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1.
BMC Geriatr ; 24(1): 400, 2024 May 06.
Article in English | MEDLINE | ID: mdl-38711009

ABSTRACT

BACKGROUND: Poverty, as a risk factor for loneliness, has been understudied, and there is a need to gain a better understanding of the relationship between poverty examined by material deprivation and loneliness among older adults in Hong Kong. It also aimed to explore the possible mediation and moderation effects of social support, social networks, neighborhood collective efficacy, and social engagement in the link between material deprivation and loneliness. METHODS: 1696 Chinese older adults aged 60 years and above (Mage = 74.61; SD = 8.71) participated in a two-wave study. Older adults reported their loneliness level, material deprivation, perceived level of social support, social network, neighborhood collective efficacy, social engagement, and sociodemographic information. Logistic regression was conducted to examine the effect of material deprivation on loneliness, as well as the mediation and moderation models. RESULTS: The results indicated that material deprived older adults reported a significantly higher level of loneliness 2 years later when controlling for demographic variables, health-related factors, and loneliness at baseline. We also found that engagement in cultural activities partially mediated the effect of material deprivation and loneliness. Furthermore, neighborhood collective efficacy and engagement in cultural activities were significant moderators that buffer the relationship between material deprivation and loneliness. CONCLUSIONS: Our results suggested the need to alleviate the negative impact of material deprivation on loneliness by developing interventions focused on promoting neighborhood collective efficacy and social engagement, which could be aimed at building meaningful bonds among Chinese older adults in Hong Kong.


Subject(s)
Loneliness , Social Support , Humans , Loneliness/psychology , Hong Kong/epidemiology , Aged , Male , Female , Aged, 80 and over , Middle Aged , Poverty/psychology , Neighborhood Characteristics
2.
JMIR Mhealth Uhealth ; 12: e50826, 2024 May 08.
Article in English | MEDLINE | ID: mdl-38717816

ABSTRACT

BACKGROUND: Mobile health (mHealth) wearable devices are increasingly being adopted by individuals to help manage and monitor physiological signals. However, the current state of wearables does not consider the needs of racially minoritized low-socioeconomic status (SES) communities regarding usability, accessibility, and price. This is a critical issue that necessitates immediate attention and resolution. OBJECTIVE: This study's aims were 3-fold, to (1) understand how members of minoritized low-SES communities perceive current mHealth wearable devices, (2) identify the barriers and facilitators toward adoption, and (3) articulate design requirements for future wearable devices to enable equitable access for these communities. METHODS: We performed semistructured interviews with low-SES Hispanic or Latine adults (N=19) from 2 metropolitan cities in the Midwest and West Coast of the United States. Participants were asked questions about how they perceive wearables, what are the current benefits and barriers toward use, and what features they would like to see in future wearable devices. Common themes were identified and analyzed through an exploratory qualitative approach. RESULTS: Through qualitative analysis, we identified 4 main themes. Participants' perceptions of wearable devices were strongly influenced by their COVID-19 experiences. Hence, the first theme was related to the impact of COVID-19 on the community, and how this resulted in a significant increase in interest in wearables. The second theme highlights the challenges faced in obtaining adequate health resources and how this further motivated participants' interest in health wearables. The third theme focuses on a general distrust in health care infrastructure and systems and how these challenges are motivating a need for wearables. Lastly, participants emphasized the pressing need for community-driven design of wearable technologies. CONCLUSIONS: The findings from this study reveal that participants from underserved communities are showing emerging interest in using health wearables due to the COVID-19 pandemic and health care access issues. Yet, the needs of these individuals have been excluded from the design and development of current devices.


Subject(s)
COVID-19 , Poverty , Qualitative Research , Wearable Electronic Devices , Humans , COVID-19/psychology , COVID-19/epidemiology , Wearable Electronic Devices/statistics & numerical data , Female , Male , Adult , Poverty/psychology , Poverty/statistics & numerical data , Middle Aged , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Telemedicine/methods , Telemedicine/statistics & numerical data , Interviews as Topic/methods , Perception
3.
JMIR Aging ; 7: e52292, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38662423

ABSTRACT

BACKGROUND: Older adults worldwide experienced heightened risks of depression, anxiety, loneliness, and poor mental well-being during the COVID-19 pandemic. During this period, digital technology emerged as a means to mitigate social isolation and enhance social connectedness among older adults. However, older adults' behaviors and attitudes toward the adoption and use of digital technology are heterogeneous and shaped by factors such as age, income, and education. Few empirical studies have examined how older adults experiencing social and economic disadvantages perceive the learning of digital tools. OBJECTIVE: This study aims to examine the motivations, experiences, and perceptions toward a community-based digital intervention among older adults residing in public rental flats in a low-income neighborhood. Specifically, we explored how their attitudes and behaviors toward learning the use of smartphones are shaped by their experiences related to age and socioeconomic challenges. METHODS: This study adopted a qualitative methodology. Between December 2020 and March 2021, we conducted semistructured in-depth interviews with 19 participants aged ≥60 years who had completed the community-based digital intervention. We asked participants questions about the challenges encountered amid the pandemic, their perceived benefits of and difficulties with smartphone use, and their experiences with participating in the intervention. All interviews were audio recorded and analyzed using a reflexive thematic approach. RESULTS: Although older learners stated varying levels of motivation to learn, most expressed ambivalence about the perceived utility and relevance of the smartphone to their current needs and priorities. While participants valued the social interaction with volunteers and the personalized learning model of the digital intervention, they also articulated barriers such as age-related cognitive and physical limitations and language and illiteracy that hindered their sustained use of these digital devices. Most importantly, the internalization of ageist stereotypes of being less worthy learners and the perception of smartphone use as being in the realm of the privileged other further reduced self-efficacy and interest in learning. CONCLUSIONS: To improve learning and sustained use of smartphones for older adults with low income, it is essential to explore avenues that render digital tools pertinent to their daily lives, such as creating opportunities for social connections and relationship building. Future studies should investigate the relationships between older adults' social, economic, and health marginality and their ability to access digital technologies. We recommend that the design and implementation of digital interventions should prioritize catering to the needs and preferences of various segments of older adults, while working to bridge rather than perpetuate the digital divide.


Subject(s)
COVID-19 , Poverty , Qualitative Research , Humans , Aged , Male , Female , COVID-19/epidemiology , COVID-19/psychology , COVID-19/prevention & control , Poverty/psychology , Middle Aged , Smartphone , Aged, 80 and over , Residence Characteristics , Motivation
4.
JMIR Aging ; 7: e51675, 2024 May 14.
Article in English | MEDLINE | ID: mdl-38599620

ABSTRACT

BACKGROUND: Digital technology is a social determinant of health that affects older people's ability to engage in health maintenance and disease prevention activities; connect with family and friends; and, more generally, age in place. Unfortunately, disparities in technology adoption and use exist among older adults compared with other age groups and are even greater among low-income older adults. OBJECTIVE: In this study, we described the development and implementation of a digital literacy training program designed with the dual goals of training low-income older adults in the community and teaching students about aging using a community-engaged learning (CEL) approach. METHODS: The training program was embedded within a 10-week CEL course that paired undergraduates (N=27) with low-income older adults (n=18) for 8 weeks of digital literacy training. Older adults and students met weekly at the local senior center for the training. Students also met in the classroom weekly to learn about aging and how to use design thinking to train their older adult trainees. Both older adults and students completed pre- and posttraining surveys. RESULTS: Older adults demonstrated increased digital literacy skills and confidence in the use of digital technology. Loneliness did not change from pre to postassessment measurements; however, older adults showed improvements in their attitudes toward their own aging and expressed enthusiasm for the training program. Although students' fear of older adults did not change, their comfort in working with older adults increased. Importantly, older adults and students expressed positive feelings about the trainee-trainer relationship that they formed during the training program. CONCLUSIONS: A CEL approach that brings together students and low-income older adults in the community has a strong potential to reduce the digital divide experienced by underserved older adults. Additional work is needed to explore the efficacy and scalability of this approach in terms of older adults' digital literacy as well as other potential benefits to both older and younger adults.


Subject(s)
Poverty , Humans , Male , Female , Poverty/psychology , Aged , Computer Literacy , Students/psychology , Young Adult , Surveys and Questionnaires , Adult , Middle Aged , Learning , Digital Technology
5.
Behav Ther ; 55(3): 443-456, 2024 May.
Article in English | MEDLINE | ID: mdl-38670660

ABSTRACT

Using a couple-centered approach, the current study seeks to understand (a) the specific ways in which help-seeking couples vary in how their relationship satisfaction changes over time, (b) whether there are important differences in relationship characteristics at the beginning of the interventions, and (c) whether couples with distinct relationship characteristics benefit equally from effective online relationship programs. Mixed-gender low-income couples (Ncouple = 659) seeking help for their relationship were randomly assigned to one of two online relationship programs (n = 432) or the wait-list control group (n = 227). Latent profile analyses were conducted to identify (a) trajectory profiles with both partners' relationship satisfaction assessed at baseline, during, and postprogram, and at 2- and 4-month follow-ups; and (b) baseline couple profiles with indicators of baseline communication, commitment, emotional support, and sexual satisfaction reported by both partners. Four unique satisfaction trajectories were identified: women-small-men-medium improvement (39%), men-only decline (25%), large improvement (19%), and women-only improvement (17%). Five unique baseline couple profiles were identified: conflictual passionate (30%), companionate (22%), men-committed languishing (22%), satisfied (16%), and languishing (10%). Compared to control couples, intervention couples' odds of following the large improvement trajectory increased and their odds of following the men-only decline trajectory decreased; the odds of following the other two intermediate trajectories did not differ by intervention status. Moreover, couples with more distressed baseline profiles were more likely to follow trajectories characterized by greater satisfaction gains regardless of their intervention status. However, program effects did not differ based on baseline couple profiles, suggesting that a universal approach may be sufficient for delivering online relationship programs to improve relationship satisfaction in this population.


Subject(s)
Couples Therapy , Personal Satisfaction , Poverty , Humans , Male , Female , Adult , Poverty/psychology , Couples Therapy/methods , Middle Aged , Interpersonal Relations , Help-Seeking Behavior , Spouses/psychology , Sexual Partners/psychology
6.
J Alzheimers Dis ; 99(1): 117-120, 2024.
Article in English | MEDLINE | ID: mdl-38640159

ABSTRACT

Dementia is a global public health priority. Physical activity has myriad health benefits, including for reducing dementia risk. To increase physical activity, detailed understanding of influencing factors is needed. Socioeconomic deprivation affects many aspects of health and wellbeing. Qualitative research with older people experiencing socioeconomic deprivation is needed to explore barriers and enablers to engaging in physical activity, with the view to co-designing interventions for implementation trials. A whole of society approach is pivotal to improving effectiveness of physical activity interventions for older adults with cognitive impairment, and target support for people experiencing socioeconomic deprivation, to improve their health outcomes.


Subject(s)
Dementia , Exercise , Humans , Dementia/epidemiology , Socioeconomic Factors , Brain , Poverty/psychology , Cognitive Dysfunction
7.
Soc Cogn Affect Neurosci ; 19(1)2024 May 06.
Article in English | MEDLINE | ID: mdl-38619118

ABSTRACT

A growing literature links socioeconomic disadvantage and adversity to brain function, including disruptions in reward processing. Less research has examined exposure to community violence (ECV) as a specific adversity related to differences in reward-related brain activation, despite the prevalence of community violence exposure for those living in disadvantaged contexts. The current study tested whether ECV was associated with reward-related ventral striatum (VS) activation after accounting for familial factors associated with differences in reward-related activation (e.g. parenting and family income). Moreover, we tested whether ECV is a mechanism linking socioeconomic disadvantage to reward-related activation in the VS. We utilized data from 444 adolescent twins sampled from birth records and residing in neighborhoods with above-average levels of poverty. ECV was associated with greater reward-related VS activation, and the association remained after accounting for family-level markers of disadvantage. We identified an indirect pathway in which socioeconomic disadvantage predicted greater reward-related activation via greater ECV, over and above family-level adversity. These findings highlight the unique impact of community violence exposure on reward processing and provide a mechanism through which socioeconomic disadvantage may shape brain function.


Subject(s)
Exposure to Violence , Magnetic Resonance Imaging , Residence Characteristics , Reward , Humans , Male , Female , Adolescent , Magnetic Resonance Imaging/methods , Exposure to Violence/psychology , Exposure to Violence/statistics & numerical data , Residence Characteristics/statistics & numerical data , Socioeconomic Factors , Poverty/psychology , Ventral Striatum/physiology , Ventral Striatum/diagnostic imaging , Brain/physiology , Brain Mapping , Child , Socioeconomic Disparities in Health
8.
Compr Psychiatry ; 132: 152476, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38552349

ABSTRACT

INTRODUCTION: Mental health conditions (MHC) among adolescents in low- and middle-income countries, including South Africa, are estimated to be high. Adaptive emotion regulation (ER) skills can protect against MHC among adolescents. In South Africa, there is limited adolescent mental health prevalence data as well as little understanding of the associations between MHC and ER among adolescents. This study aimed to address these gaps by describing the psychosocial characteristics of older South African adolescents from low-income settings as well as investigating associations between depression and anxiety symptoms and ER. METHODS: We selected 12 schools in collaboration with two NGOs. Learners aged 15-18-years were recruited to complete a tablet-based survey. ER, depression, anxiety, and other psychosocial measures were included. Two multiple linear regression models were used to determine associations between depression symptoms, anxiety symptoms, other psychosocial factors, and ER. RESULTS: Of the 733 participants from 12 Western Cape schools, 417 (56.90%) screened at risk for clinically significant anxiety symptoms, 423 (57.70%) participants for depression symptoms, 229 (31.40%) participants for PTSD symptoms and 263 (35.90%) for risky alcohol use. Depression and anxiety scores were found to be significantly positively correlated with ER difficulties and adolescents struggled most with identifying and utilizing adaptive ER strategies. The adjusted linear regression model reported that female gender, clinically significant depressive, anxiety, post-traumatic stress symptoms and risky-alcohol use were all significantly associated with poorer ER scores, while self-esteem was significantly associated with better ER scores. CONCLUSION: These findings contribute to the South African adolescent mental health literature and to the research gap on the links between depression and anxiety and ER. Future research should consider further exploration of the relationships between psychosocial factors and ER to inform the urgent development and testing of appropriate adolescent interventions in this setting.


Subject(s)
Anxiety , Depression , Emotional Regulation , Poverty , Humans , Adolescent , South Africa/epidemiology , Female , Male , Depression/psychology , Depression/epidemiology , Anxiety/psychology , Anxiety/epidemiology , Poverty/psychology
9.
Creat Nurs ; 30(1): 65-73, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38304931

ABSTRACT

Holistic nursing practice requires an understanding of the constraints of poverty as one of the social determinants of health. Future nurses need to be change agents for social justice. A descriptive, qualitative study was conducted to explore students' experience of the Missouri Association for Community Action Poverty Simulation© (CAPS) and its impact on empathy and social justice awareness among a purposive sample of 56 sophomore baccalaureate nursing students at a public university in the Northeastern United States. Inductive thematic analysis was applied to data collected from a postparticipation reflection paper. Five themes emerged: (a) emotions, (b) personal history of poverty, (c) empathy, (d) rising advocacy, and (e) lessons learned. The results support that the CAPS simulation provides an experiential opportunity which impacts empathy and foundational attitudes to be a change agent for social justice. Recommendations include structured education about social determinants of health prior to the CAPS simulation, continued education throughout nursing curricula, and experiential opportunities to apply social justice skills before graduation.


Subject(s)
Education, Nursing, Baccalaureate , Students, Nursing , Humans , Empathy , Students, Nursing/psychology , Attitude of Health Personnel , Education, Nursing, Baccalaureate/methods , Poverty/psychology , Social Justice
10.
Brain Behav ; 14(2): e3426, 2024 02.
Article in English | MEDLINE | ID: mdl-38361316

ABSTRACT

BACKGROUND: Food insecurity is a persistent concern in the United States and has been shown to affect child mental health and behavior. The SLC6A4 gene has been indicated as a moderator of the effects of chronic stress on anxiety in adolescents aged 14-21. However, it is unclear if SLC6A4 may also play a role in the effects of childhood food insecurity, a form of chronic stress, on adolescent mental health. This study aimed to identify effects of food insecurity on adolescents' mental health and delinquent behavior when both mom and child go hungry in the child's early years, and the potential interaction with SLC6A4 variants (SS/LL). METHODS: The data and sample for this research are from the Future of Families and Child Wellbeing Study. The cohort consists of 4898 children (age 1-15 years, male = 47%, African American = 50%) and their respective caregivers sampled from large cities in the United States from 1998 to 2000. RESULTS: The SLC6A4 serotonin transporter short/short allele emerged statistically significant as a moderator of childhood food insecurity and adolescent mental health. Specifically, the presence of the short/short allele increased anxiety symptoms in adolescents with exposure to food insecurity in childhood. CONCLUSION: The SLC6A4 short/short allele amplifies risk of anxiety-related mental illness when children experience food insecurity. The gene-environment interaction provides insight into the mechanistic pathway of the effects of poverty-related adversity, such as food insecurity, on developmental trajectories of mental health.


Subject(s)
Food Insecurity , Mental Disorders , Mental Health , Serotonin Plasma Membrane Transport Proteins , Adolescent , Child , Humans , Male , Mental Disorders/epidemiology , Mental Disorders/genetics , Poverty/psychology , Serotonin Plasma Membrane Transport Proteins/genetics , United States/epidemiology
11.
J Psychol ; 158(4): 309-324, 2024.
Article in English | MEDLINE | ID: mdl-38227200

ABSTRACT

Income poverty is associated with an enhanced tendency to avoid losses in economic decisions, which can be driven by a response bias (risk avoidance) and a valuation bias (loss aversion). However, the impact of non-income dimensions of poverty on these biases remains unclear. The current study tested the impact of material hardship on these biases, and the mediating effects of anxiety, depression, and cognitive control in these associations. Healthy adults (N = 188) completed questionnaire and behavioral measures of the variables. Results of regression-based analyses showed that participants who reported higher material hardship exhibited greater response bias, but not valuation bias. This effect was mediated by anxiety. Although material hardship predicted lower cognitive control, cognitive control did not mediate the association between material hardship and either type of bias. These findings suggest that material hardship may lead to economic decision-making biases because it impacts emotional states rather than cognitive control.


Subject(s)
Anxiety , Decision Making , Poverty , Humans , Female , Male , Adult , Anxiety/psychology , Young Adult , Poverty/psychology , Executive Function/physiology , Middle Aged , Depression/psychology , Adolescent
12.
JBI Evid Synth ; 22(5): 940-946, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38247722

ABSTRACT

OBJECTIVE: The objective of this review is to synthesize the best available qualitative evidence on the weight management practices, views, and experiences of adults living with poor socioeconomic circumstances and obesity. Additionally, the review aims to deepen our understanding of the common narratives of obesity according to these people. INTRODUCTION: People living with poor socioeconomic circumstances are at increased risk of obesity, particularly in high-income countries, and their weight management practices (eg, weight-related behaviors) tend to be less healthy. Since prior research on socioeconomic inequalities in obesity is mostly from quantitative studies, the individual views and experiences related to weight management have been largely ignored. Thus, systematic qualitative evidence is needed on the weight management practices, views, and experiences of adults living with poor socioeconomic circumstances and obesity. INCLUSION CRITERIA: Qualitative studies examining adults (aged 18 to 74 years) living with poor socioeconomic circumstances and obesity, and conducted in high- and upper-middle-income countries will be considered. The phenomenon of interest is these people's weight management practices, views, and experiences. METHODS: Searches will be conducted in MEDLINE (Ovid), APA PsycINFO (Ovid), CINAHL (EBSCOhost), Scopus, Web of Science, and the Finnish health sciences database, MEDIC, restricted to the English and Finnish languages. Sources of unpublished studies and gray literature will include Google Scholar and ProQuest Dissertations and Theses. Two independent reviewers will screen the papers, assess methodological quality, and extract data following JBI's procedures. The meta-aggregative approach will be used for data synthesis. Confidence in the findings will be assessed using the ConQual approach. REVIEW REGISTRATION: PROSPERO CRD42023407938.


Subject(s)
Obesity , Qualitative Research , Systematic Reviews as Topic , Humans , Obesity/therapy , Obesity/epidemiology , Obesity/psychology , Adult , Socioeconomic Factors , Poverty/psychology
13.
Sleep Health ; 10(2): 182-189, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38245475

ABSTRACT

OBJECTIVE: Families with low-income experience suboptimal sleep compared to families with higher-income. Unique drivers likely contribute to these disparities, along with factors that universally impede sleep patterns, despite income level. To inform intervention tailoring, this mixed-methods study gathered parent's perceptions about child sleep challenges to identify similarities/differences in families with lower-income and higher-income. METHODS: Parents who experienced difficulties with their child (ages 2-4years) sleep were categorized as lower income (n = 15; $30,000 ± 17,845/year) or higher income (n = 15; $142,400 ± 61,373/year). Parents completed a survey and semistructured interview to explore barriers and facilitators for child sleep. Two coders independently evaluated transcripts for lower-income and higher-income groups using inductive analyses. Constant-comparison methods generated themes and characterized similarities/differences by income group. RESULTS: Groups were similar in themes related to diverse bedtime routines, nighttime struggles with child sleep, parent strategies to reduce night wakings, parent effort to provide a sleep-promoting environment, and presence of electronic rules. Groups differed in themes related to factors influencing routine setting (eg, lower income: external factors influencing routines; higher income: personal attributes for structure), parent appraisal of child sleep (eg, higher income: ambivalence; lower income: mostly negative appraisal), nap timing and duration (eg, lower income: longer naps), and strategy utilization and pursuit of resources (eg, higher income: more parents tried various strategies and accessed online/print resources). CONCLUSIONS: Parents experienced many similar barriers to child sleep, with a few distinct differences by income group. These findings can inform future intervention components for all families, as well as customized components to address the unique needs of families across income levels.


Subject(s)
Income , Parents , Poverty , Sleep , Humans , Male , Female , Income/statistics & numerical data , Child, Preschool , Parents/psychology , Poverty/psychology , Adult , Surveys and Questionnaires
14.
Fam Process ; 63(1): 331-347, 2024 Mar.
Article in English | MEDLINE | ID: mdl-36720209

ABSTRACT

Low-income, rural families face significant mental health risks. However, the understanding of resources associated with mental health risks is limited. The present study investigated the associations between perceived resources of low-income, rural mothers, and longitudinal maternal and child outcomes. This study utilized longitudinal data from the Family Life Project (N = 1203), from US rural areas with high poverty rates. Mothers reported their resources at 6-month postpartum, and their levels of depression, anxiety, and role overload were assessed at 2-year postpartum. Mothers reported their children's behavioral problems at 3 years old. Using a person-centered approach, we identified four maternal profiles: lower resources (7.1%); higher intra-family support (11.1%); higher inter-family support (20.8%); and higher resources (60.9%). In general, the higher resource profile was associated with lower mental health concerns of mothers and lower levels of behavior problems of children. Mothers in the higher intra-family support profile had disproportionately higher role overload. Children of mothers in the higher inter-family support profile showed disproportionately higher behavioral problems. Maternal partner status and education were significant predictors of resource profiles. Findings support the heterogeneity in perceived resources among low-income, rural families and different risk levels. Identifying these subgroups has significant implications for policy and interventions aimed toward this vulnerable population.


Subject(s)
Mothers , Problem Behavior , Child , Female , Humans , Child, Preschool , Mothers/psychology , Poverty/psychology , Mental Health , Anxiety
15.
J Fam Psychol ; 38(2): 309-319, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38032652

ABSTRACT

An important issue associated with at-risk families in the child welfare system is the impact of familial stress processes on child developmental outcomes. The present study used the family stress model (FSM) to examine the impact of economic hardship, economic pressure, caregiver emotional distress, caregiver/partner conflict, caregiver harsh parenting, and adverse childhood experiences (ACEs) on child's cognitive, behavioral, and social outcomes. Data from the National Survey on Child and Adolescent Well-Being II were utilized, and 1,363 children (709 male, 654 female) ages 2-18 months (at Wave 1) were included in the present study. Three waves of data were analyzed in the longitudinal structural equation model, with economic hardship and economic pressure at Wave 1, caregiver emotional distress, caregiver/partner conflict, and caregiver harsh parenting at Wave 2 predicting ACEs and child outcomes at Wave 3. Results were overall consistent with the FSM in that economic hardship led to economic pressure, and caregiver emotional distress and caregiver/partner conflict led to harsh parenting, which subsequently led to ACEs. ACEs led to negative child cognitive outcomes, and for female children only, ACEs led to internalizing/externalizing behaviors. The results demonstrate that over time, familial stress processes led to negative child developmental outcomes in this sample. Study results also highlight the inextricable connection between mild harsh parenting behaviors and more severe forms of maltreatment on child outcomes. The prevention of child maltreatment is emphasized, with a specific focus on increasing positive parenting behaviors and decreasing caregiver emotional distress and caregiver/partner conflict. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Adverse Childhood Experiences , Child , Adolescent , Humans , Male , Female , Child, Preschool , Parenting/psychology , Child Development , Anxiety , Poverty/psychology
16.
J Adolesc Health ; 74(1): 60-70, 2024 01.
Article in English | MEDLINE | ID: mdl-37831048

ABSTRACT

PURPOSE: Exposure to parental mental ill-health and poverty in childhood impact health across the lifecourse. Both maternal and paternal mental health may be important influences, but few studies have unpicked the complex interrelationships between these exposures and family poverty for later health. METHODS: We used longitudinal data on 10,500 children from the nationally representative UK millennium cohort study. Trajectories of poverty, maternal mental health, and secondary caregiver mental health were constructed from child age of 9 months through to 14 years. We assessed the associations of these trajectories with mental health outcomes at the age of 17 years. Population-attributable fractions were calculated to quantify the contribution of caregivers' mental health problems and poverty to adverse outcomes at the country level. RESULTS: We identified five distinct trajectories. Compared with children with low poverty and good parental mental health, those who experienced poverty and poor primary or secondary caregiver mental health (53%) had worse outcomes. Children exposed to both persistent poverty and poor caregiver mental health were at markedly increased risk of socioemotional behavioural problems (aOR 4.2; 95% CI 2.7-6.7), mental health problems (aOR 2.5; CI 1.6-3.9), and cognitive disability (aOR 1.7; CI 1.1-2.5). We estimate that 40% of socioemotional behavioural problems at the age of 17 were attributable to persistent parental caregivers' mental health problems and poverty. DISCUSSION: More than half of children growing up in the UK are persistently exposed to either one or both of poor caregiver mental health and family poverty. The combination of these exposures is strongly associated with adverse health outcomes in the next generation.


Subject(s)
Fathers , Mental Health , Male , Child , Female , Humans , Adolescent , Cohort Studies , Poverty/psychology , United Kingdom/epidemiology
17.
Psychiatry Res ; 331: 115677, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38113812

ABSTRACT

Maternal mental health is crucial to healthy family functioning and child well-being. Housing hardship may increase risk for mood disorders among mothers of young children in renter households. The present study used latent class analysis to investigate manifestations of housing hardship during the postpartum year in a sample of renter mothers in the United States (N = 2,329), as well as whether housing hardship types were associated with subsequent maternal depression and anxiety. The majority of mothers were relatively stably housed ("Stable"), one in six made do with governmental rental assistance ("Rent-Assisted"), and more than one in ten struggled to afford or maintain stable housing ("Cost-Burdened" or "Housing Insecure"). The most severe housing hardship was associated with the greatest depression risk, whereas the best determinant of anxiety risk was whether rent was paid each month; mothers whose rent was paid with government assistance did not differ on anxiety risk compared to those who paid their rent independently. Findings suggest that different types of housing hardship are linked with distinct mental health sequelae. Widely available housing assistance may reduce cost burden and prevent displacement, with the potential to reduce mental disorder among low-income mothers of young children.


Subject(s)
Housing , Mental Health , Child , Female , Humans , United States/epidemiology , Child, Preschool , Poverty/psychology , Family Characteristics , Mothers
18.
J Epidemiol Community Health ; 77(8): 534-541, 2023 08.
Article in English | MEDLINE | ID: mdl-37280065

ABSTRACT

BACKGROUND: Adolescent mental health is a public health priority. Maternal mental ill health and adverse socioeconomic exposure (ASE) are known risk factors of adolescent mental ill health. However, little is known about the extent to which cumulative ASE over the life course mediates the maternal-adolescent mental health association, which this study aims to explore. METHODS: We analysed data from more than 5000 children across seven waves of the UK Millennium Cohort Study. Adolescent mental ill health was measured using the Kessler 6 (K6) and Strengths and Difficulties Questionnaire (SDQ) at age 17. The exposure was maternal mental ill health as measured by the Malaise Inventory at the child's birth. Mediators were three measures of cumulative ASE defined by maternal employment, housing tenure and household poverty. Confounders measured at 9 months were also adjusted for, these were: maternal age, maternal ethnicity, household poverty, maternal employment, housing tenure, maternal complications during labour and maternal education. Using causal mediation analysis, we assessed the cumulative impact of ASE on the maternal-adolescent mental ill health relationship between birth and age 17. RESULTS: The study found a crude association between mothers' mental health at the child's birth and mental health of their children at age 17, however, when adjusting for confounders this association was reduced and no longer significant. We did not find an association between cumulative exposure to maternal non-employment or unstable housing over the child's life course and adolescent mental health, however, cumulative poverty was associated with adolescent mental ill health (K6: 1.15 (1.04, 1.26), SDQ: 1.16 (1.05, 1.27)). Including the cumulative ASE measures as mediators reduced the association between maternal and adolescent mental health, but only by a small amount. CONCLUSIONS: We find little evidence of a mediation effect from cumulative ASE measures. Experiencing cumulative poverty between the ages of 3-14 was associated with an increased risk of adolescent mental ill health at age 17, suggesting actions alleviating poverty during childhood may reduce adolescent mental health problems.


Subject(s)
Mental Health , Mothers , Child , Female , Infant, Newborn , Humans , Adolescent , Child, Preschool , Cohort Studies , Mothers/psychology , Poverty/psychology , Adolescent Health
19.
J Fam Psychol ; 37(6): 796-805, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37166903

ABSTRACT

Eating meals as a family is associated with multiple positive nutritional and emotional outcomes for parents and children. Although the benefits of mealtimes extend to all families, families of color and those in poverty face disproportional barriers to eating frequent meals together. No previous study has properly attended to the heterogeneity of racial and ethnic groups in the United States when assessing mealtime barriers. Focusing on adverse childhood experiences (ACEs), our analyses tested whether an increased number of adversities, and particular types of adversities, were associated with a decrease in mealtime frequency for different racial/ethnic families in the United States. Utilizing a large, nationally representative sample of families (n = 59,963), results showed that higher cumulative ACE scores reduced the number of days a family eats meals together in a given week. For specific ACE items, seven out of nine individual ACE items were associated with decreased mealtimes (excluding parental death and racial discrimination). Stratification resulted in varied associations between accumulated and individual ACE items and mealtime frequency depending on racial/ethnic group. Asian families in particular had greater odds of infrequent meals than other families, while Native American, Alaskan Native, Pacific Islander, and other racial/ethnic families were unaffected by increased ACEs. Results indicate that a family's accumulation of multiple adversities may impede mealtimes by either forcing families to prioritize the management of other stressors or by depleting the physical and mental resources needed to establish a routine. Focusing on family cultural traditions as protective factors may be an area of future intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Adverse Childhood Experiences , Child , Humans , United States , Ethnicity , Parents , Poverty/psychology , Meals/psychology , Family/psychology
20.
PLoS One ; 18(5): e0285510, 2023.
Article in English | MEDLINE | ID: mdl-37167267

ABSTRACT

Residential greenness may support mental health among disaster-affected populations; however, changes in residential greenness may disrupt survivors' sense of place. We obtained one pre- and three post-disaster psychological distress scores (Kessler [K]-6) from a cohort (n = 229) of low-income mothers who survived Hurricane Katrina in New Orleans, Louisiana, USA. Greenness was assessed using average growing season Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) in the 300 m around participants' homes at each time point. We used multivariable logistic regressions to evaluate two hypotheses: 1) that cross-sectional greenness (above vs. below median) was associated with reduced psychological distress (K6≥5); and 2) that changes in residential greenness were associated with adverse mental health. When using EVI, we found that a change in level of greenness (i.e., from high to low [high-low], or from low to high [low-high] greenness, comparing pre- and post-Katrina neighborhoods) was associated with increased odds of distress at the first post-storm survey, compared to moving between or staying within low greenness neighborhoods (low-high odds ratio [OR] = 3.48; 95% confidence interval [CI] = 1.40, 8.62 and high-low OR = 2.60; 95% CI: 1.05, 6.42). Results for NDVI were not statistically significant. More research is needed to characterize how residential greenness may impact the health of disaster survivors, and how these associations may change over time.


Subject(s)
Cyclonic Storms , Female , Humans , Cross-Sectional Studies , Mothers , Poverty/psychology , Survivors/psychology
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