Active Moms: a feasibility study of a community-based and home-based physical activity intervention for low-income, ethnic-minority mothers.

BACKGROUND: Despite the health benefits of physical activity, increasing regular physical activity levels among low-income, ethnic-minority mothers has remained a significant challenge. Yet, few studies have examined the feasibility of implementing interventions to address physical activity barriers often experienced by this population. METHODS: The current mixed-methods pilot study assessed the feasibility, impact, and acceptability of a 3-month community-based (CBI) and a home-based intervention (HBI) designed to improve physical activity and fitness levels, as well as psychosocial outcomes (self-efficacy and social support), among low-income, ethnic minority mothers. Mothers were randomized to either a 3-month CBI or HBI and completed pre- and post-intervention assessments of physical activity, fitness, self-efficacy, and social support. Intervention feasibility was assessed by tracking recruitment, retention, and adverse event rates, whereas intervention acceptability was assessed through post-intervention focus groups. RESULTS: Although participant recruitment was lower than expected (30 vs. target of 52 mothers), retention and adverse event feasibility goals were met (> 60% retention rate, 0% adverse events). Mothers in both groups (CBI and HBI) showed significant improvements in their physical activity and fitness levels and short-term improvements in receiving social support for physical activity. However, only mothers in the CBI group showed improvements in their self-efficacy for physical activity. Mothers also reported both types of interventions (CBI and HBI) to be acceptable with minor modifications highlighted, including the potential for graduates of these programs to serve as group facilitators. CONCLUSIONS: Overall, the study protocol was feasible, impactful, and acceptable to low-income, ethnic minority mothers with modifications required before large-scale evaluation. (TRN: NCT05540509; 9/12/22; retrospectively registered; ClinicalTrials.org).

Factors Associated with Prenatal Health Behaviors among Low-Income, Ethnic Minority Women.

Less than one-third of pregnant women in the U.S. meet prenatal nutrition, exercise, and stress management health behavior guidelines. Low rates of these prenatal health behaviors have been especially observed among low-income, ethnic minority women, placing them and their infants at a disproportionally higher risk for health complications. Yet, few studies have identified factors associated with these prenatal health behaviors in this population. This study examined whether certain demographic (e.g., ethnicity) and psychosocial characteristics (i.e., coping, stress, pregnancy-specific stress, and depression) were associated with prenatal nutrition (i.e., high-fat food and fruit and vegetable intake), exercise, and stress management health behaviors in 100 low-income, pregnant women (39% African American, 30% foreign-born Latinas, 15% U.S.-born Latinas, 10% non-Hispanic white, and 6% Asian American/Pacific Islander) in southern California using an embedded, mixed-methods, cross-sectional design. Results demonstrated that ethnic minority women who experienced more stress and used more maladaptive coping strategies (e.g., avoidance) were particularly at risk of consuming more high-fat foods and engaging in less exercise and stress management during pregnancy. Qualitative responses revealed women's experiences with these prenatal health behaviors. These findings highlight the need for interventions and collaborative care models that target psychosocial factors in order to optimize prenatal health behaviors and health outcomes among ethnic minority women.

Marine fish and benthic biota before the 2019 oil spill: A baseline dataset for monitoring programs and impact assessments at Rio Grande Norte state, Northeastern Brazil.

In 2019 an oil spill spread over more than 4000 km of the Brazilian coastline. Monitoring programs that allow for the evaluation of potential impacts on communities and ecosystems and their recovery through time are needed and rely on baseline information previous to the oil spill. Here we compiled qualitative and quantitative data available from 8 studies on fish and benthic species from different habitats of Rio Grande do Norte (RN) from 2007 to 2018. We assessed the number of species from different locations and compiled information on conservation status and human use. We mapped the study areas and habitats and overlapped them with those affected by the oil spill. The RN state has a high diversity of fish (175 species) and benthic species (285 species), of which more than half of fish (52%) and 2% of benthic species are threatened and 72,8% of fish and 7,9% of benthic species are of commercial interest. Information of most habitats is still poorly known (i.e.majority ofthe available data are from unique and punctual sampling), which may weaken future evaluations of the real impact of the oil spill. Nonetheless, it is possible to design reliable monitoring based on our dataset, persistent contamination and future loss of diversity.

Developmental trajectories of internalizing distress among ethnic minoritized mothers following childbirth: Associations with early child psychological adjustment.

A substantial body of work has established that mothers' internalizing distress can negatively affect children's socioemotional development. Yet few studies have examined how distinct patterns of mothers' distress over time differentially impact child behaviors across early childhood. To address this gap, the current study explored developmental trajectories of mothers' internalizing distress and examined the associations of these patterns with child adjustment outcomes. Mexican immigrant, Dominican immigrant, and African American mothers (N = 272) were annually assessed for internalizing distress over the first 6 years following childbirth. Children's psychological adjustment (internalizing, externalizing, and hyperactivity behaviors) was measured at the last yearly assessment in first grade. A growth mixture model revealed two distinct classes of distress where mothers were classified as having low stable distress (82.4%) or moderate distress that began as stable then declined when their children were 64 months old (17.6%). Children of mothers in the moderate, late decline class showed greater internalizing, externalizing, and hyperactivity behaviors in the first grade compared to children of mothers in the low stable class. Findings highlight the necessity of supporting the mental health of ethnic minoritized mothers following childbirth and further expand our knowledge of family psychopathology to promote healthy psychological adjustment in children.

Racism, shame, and stress reactivity among young black women.

Black women experience disproportional rates of cardiovascular disease (CVD) warranting further exploration of CVD risk factors. Growing evidence suggests acute stress reactivity studies may elucidate the mechanisms driving psychosocial correlates of CVD risks. Race-related stress has been identified as a CVD risk factor among Black women though recent evidence suggests emotions may facilitate these risks. Black women may be vulnerable to shame related to frequent racist experiences. Yet, no study to date has examined racism, shame, and stress reactivity in this population. The current study utilized mixed linear models to test for time and group effects of racism and shame on stress reactivity (e.g., cortisol and C-reactive protein [CRP]) among 34 Black women who completed the Trier Social Stress Test. Tests for two-way interactions (i.e., shame by racism) were also performed. Significant time and group effects were observed for shame and racism on stress reactivity. Black women who experienced greater lifetime racism, stress appraised, but lower racism during the past year, exhibited greater CRP responses. Black women who experienced high levels of shame and racism during the past year and their lifetime demonstrated greater cortisol reactivity. These results prompt further research on racism and shame as CVD risk factors among Black women.

Psychological Interventions for Prenatal Anxiety in Latinas and Black Women: A Scoping Review and Recommendations.

Anxiety symptoms are common among pregnant women worldwide. In the United States, prenatal anxiety symptoms tend to be elevated among Black and Latin American women as compared to non-Latina White women. Despite the high prevalence of anxiety and associations with adverse maternal and offspring outcomes, interventions have not been developed or tailored sufficiently to Black women or Latinas who need efficacious treatment. This article provides a scoping review of articles published since 2017 that test the effects of randomized and non-randomized psychological interventions designed to reduce prenatal anxiety in samples comprised primarily of ethnic/racial minority women. We also review published protocols of planned psychological interventions to reduce prenatal anxiety in order to highlight novel approaches. In addition to summarizing intervention efficacy and participant acceptability, we highlight gaps in the literature which, if addressed, could improve perinatal mental health equity. Finally, we discuss future directions in prenatal anxiety intervention science beginning preconception including intervention design and prevention models.

Mental health outcomes and experiences of family caregivers of children with disabilities during the COVID-19 pandemic in Bolivia.

This study examined whether certain demographic characteristics, caregiver strain, and coping behaviors were associated with the mental health outcomes of family caregivers of children with disabilities in Bolivia during the COVID-19 pandemic. A mixed-methods convergent study design was used with virtual interviews to quantitatively assess caregivers' demographic characteristics, caregiver strain, coping behaviors, and mental health outcomes, as well as qualitatively assess how the pandemic affected their family. Approximately 32%-71% of caregivers experienced poor mental health outcomes (stress, anxiety, and depression), especially among those experiencing poor health, high caregiver strain, and those using maladaptive coping strategies. Qualitative responses revealed that they experienced several unique stressors during the pandemic that affected them and their children. These findings highlight the need for culturally tailored prevention and treatment interventions to help offset the adverse effects of the COVID-19 pandemic on the mental health outcomes of this at-risk population.

Implementation of Interdisciplinary Health Technologies as Active Learning Strategies in the Classroom: A Course Redesign.

The number of health psychology courses offered in higher education institutions has dramatically increased over the past 30 years. Health psychology courses provide students a unique opportunity to learn about important public health issues and health disparities affecting our society from a biopsychosocial perspective. Prior research indicates that students taking these courses, many of whom are non-biology majors, often report feeling anxious about learning the underlying biological mechanisms that affect health outcomes, particularly as they relate to stress and disease. Therefore, innovative teaching strategies, such as the use of active learning approaches, are needed to promote student confidence and engagement in learning these interdisciplinary models of health. Despite rapid advancements and innovations in health technologies, few health psychology courses have integrated these technologies as a modality of active learning. This article describes the implementation of health technologies (e.g., biosensors, biofeedback equipment, wearable technologies) as an active learning modality and innovative teaching approach to promote student engagement and learning outcomes in an undergraduate health psychology course taught in the U.S. Eighty students from a minority-serving university participated in this pilot course redesign. Student responses to the use of health technologies in their course were very positive. A description of the course curriculum is provided and results from student responses and feedback are presented. Implications and recommendations for implementing these technologies and pedagogies in future health courses are also discussed, including university support for sustaining these high impact teaching practices.

Role of Maternal Depression on Child Development: A Prospective Analysis from Pregnancy to Early Childhood.

Few studies have examined how different characteristics of maternal depression may be associated with developmental outcomes among low-income children. The current study prospectively examined whether the timing (pregnancy vs. early postpartum), severity, and chronicity of maternal depression were associated with child cognitive and social-emotional development in two cohorts of primarily low-income Latinx immigrant mothers and their children. Maternal depression was assessed during pregnancy and at 6 months postpartum. Child development was assessed up to 5 years postpartum. Results showed that maternal depression experienced during pregnancy was associated with lower child cognitive development, particularly among girls. Additionally, both the timing (pregnancy and early postpartum) and severity/chronicity of maternal depression were each independently associated with lower child social-emotional development. These findings highlight the need for early prevention interventions to help offset the adverse effects of maternal depression on child developmental outcomes in this at-risk population.

Cognitive behavioral stress management effects on prenatal anxiety among low-income women.

OBJECTIVE: Few studies have tested cognitive behavioral therapy to reduce prenatal anxiety despite substantial empirical support among individuals seeking treatment for anxiety symptoms. We examined whether a brief cognitive behavioral intervention delivered to low-income pregnant women would be efficacious for reducing prenatal anxiety. METHOD: A sample of 100 primarily ethnic and racial minority pregnant women with subclinical anxiety (74% Latina, 18% Black; Mage = 26.5) were randomized to an 8-week cognitive behavioral stress management (CBSM) intervention (n = 55), or to an attentional control condition (n = 45). Two forms of anxiety (state and pregnancy-specific) were measured at baseline, post-treatment, and at follow-up in the postpartum using the State-Trait Personality Inventory-State and the Pregnancy Related Anxiety scale, respectively. Intent-to-treat (ITT) and completer analyses were conducted using linear mixed models to test mean differences in both forms of anxiety by group assignment and by intervention completion (< 7 vs. ≥ 7 sessions) at post-treatment and follow-up timepoints. RESULTS: ITT results revealed no intervention Group × Time interactions for state, F(3, 356) = .51, p = .68, or pregnancy-specific anxiety, F(2, 184.39) = .75, p = .47, indicating no intervention effect post-treatment or at follow-up. Completer analyses showed that women who received all intervention content (34.5%) had significantly less state anxiety at post-treatment compared to women who had not completed the intervention, (65.5%; Msessions = 3.62); F(6, 270.67) = 2.35, p = .03, and those in the control condition. CONCLUSIONS: While we did not find support for the use of CBSM to treat prenatal anxiety among low-income women, those who received a full dose benefited in state anxiety immediately postintervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Impact of Undergraduate Research Training Programs: An Illustrative Example of Finding a Comparison Group and Evaluating Academic and Graduate School Outcomes.

In this study, researchers at a large, urban, comprehensive minority-serving institution used propensity score matching to identify a unique comparison group to study academic and graduate school outcomes in students served by the National Institutes of Health-funded Building Infrastructure Leading to Diversity (BUILD) Initiative. Acknowledging that students' self-selection biases may confound findings, the use of propensity methods to match students served with those who were not (but were otherwise eligible) provides a valuable tool for evaluators and practitioners to combat this challenge and better evaluate their effectiveness and impact on students' success. This study's findings indicate that BUILD participants had higher academic and graduate school success with regard to cumulative GPA, units attempted and completed, graduation status, and application and admission to graduate programs.

Destined for Greatness: A Family-Based Stress Management Intervention for African-American Mothers and their Children.

RATIONALE: African-American mothers in the U.S. experience high rates of stress, placing them at risk for depression, anxiety, and preterm births, and their children at risk for poor social-emotional development later in childhood. Yet, few studies have developed and tested family-based interventions that target optimal management of stress in this population. OBJECTIVE: The current mixed methods study examined whether a six-week family-based intervention (e.g., cognitive behavioral stress management intervention component for mothers and mindfulness-based kindness curriculum for their children) was effective in improving psychosocial outcomes among low-income African-American mothers and increasing prosocial behaviors in their children. METHOD: Seventy-two mothers (28% pregnant, 72% postpartum) completed pre- and post-intervention assessments of stress, depression, anxiety, and self-efficacy for stress management. Prosocial behaviors for 38 of their children (3-10 years of age) were also assessed via mother's self-report and two observational child assessments of sharing and helping behaviors. Qualitative interviews at post-intervention and reunion focus groups (up to two years later) were also conducted. RESULTS: Mothers showed significant reductions in perceived stress, depressive symptoms, and anxiety, as well as improved self-efficacy for stress management at post-intervention. Although observational assessments of children's sharing and helping behaviors did not change, mothers' qualitative responses indicated improvements in their child's prosocial behaviors at home. Qualitative responses also revealed unique stressors that mothers experienced, the short- and long-term impact of these interventions on mothers and their children, and program recommendations. CONCLUSIONS: These results support the efficacy of family-based stress management interventions in this at-risk population.

Internalized Shame and Social Stress-Induced Blood Pressure Patterns among Young Black Women.

Background: The increasing prevalence of hypertension among young Black women warrants further exploration of hypertension risk factors in this population. Social cognitive pathways that increase hypertension risk have been understudied among Black women. Shame, an emotional response to social evaluative threats, may be important to understanding the contribution of social emotions to hypertension risk. The current study examined the association of internalized shame on systolic (SBP) and diastolic blood pressure (DPB) patterns of reactivity and recovery in a sample of Black women. Methods: Black women (N=32) aged 18-22 were recruited from a public university in August 2019 and January 2020. Participants completed the Internalized Shame Scale, Self-Esteem subscale, and the Perceived Stress Scale. All participants completed the Trier Social Stress Test (TSST) and subsequent blood pressure readings were recorded at baseline and 1 min, 15 min, 30 min, 45 min, and 60 min post-TSST. Two separate repeated measures ANOVAs examined time and group effects of low shame (ISS score ≤ 39.9) vs high shame (ISS score ≥ 40) on blood pressure reactivity patterns. Results: A significant effect of shame on DBP responses to the TSST was observed (P=.020). DBP for women in the low shame group peaked immediately following the TSST relative to baseline (M =81.2 mm Hg vs M =72.2 mm Hg) and remained stable during 60-minute recovery. DBP for women in the high shame group did not peak until 45 min post-TSST relative to baseline (M =84.2 mm Hg vs M =68.0 mm Hg) only slightly decreasing at 60 min post-TSST. Implications: These results highlight the need to further examine the role of shame on hypertension risk among young Black women.

Effects of Health Behavior Interventions on Psychosocial Outcomes and Cortisol Regulation Among Chronically Stressed Midlife and Older Adults.

BACKGROUND: Altered cortisol dynamics have been associated with increased risk for chronic health problems among midlife and older adults (≥ 45 years of age). Yet, studies investigating the impact of health behavior interventions on cortisol activity in this age group are limited. OBJECTIVE AND METHODS: The current study examined whether 48 midlife and older adults (50% family caregivers, 69% women) randomized to one of four telephone-based health behavior interventions (stress management (SM), exercise (EX), nutrition (NUT), or exercise plus nutrition (EX+NUT)) showed improvements in their perceived stress, mood, and cortisol dynamics at 4 months post-intervention. Participants collected four salivary cortisol samples (waking, 30 min after waking, 4 p.m., and bedtime) across two collection days at baseline and at 4 months post-intervention to assess for total cortisol, cortisol awakening response (CAR), and diurnal cortisol slope. RESULTS: Participants in SM showed lower levels of total cortisol and a smaller CAR compared with those in EX, NUT, or EX+NUT from baseline to 4 months post-intervention. Participants in EX showed lower levels of perceived stress, depression, and anxiety compared with those in NUT or SM. Finally, participants in NUT showed a greater diurnal decline in cortisol and lower levels of anxiety compared with those in SM. CONCLUSIONS: These findings provide support for the efficacy of telephone-based, health behavior interventions in improving different stress outcomes among chronically stressed midlife and older adults and suggest the need to test the longer-term effects of these interventions for improving health outcomes in this population.

Examining the role of ethnic microaggressions and ethnicity on cortisol responses to an acute stressor among young adults.

Objective: This study examined whether the frequency of experiences of ethnic microaggressions and the sensitivity to such experiences were associated with cortisol responses to an acute social stressor (Trier Social Stress Test; TSST) among an ethnically diverse sample of young adults (N = 109, Mage = 18.82 years, SD = 1.40 years, 74% female, 44% Latinx). Method: Self-reported experiences of and sensitivity to microaggressions were assessed using the Everyday Microaggressions Scale. Participants' salivary cortisol was collected before, immediately after, and at three 15-min intervals after the TSST (for a total of 5 salivary samples) to assess their cortisol responses to an acute social stressor. Results: Mixed model analyses revealed that experiencing a higher frequency of microaggressions (p = .005) and being more sensitive to those experiences (p = .001) were associated with a more blunted cortisol response (i.e., lower cortisol reactivity and recovery) to the TSST, relative to experiencing a lower frequency of microaggressions and being less sensitive to them. Furthermore, this blunted cortisol response to the TSST was more prominent among young adults of Latinx and other ethnic backgrounds (i.e., biracial, African American, and Native American) compared to their Asian American and non-Hispanic White peers (p = .034). Conclusion: Findings provide insight into the different ways in which experiences of ethnic microaggressions can be associated with biological markers of stress. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Validation of an Electrochemical Sensor to Detect Cortisol Responses to the Trier Social Stress Test.

Recent advances in sensor technology allow for the detection of salivary cortisol levels in real-time, yet studies are needed to test their reliability in clinically at-risk populations. This study examined whether a new electrochemical sensor reliably detected cortisol patterns, compared to a conventional immunoassay test (i.e., ELISA), among women and men with low and high depressive symptoms who participated in the Trier Social Stress Test (TSST; a laboratory-based stressor). Results demonstrated that women and those with high depressive symptoms showed lower cortisol levels throughout the TSST overall compared to men and those with low depressive symptoms. The cortisol sensor was highly reliable when compared to the ELISA immunoassay in detecting cortisol responses to the TSST for both women and men and for participants with low and high depressive symptoms. These results suggest that the sensor is a promising tool for assessing real-time cortisol responses to laboratory stressors in at-risk populations.

Process Evaluation of a Stress Management Program for Low-Income Pregnant Women: The SMART Moms/Mamás LÍSTAS Project.

Background. The SMART Moms/Mamás LÍSTAS Project was a randomized control trial that tested the efficacy of a prenatal stress management program in reducing stress and cortisol levels among low-income women. The current study is a process evaluation of the stress management program (intervention arm of the original randomized controlled trial) and assessed whether implementation fidelity factors (i.e., intervention delivery, receipt, and enactment) were associated with lower stress (perceived stress, salivary cortisol), improved negative and positive mood states (Positive and Negative Affect Schedule), and increased confidence to use relaxation and coping skills. Method. Fifty-five low-income pregnant women (71% Latina, 76% annual income <$20,000) attended weekly group-based sessions over an 8-week period in which a clinically trained researcher taught relaxation and coping skills. Process evaluation measures were obtained via participant self-report and videotaped class sessions that were coded for delivery, receipt, and enactment of the intervention to determine which implementation factors were associated with changes in program outcomes (stress, mood, confidence) over the 8-week period. Results. Women in stress management showed a significant reduction in their stress and cortisol levels (p < .001), improvements in negative and positive mood states (p < .001) and were more confident in using relaxation and coping skills postintervention (74%). The implementation factors of delivery (i.e., instructor adherence to intervention content; p = .03) and enactment (i.e., participant use of intervention skills; p = .02) were most associated with improvements in program outcomes. Conclusion. These findings highlight that implementation factors should be considered when delivering stress management interventions in underserved communities.

Testing plausible biopsychosocial models in diverse community samples: Common pitfalls and strategies.

It is imperative that research interrogating the biological pathways linking stress processes to health continue to translate the results of basic, preclinical experimental research to diverse and under-represented populations, particularly those at elevated risk for morbidity and mortality. Conducting research within these populations and in community settings involves a number of challenges that ultimately contribute to their rarity and uneven quality in the scientific literature. In this review, we summarize the experiences and insights of members of an expert panel on this topic held at the 2018 meeting of the International Society of Psychoneuroendocrinology in Newport Beach, CA. The goals of the session were to identify challenges and share strategies for testing plausible biopsychosocial models within diverse community samples in order to encourage others and improve future research. The present paper is organized into three themes: 1) Recruitment and retention, 2) Collecting biological samples outside of the laboratory, 3) Data analysis, interpretation, and dissemination. Our goal in composing this overview of the conference session was to share within the field of psychoneuroendocrinology the challenges inherent in translating basic research to community populations.

MRI of Uveal Melanoma.

Uveal Melanoma (UM) is the most common primary malignant ocular tumor. The high soft tissue contrast and spatial resolution, and the possibility of generating 3D volumetric and functional images, make Magnetic Resonance Imaging (MRI) a valuable diagnostic imaging technique in UM. Current clinical MRI protocols, however, are not optimized for UM and therefore lack the quality for accurate assessments. We therefore developed a dedicated protocol at a 3 Tesla MRI, using an eye coil, consisting of multi-slice 2D sequences, different isotropic sequences and diffusion and perfusion-weighted images. This protocol was prospectively evaluated in 9 uveal melanoma patients. The multi-slice 2D sequences had the highest in-plane resolution, being the most suited for lesion characterization and local extension evaluation. The isotropic 3D Turbo-Spin Echo (TSE) sequences were the most suitable for accurate geometric measurements of the tumor and are therefore important for therapy planning. Diffusion and perfusion-weighted images aid in differentiating benign from malignant lesions and provide quantitative measures on tumor hemodynamics and cellularity, which have been reported to be effective in predicting and assessing treatment outcome. Overall, this dedicated MRI protocol provides high-quality imaging of UM, which can be used to improve its diagnosis, treatment planning, and follow-up.

The influence of mindfulness and social support on stress reactivity during pregnancy.

Exaggerated stress reactivity can lead to negative health outcomes, which can be especially harmful during important periods of development such as pregnancy. Therefore, studies are needed to examine potential protective factors associated with lower perceived stress reactivity and lower cortisol awakening response (CAR) during pregnancy. The current cross-sectional study examined whether low-income women (n = 152) with higher mindfulness (attentiveness and awareness of the present moment) and more perceived social support had lower levels of perceived stress reactivity and a lower CAR during pregnancy. Women completed self-report measures of mindfulness (Mindful Attention Awareness Scale), social support (Medical Outcomes Study-Social Support Scale), and perceived stress reactivity (Perceived Stress Reactivity Scale) during their first trimester of pregnancy and collected saliva using the passive drool procedure at home (at awakening and at 30 min after awakening). Results showed that women with greater mindfulness and greater perceived social support had significantly lower perceived stress reactivity, but not a lower CAR. These results provide preliminary support for mindfulness and social support as potential protective factors of perceived stress reactivity and have implications for experimental studies aimed at improving pregnant women's mindfulness and social support for reducing their stress reactivity and potentially improving health outcomes.