories across young adulthood and adulthood. Findings suggest the need to better understand the impact of multilevel risk and protective factors on depressive symptoms trajectories for individuals with asthma, especially marginalized populations.

Depressive Symptoms, Cannabis Use, and Transition Readiness among College Students with and without Chronic Medical Conditions.

Background: College students experience increased responsibility for healthcare transition. They are at increased risk for depressive symptoms and cannabis use (CU), potentially modifiable predictors of successful healthcare transition. This study investigated how depressive symptoms and CU related to transition readiness, and if CU moderated the association between depressive symptoms and transition readiness for college students. Methods: College students (N = 1,826, Mage=19.31, SD = 1.22) completed online measures of depressive symptoms, healthcare transition readiness, and past-year CU. Regression identified 1) the main effects of depressive symptoms and CU on transition readiness and 2) examined if CU moderated the relationship between depressive symptoms and transition readiness with chronic medical conditions (CMC) status as a covariate. Results: Higher depressive symptoms were correlated with past-year CU (r=.17, p<.001) and lower transition readiness (r=-0.16, p<.001). In the regression model, higher depressive symptoms were related to lower transition readiness (ß=-0.02, p<.001); CU was not related to transition readiness (ß=-0.10, p=.12). CU moderated the relationship between depressive symptoms and transition readiness (B=.01, p=.001). The negative relationship between depressive symptoms and transition readiness was stronger for those with no past-year CU (B=-0.02, p<.001) relative to those with a past-year CU (ß=-0.01, p<.001). Finally, having a CMC was related to CU and higher depressive symptoms and transition readiness. Conclusions: Findings highlighted that depressive symptoms may hinder transition readiness, supporting the need for screening and interventions among college students. The finding that the negative association between depressive symptoms and transition readiness was more pronounced among those with past-year CU was counterintuitive. Hypotheses and future directions are provided.

Longitudinal Associations Between Depression and Religiosity/Spirituality Among Individuals with Asthma in the United States.

There is limited literature examining the longitudinal stability of depressive symptoms for individuals with asthma, or how religiosity/spirituality relates to depressive symptoms across time. The present study aimed to identify the stability of and the longitudinal associations between depressive symptoms and R/S across multiple developmental periods for adolesents with asthma (N = 998) within the United States. Depressive symptoms (ßrange 0.33 - 0.60) and R/S (ßrange 0.26 - 0.73) were stable across time, with some variability. A cross-lagged association demonstrated that use of R/S in young adulthood (Wave 3) was associated with decreased depressive symptoms in adulthood (ß = -0.17, p < .001, CI - 0.25 - - 0.09, SE = 0.04). Use of R/S in adolescence (Wave 2) was predictive of increased depression in adulthood (ß = 0.13, p < .001, CI 0.05 - 0.20, SE = 0.04). Results demonstrated differential relations between R/S and depressive symptoms across development, and highlight the potential importance of integrating conversations focused on R/S within healthcare settings, especially as R/S during young adulthood may buffer against or reduce depressive symptoms in adulthood.

Profiles of Nicotine and Cannabis Exposure among Young Adults with Asthma.

There is a paucity of data on nicotine and cannabis use among young adults (YAs) with asthma. This study aimed to do the following among YAs with asthma: (1) describe YAs' active and passive exposure to nicotine and cannabis; (2) identify latent classes of active use of nicotine and cannabis; and (3) explore predictors of class membership (i.e., demographics, parental and friend use of nicotine and cannabis, and hours of environmental exposure to tobacco smoke, e-cigarette vapor, and marijuana smoke). YAs with asthma (N = 178) self-reported on nicotine and cannabis exposure and the included covariates. Latent class analysis was used to identify latent classes of lifetime nicotine and cannabis use. High rates of nicotine and cannabis use among YAs with asthma were found: 37% reporting a lifetime history of using both nicotine and cannabis. Regarding past year use, 25% had smoked cigarettes, 40% had used e-cigarettes, and 35% had used cannabis. Five classes of lifetime use were identified. The largest class was a non-user class (53%); the other four classes indicate concerning patterns of nicotine and cannabis use. The most consistent predictor of being in a class characterized by more nicotine and cannabis exposure (versus being in the non-user class) was past week exposure to cannabis smoke. This is the first study to identify classes of lifetime nicotine and cannabis use, and examine predictors of class membership, among YAs with asthma. There is a critical need to address environmental and active tobacco and marijuana exposure among YAs with asthma.

Racial and ethnic differences in distress, discrimination, substance use coping, and nicotine use among parents during COVID-19.

This study identified contributing factors for tobacco-related inequities among parents (N = 331) during COVID-19. Compared to non-Hispanic White parents, Asian, Black, and multiracial parents experienced greater discrimination. Parents with a nicotine use history experienced greater discrimination and substance use coping relative to tobacco abstainers. Among parents who used nicotine during the pandemic (n = 45), experiencing financial loss, having COVID-19, and greater worries were positively associated with nicotine reductions during COVID-19. Being female, increased family members with COVID-19, discrimination, and substance use coping were negatively associated with nicotine reductions. Tobacco interventions that reduce substance use coping and increase alternative coping are needed.

Assessing neuropsychological phenotypes of pediatric brain tumor survivors.

INTRODUCTION: Pediatric brain tumor survivors (PBTS) are at risk for both neurocognitive impairments and psychological difficulties, yet these two domains have historically been discretely examined, with assessment of psychosocial outcomes rarely included in studies of cognitive outcomes. Taking a person-centered approach, the current study aimed to more comprehensively evaluate PBTS late effect profiles, including both neurocognitive and psychological sequelae, and predictors of these profiles. METHOD: PBTS (N = 89) were assessed in a pediatric neuropsychological clinic between May 2009 and May 2018, diagnosed at least 1 year prior, and off-treatment for at least 3 months (Mage  = 6.57 years, SD = 4.53; 46.1% female). Parent- and teacher-report of psychological symptoms, and performance-based measures of neurocognitive functioning were examined using latent profile analysis. The R3STEP procedure identified predictors of class membership. RESULTS: The optimal model identified four classes characterized by: (1) average functioning across all measures ("Average," n = 47), (2) average psychosocial functioning and impaired neurocognitive functioning ("Cognitive Deficit," n = 25), (3) elevated social problems and significant neurocognitive impairments ("Social/Cognitive Deficit," n = 9), and (4) impaired visual planning and problem-solving and elevated parent-reported psychosocial problems, but average processing speed, working memory, and teacher-reported psychosocial outcomes ("Discrepant," n = 8). Ethnicity, race, radiation treatment, and diagnoses of neurofibromatosis 1, hydrocephalus, and cerebellar mutism syndrome were significant predictors of class membership (ps < 0.05). CONCLUSION: The present study identified distinct phenotypes with unique patterns of relations among neurocognitive and psychological domains. These findings are a vital first step toward identifying those at highest risk for poor outcomes and informing interventions that effectively address interrelated treatment targets for specific groups.

COVID-19 Impacts on Families of Color and Families of Children With Asthma.

OBJECTIVE: This cross-sectional study quantified differences in (a) social determinants of health (SDOH) and perceived changes in SDOH during the 2019 novel coronavirus (COVID-19) pandemic and (b) COVID-19 psychosocial impacts across four groups: (a) non-Hispanic White (NHW) parents of children with asthma, (b) Black, Indigenous, or other People of Color (BIPOC) parents of healthy children, (c) BIPOC parents of children with asthma, and (d) NHW parents of healthy children (referent). The NIMHD Framework was used to identify SDOHs that may change for families during COVID-19. METHODS: Parents were recruited via Prolific (N = 321) and completed questions about COVID-19 family impacts on employment, income, access to food and healthcare, and psychosocial functioning, including discrimination. It was hypothesized that NHW families of children with asthma and BIPOC families would endorse greater negative outcomes relative to NHW parents of healthy children. RESULTS: BIPOC families experienced greater food insecurity and discrimination relative to NHW parents of healthy children. When compared with the NHW healthy group, COVID-19 resulted in greater parent-reported resource losses for both BIPOC groups and greater reductions in healthcare access for both asthma groups. Children with asthma and BIPOC children had greater distress surrounding COVID-19. BIPOC and NHW parents of children with asthma reported greater worries about resource losses due to COVID-19. CONCLUSIONS: The pandemic is widening inequities for BIPOC families, especially for families of children with asthma. These results highlight the need for interventions that address the needs of underserved communities, providing the infrastructure, policies, and supports needed to reduce health inequities during and after COVID-19.

Distress Trajectories for Parents of Children With DSD: A Growth Mixture Model.

OBJECTIVE: This study identifies trajectories of parent depressive symptoms after having a child born with genital atypia due to a disorder/difference of sex development (DSD) or congenital adrenal hyperplasia (CAH) and across the first year postgenitoplasty (for parents who opted for surgery) or postbaseline (for parents who elected against surgery for their child). Hypotheses for four trajectory classes were guided by parent distress patterns previously identified among other medical conditions. METHODS: Participants included 70 mothers and 50 fathers of 71 children diagnosed with a DSD or CAH with reported moderate to high genital atypia. Parents were recruited from 11 US DSD specialty clinics within 2 years of the child's birth and prior to genitoplasty. A growth mixture model (GMM) was conducted to identify classes of parent depressive symptoms over time. RESULTS: The best fitting model was a five-class linear GMM with freely estimated intercept variance. The classes identified were termed "Resilient," "Recovery," "Chronic," "Escalating," and "Elevated Partial Recovery." Four classes have previously been identified for other pediatric illnesses; however, a fifth class was also identified. The majority of parents were classified in the "Resilient" class (67.6%). CONCLUSIONS: This study provides new knowledge about the trajectories of depressive symptoms for parents of children with DSD. Future studies are needed to identify developmental, medical, or familial predictors of these trajectories.

Race, sex, and physician communication about tobacco as predictors of adolescent smoking trajectories in a primarily African American sample.

This study identified latent classes of adolescent smoking and examined race, gender, and physician communication (PC) as predictors of class membership. Data were drawn from five waves of a large (N = 3,049), diverse (82.9% African American) study. Several latent classes were identified: nonsmoker, quitter, early-onset escalating smoking, early-onset stable high smoking, late-onset smoking, and declining smoking. Males, Whites, and teens who received PC were more likely to be in classes with more smoking. Our study identified several youth smoking patterns and differences in smoking based on race, gender, and receipt of PC.

The relationship of child executive functions to parenting capacities in childhood acute lymphoblastic leukemia survivors.

OBJECTIVE: The current study examined associations between child executive functions and parenting capacities in long-term survivors of childhood acute lymphoblastic leukemia (ALL). METHODS: Participants included 188 parent-child dyads; children were at least 8 years of age, 5 years postdiagnosis of ALL, and previously treated with chemotherapy only. Parents completed the Parental Protection Scale (PPS), Child Vulnerability Scale (CVS), and Decision-Making Questionnaire (DMQ). Children completed measures of executive functioning and general cognitive abilities. Multivariate multiple regression examined associations between child executive functioning and parenting, while controlling for child age, treatment risk, maternal education, and child intelligence quotient. An exploratory aim identified latent profiles of parenting capacities. RESULTS: Higher child cognitive flexibility (ß = -0.16, P = .02) and planning abilities (ß = -0.16, P = .049) were related to less parental overprotection. No other neurocognitive measures were related to child autonomy in decision making or perceived child vulnerability. For the exploratory aim, we found (a) a large class defined by normative parenting (94.3%) and (b) a small class characterized by higher levels of child vulnerability and overprotection. Class membership was unrelated to executive functioning, but higher maternal education was related to higher odds of class 2 membership (OR = 0.58, P = .04). CONCLUSIONS: Results suggest that parents respond to child executive function difficulties with greater overprotection, which may be adaptive but not conducive to the development of independence. Although most parents report normative levels of child vulnerability and overprotection, a small subset demonstrate parenting practices that may place some survivors at risk for adverse outcomes.

Parental Depression is Prospectively Associated With Lower Smoking Cessation Rates and Poor Child Asthma Outcomes.

Background: Depressive symptoms are elevated in parents of asthmatic children compared with parents of healthy children. The role of depression in smoking cessation and pediatric asthma outcomes in this population is unclear. Purpose: To prospectively examine the effect of parent depression on smoking cessation and child asthma outcomes. Methods: Secondary analysis from a cessation induction trial involving Motivational Interviewing (MI) and biomarker feedback on secondhand smoke exposure (SHSe). Parents (n=341) had an asthmatic child (mean age=5.2 years) and did not have to want to quit smoking to enroll. Intervention included asthma education, MI, and SHSe feedback plus randomization to six counseling (MI; repeated feedback) or control calls (brief check on asthma) for 4 months. Depressive symptoms were defined as scoring ≥22 on the Center for Epidemiologic Study-Depression scale. Smoking outcomes were bioverified 7- and 30-day point-prevalence abstinence (ppa). Child asthma outcomes were past month functional limitation, health care utilization, and number of days with asthma symptoms. Data were obtained at baseline, 2, 4, and 6 months. Results: Parental depression was associated with lower odds of abstinence (7-day ppa odds ratio [OR]=0.38, 95% confidence interval [CI]=0.23, 0.64; 30-day ppa OR=0.27, 95% CI=0.15, 0.47), greater odds of child health care utilization for asthma (OR=1.71, 95% CI=1.01, 2.92), and greater child asthma functional limitation (B=0.16, SE=0.06, p=.03) even after controlling for smoking status. Depression predicted a greater number of child asthma symptom days (B=1.08, SE=0.44, p=.01), but this became nonsignificant after controlling for smoking status. Conclusions: Among parents who smoke, both depressive symptoms and smoking should be targeted for treatment aimed at improving pediatric asthma.

Smokers who have children with asthma: Perceptions about child secondhand smoke exposure and tobacco use initiation and parental willingness to participate in child-focused tobacco interventions.

OBJECTIVE: This study examined, among parents who smoke and have children with asthma, perceptions about child secondhand smoke exposure (SHSe), child tobacco use (TU) initiation, and parent willingness to participate in child-focused tobacco interventions. METHODS: Participants were 300 caregivers who smoked and had a child with asthma (aged 10-14). Parents completed an online survey and self-reported perceptions about child SHSe elimination, child TU prevention, and willingness to participate in three types of interventions with and without their child (SHSe reduction intervention, tobacco prevention intervention, and the combination of the two). Correlates of perceptions and willingness were examined. RESULTS: Parents who were ready to quit smoking and who reported home smoking bans (HSBs) were more motivated to eliminate SHSe (p < 0.05). Being white, younger, ready to quit, and having HSBs were associated with greater confidence to eliminate SHSe (p < 0.05). Parents with HSBs reported higher perceived importance about preventing child TU (p < 0.05). Parents were less confident about preventing male children from using tobacco (p = 0.001). Parents were highly willing to participate in all the described intervention approaches, with or without their child. CONCLUSIONS: Parents were willing to participate in child-focused tobacco interventions, with or without their child with asthma, including interventions that address both child SHSe and TU prevention. This research demonstrates the acceptability of child-focused tobacco interventions among a high-risk population and may be a foundational step for intervention development.

The longitudinal, bidirectional relationships between parent reports of child secondhand smoke exposure and child smoking trajectories.

This study examines the longitudinal relationships between child smoking and secondhand smoke exposure (SHSe). Participants were 222 parent-child dyads. The parents smoked, had a child with (48%) or without asthma, and were enrolled in a smoking/health intervention. Parent-reported child SHSe was measured at baseline and 4, 6, and 12-month follow-ups; self-reported child smoking was assessed at these points and at 2-months. A parallel process growth model was used. Baseline child SHSe and smoking were correlated (r = 0.30). Changes in child SHSe and child smoking moved in tandem as evidenced by a correlation between the linear slopes of child smoking and SHSe (r = 0.32), and a correlation between the linear slope of child smoking and the quadratic slope of child SHSe (r = - 0.44). Results may inform interventions with the potential to reduce child SHSe and smoking among children at increased risk due to their exposure to parental smoking.

Post traumatic stress symptoms in parents of children with cancer: A mediation model.

OBJECTIVE: Caregivers of pediatric cancer patients are at risk for posttraumatic stress symptoms (PTSS). Previous literature has identified caregiver illness uncertainty as a predictor of PTSS, yet little is known about the mechanism by which illness uncertainty may affect PTSS. Rumination, or perseverations about the cause and consequences of an event, has been related to posttraumtic stress disorder in other populations. However, limited research of this relationship exists for pediatric cancer caregivers. Further, no studies have evaluated rumination in relation to illness uncertainty. The current study examined rumination in relation to illness uncertainty and PTSS in caregivers with children actively receiving treatment for cancer. It was hypothesized that rumination would be related to illness uncertainty and would mediate the relationship between illness uncertainty and PTSS. METHODS: Caregivers (N = 59) completed the Parent Perception of Uncertainty Scale, Ruminative Responses Scale, and the Impact of Event Scale-Revised. RESULTS: illness uncertainty was identified as a significant predictor of rumination (B = 0.148, p = .015), and rumination was a significant predictor of PTSS (B = 1.83, p < .001). Biased-corrected bootstrap regression analysis revealed that rumination mediated the relationship between illness uncertainty and PTSS (R2 = 0.53, p < .001). CONCLUSIONS: Rumination was identified as a mediator between the relationship of illness uncertainty and PTSS. These findings underscore the importance of rumination in caregivers of children with cancer, as a potential construct for identifying caregivers at risk of PTSS, and as a possible mechanism for targeted intervention.

The Moderating Role of Health Status on the Association Between Depressive Symptoms and Cannabis Vaping.

Objective: Cannabis vaping is increasing among college students. There is little information on risk factors for vaping cannabis. Consistent with the self-medication hypothesis, experiencing depressive symptoms and having a chronic medical condition (CMC) are associated with cannabis use among young adults. Individuals who experience both risk factors may be at higher risk for cannabis vaping. This study examined cross-sectional associations between depressive symptoms, CMC status, and cannabis vaping, and identified the moderating role of CMC status on depressive symptoms and cannabis vaping. Method: College students (N = 3,742) self-reported on depressive symptoms, CMC status, and lifetime and current cannabis vaping (i.e., cannabis vaporizers; electronic nicotine devices to use cannabis). Data were collected Fall 2017 until Spring 2021. The sample was predominantly female (70.9%) and White (75.4%). Regression analyses were used. Results: Greater depressive symptoms were related to increased likelihood of cannabis vaping across outcomes. Having a CMC was related to lifetime history of cannabis vaporizing. CMC status moderated the associations between depressive symptoms and lifetime cannabis vaporizing. Depressive symptoms were only a risk factor for cannabis vaporizing among college students without a CMC, not those with a CMC. Conclusions: Interventions that teach adaptive ways of coping with depressive symptoms and the potential demands of managing a CMC in college are needed. Comprehensive programs for college students, with and without CMCs, are needed to support those with comorbid depression and cannabis vaping use.

Concordance of parent proxy report and child self-report of posttraumatic stress in children with cancer and healthy children: influence of parental posttraumatic stress.

OBJECTIVE: This study examined the relationships between parental posttraumatic stress symptoms (PTSS), child PTSS, and parent-child concordance for child PTSS. METHOD: Participants were children with cancer (n = 199), and healthy children (n = 108) and their parents. Children self-reported on PTSS and parents completed measures of child and parent PTSS. RESULTS: In the cancer group, child and parent reports of child PTSS were significantly correlated with no mean differences between reporters. In contrast, correlations were non-significant in the control group, and parents reported significantly lower levels of child PTSS than children. Increased parental PTSS was associated with better concordance in the cancer group but not in the control group. In fact, in the cancer group, parent-child concordance was strongest at the highest level of parental PTSS. CONCLUSIONS: Parents of children with cancer were found to be accurate reporters of their children's distress, even with high levels of reported personal distress. In contrast, parents of healthy children appear primarily influenced by personal distress when reporting child PTSS. Although multiple informant assessments are always desirable, it appears that utilization of a single informant may be reasonable in the cancer setting when access to informants is limited.

COVID-19 Mental Health Impacts Among Parents of Color and Parents of Children with Asthma.

OBJECTIVES: This study investigated whether select social determinants of health and worries about COVID-19 resource losses mediated the relations between four parent groups: [1) non-Hispanic White (NHW) parents of children with asthma; 2) Black, Indigenous, or other Persons of Color (BIPOC) parents of healthy children; 3) BIPOC parents of children with asthma; and 4) NHW parents of healthy children (referent)] and parent anxiety and depression symptoms during COVID-19. METHODS: Parents (N = 321) completed online questionnaires about discrimination, anxiety, depression, and COVID-19 impacts on employment/income and access to food and health care. Mediation analyses were conducting using nonparametric bootstrapping procedures. RESULTS: BIPOC parents of children with and without asthma experienced greater anxiety and depression symptoms through greater discrimination compared to NHW parents of healthy children. BIPOC parents of children with asthma experienced greater anxiety symptoms, and both BIPOC groups experienced greater depression symptoms, through greater COVID-19 income losses. NHW parents of children with asthma and both BIPOC groups experienced greater anxiety and depression symptoms through greater worries about COVID-19 resource losses. CONCLUSIONS: The suffering of BIPOC parents, especially BIPOC parents of children with asthma, necessitates multi-level COVID-19 responses to address key drivers of health inequities.

Quality of Life in Adolescents and Young Adults With a Chronic Medical Condition: The Role of Perceived Maturity and Transition Readiness.

INTRODUCTION: Adolescents and young adults (AYA) with a chronic medical condition (CMC) attending college must learn to manage their own healthcare (i.e., transition readiness). Maturity has been linked to positive outcomes in AYAs. Research has established a positive relationship between transition readiness and quality of life. The current study aimed to examine a model of perceived maturityàtransition readinessàmental and physical quality of life. METHOD: AYA (N = 153) with a CMC completed self-report questionnaires. RESULTS: The perceived maturity→transition readiness→mental quality of life indirect path was significant (ab = 1.96, 95% CI = 0.53 to 3.62). The perceived maturity→transition readiness→physical quality of life direct and indirect paths were not significant. DISCUSSION: Results showed that maturity and transition readiness are positively associated. Transition readiness may be one mechanism by which maturity results in enhanced quality of life. PRACTICE IMPLICATIONS: Findings highlight the value of enhancing strengths such as maturity to promote AYA independence/autonomy.

Smoking across adolescence and adulthood with cardiovascular risk among American Indian peoples.

OBJECTIVE: American Indian peoples (AIs) have high smoking rates and cardiovascular risk factor burden. The present study aimed to (a) investigate latent smoking classes across adolescence and adulthood, (b) investigate adolescent predictors of smoking classes, and (c) assess how smoking class is related to adult cardiovascular risk in a sample of AIs. METHOD: A sample of AIs (N = 338) from the National Adolescent to Adult Health Study self-reported on smoking across four assessment waves (W1: 7th-12th grade; W2: 8th-12th grade; W3: ages 18-26; W4: ages 24-32). The socioecological framework for addressing tobacco-related disparities was used to identify potential adolescent (W1) risk and resource factors. C-reactive protein, blood pressure, and lipids were collected at W4. Growth mixture modeling and regressions were used. RESULTS: Six smoking classes were identified: light smoking (36%), nonsmoking (23%), escalating, adult daily smoking (13%), chronic heavy smoking (12%), escalating, young adult daily smoking (9%), and reducing smoking (7%). Risk factors for being in the chronic heavy smoking class included peer smoking and older age at W1. Compared with the chronic heavy smoking class, AIs in the reducing smoking class lived in in more impoverished neighborhoods during adolescence. Relative to several classes with less smoking, being in the chronic heavy smoking class was associated with higher C-reactive protein and less favorable lipid levels. W1 social support was a resource factor for adult diastolic blood pressure and some lipids. CONCLUSIONS: Socioecologically informed tobacco interventions have the potential to reduce smoking and cardiovascular risk among AIs, and bolstering social support may be important. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Longitudinal smoking patterns and adult cardiometabolic risk among African Americans.

OBJECTIVE: To better understand mechanisms influencing health in African Americans (AAs), the aims of this study were (a) to identify longitudinal cigarette smoking classes among AAs across adolescence and into young adulthood; (b) to identify risk factors for smoking and how cardiometabolic health in adulthood differs by smoking class; and (c) to investigate whether smoking mediates the relation between adolescent risk factors and adult cardiometabolic health. METHOD: This study used 4 waves of nationally representative data, restricted to an AA subsample (N = 2,009). Participants self-reported on multilevel risk factors in adolescence and smoking across adolescence and young adulthood; cardiometabolic risk was assessed in adulthood. Growth mixture modeling and structural equation modeling were conducted. RESULTS: Five classes emerged: nonsmoker; early onset, heavier smoking; later onset; early onset, light smoking; and maturing out or declining smoking. Predictors of class membership included living with individuals who smoke, having friends who smoke, and limited access to medical care. The early onset, light smoking class had the greatest cardiometabolic risk. Smoking class mediated the relation between living with people who smoke in adolescence and adult cardiometabolic risk. CONCLUSIONS: Nuanced smoking patterns among AAs were identified, and 23% fell into classes characterized by an early onset and persistent smoking trajectory. The early onset, light smoking class had the greatest cardiometabolic risk in adulthood. The results suggest unique protective factors may be present for youth who remain nonsmokers even when their family smokes. Results have implications for health promotion and tobacco prevention efforts among AA families. (PsycInfo Database Record (c) 2020 APA, all rights reserved).