Impact of the COVID-19 pandemic on suicide-related risk among college students: A cross-sectional analysis.

This study aimed to investigate the factors contributing to suicide-related risks among college students during a stressful life event, specifically the COVID-19 pandemic. Employing a Classification and Regression Tree (CART) model, data from 808 college students were analyzed, revealing key interactions and predictive insights into suicide-related risk. Results indicated that preexisting depression emerged as the most significant risk factor, followed by anxiety, discrimination, stress, and younger age. These findings emphasize the importance of preventive measures targeting depression and anxiety to enhance college students' mental health and well-being. The study's implications extend to informing future research, practical interventions, and policy-making efforts addressing suicide-related risk among college students.

Transition, Adjustment, and Healthcare Avoidance: African Immigrant Women's Experiences and Perceptions of Navigating Primary Healthcare in the USA.

This study explores the transition and adjustment of African immigrant women, particularly Ethiopian immigrant women (EIW), as they navigate the U.S. healthcare system and their ability to access and utilize healthcare services. A qualitative cross-sectional design with a mix of purposive and snowball sampling techniques was utilized to recruit EIW (N = 21, ≥18 years) who arrived in the U.S. within the last five years. One-on-one in-depth interviews were conducted to collect data. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically using Nvivo12 software. The thematic analysis revealed three major themes: (1) settling into new life in the U.S. delays EIWs' ability to access primary healthcare; (2) adjusting to the U.S. healthcare system: confusions and mixed perceptions; and (3) avoidance of care: EIW's reasons for PHC visits changed in the U.S. Participants avoided healthcare, except for life-threatening conditions, general check-ups, and maternal healthcare services. Transitional support for legal, residential, employment, and health information could help tackle the challenges of accessing primary healthcare for EIW. Future research should analyze access to healthcare in relation to the everyday struggles of immigrant women, as well as legal and complex structural issues beyond acculturative issues.

Anxiety sensitivity among Black youth: A cross-sectional analysis of the direct and indirect effects of community violence exposure, neighborhood risk, parenting practices, and peer effects.

Youth exposed to community violence and neighborhood stressors report devastating mental health consequences. Black youth are at greater risk and experience community violence at rates higher than other youth populations. An underexplored mental health consequence is anxiety sensitivity, the fear of experiencing anxiety-related symptoms, which contributes to maladaptive coping strategies and the development and severity of other mental health problems. This study utilized structural equation modeling (SEM) to examine socio-ecological risk and protective factors associated with community violence exposure and anxiety sensitivity among low-income Black youth. Survey data are from a sample of 320 Black youth residing in public and subsidized housing in a Northeastern city in the United States. Results indicated that neighborhood risk, parenting behaviors, and exposure to delinquent peers were indirectly associated with anxiety sensitivity, which occurred through community violence exposure. Additionally, neighborhood risks had direct effects on anxiety sensitivity. Results point to the need to incorporate social and environmental factors in interventions addressing anxiety sensitivity among Black youth in urban communities.

Examining the Utility of the Early Childhood Development Index (ECDI) among Children in the Nigeria Context.

An estimated 6 million children under the age of five in Nigeria (out of nearly 31 million) risk not reaching their full developmental potential. The dearth of context-relevant measures poses a challenge to the planning and implementation of effective interventions. This study assesses the utility of the Early Childhood Development Index (ECDI) in Nigeria. We used the Multiple Indicator Cluster Surveys to track progress among 3- to 4-year-old children (n = 11,073); 3-year-old, 51%; female, 49%. Using random calibration samples, the results from psychometric tests indicate that while over half of the children were on track in their development based on the ECDI, the instrument had low to average internal consistency and weak face validity, suggesting an inadequacy in capturing ECD information of value. At the outset of the launch of the new ECDI2030, the results of this study point to the need for continued discourse and advocacy for the use of culturally appropriate measures of child development, and a child-centered community engagement approach. This is essential in ensuring accountability and responsive interventions for the children served and their families.

Effectiveness of Different Online Intervention Modalities for Middle-Aged Adults with Overweight and Obesity: A 20-Year Systematic Review and Meta-analysis.

The main objectives of this systematic review and meta-analysis study include evaluating the methodological quality of existing randomized controlled trials (RCTs) for weight loss and features of online intervention [OI]s in each trial, examining the associations between the methodological quality, intervention features and the effectiveness of OIs, and comparing the effectiveness of OIs and other intervention modalities through systematic review and meta-analysis. Systematic searches were conducted using PubMed, Cochrane Library, CINAHL, and PsycINFO in the past two decades (2000 through 2019). Inclusion criteria includes Online intervention (intervention modality), middle-aged adults with overweight or obesity, at least six months or longer study period, an RCT, and 70% plus retention rate. Risk of Bias was assessed using Miller et al. in (Hester, Miller (eds) Handbook of alcoholism treatment approaches: Effective alternatives (3rd ed.). Allyn & Bacon, Boston, 2003)'s Methodological Quality Rating Scale (MQRS) and GRADE. MOOSE guidelines was referred for data synthesis. In total, 29 OIs were evaluated using 10 criteria for methodological quality and eight criteria for intervention features. Results revealed that the mean methodological quality score of the RCTs was 12.1 (out of 16), and the mean intervention features score was 6.6 (out of 8). RCTs with higher scores were more effective in weight loss than those with lower scores. Results of meta-regression showed that methodological quality was more important than intervention features to increase the effectiveness. Results of meta-analysis showed that OIs were significantly more effective than controls. Compared to OIs only, OIs with interactions with others and professionals were more effective. The study limitation includes assessing 'effectiveness' based on weight only due to lack of other indicators to compare between studies; some results are self-reported; and feedback from intervention participants were hard to review. Nevertheless, this study may contribute to improving the effectiveness of existing OIs for weight loss considering methodological quality and better intervention features.

Stress Biomarkers in Black Youth: Exploring Psychological, Behavioral, and Socio-Ecological Correlates.

Exposure to chronic stress is a major public health concern. Black youth are vulnerable to chronic stress exposure given their overrepresentation in urban neighborhoods characterized by socio-ecological stressors. We contribute to this emerging body of knowledge by (1) investigating stress-induced variability in cortisol response patterns among Black youth, and (2) examining risk and protective factors associated with physiological stress responses. Salivary cortisol was collected from a community sample of 123 low-income Black youth ages 13 to 21. Latent class analysis (LCA) and logistic regression were utilized to identify discrete groups based on cortisol reactivity, and psychological, behavioral, and socio-ecological correlates of class membership. LCA supported a 2-class model of cortisol reactivity. Youth in class one were indicative of a normative stress response with mean cortisol awakening response of 0.38 µg/dL (SD = 0.19), 0.48 µg/dL (SD = 0.20) at time 2, and 0.44 µg/dL (SD = 0.20) at time 3. Youth in class two exhibited a blunted stress response with mean cortisol awakening response of 0.20 µg/dL (SD = 0.11), 0.21 µg/dL (SD = 0.09) at time 2, and 0.18 µg/dL (SD = 0.08) at time 3. Delinquent peer exposure and post-traumatic stress symptoms were negatively associated with blunted stress responses, while greater depressive symptoms were positively associated with blunted stress responses. Black youth displayed distinct physiological stress reactivity patterns. Interventions are needed to assist youth in coping with stress while transforming the upstream factors that give rise to adverse community conditions.

Assessing the Modified Neighborhood Cohesion Index Among African American Adolescents Living in Public Housing: An Exploratory and Confirmatory Factor Analysis.

Objective: African American youth are disproportionately overrepresented in low-resourced segregated urban neighborhoods. Consequently, they experience greater exposure to neighborhood risks and subsequent depressive symptoms. Neighborhood cohesion represents a protective factor for youth in such environments. However, the concept remains underexplored among African American youth. This study examines the psychometric properties of a modified version of the Neighborhood Cohesion Index (NCI) among African American youth living in public housing. Method: Psychometric properties were assessed through exploratory and confirmatory factor analyses using data from African American youth (N = 235) living in public housing in two large northeastern cities. Results: The EFA resulted in the use of a single-factor structure with two dropped items and good internal validity. Findings from the CFA indicated that model fit indices were unacceptable for chi-square and RMSEA (χ2 [62; N = 235] = 170.19, p < .001); RMSEA = 0.09 [90% CI: 0.071, 0.102]) but were acceptable for SRMR and CFI (SRMR = 0.06; CFI = 0.91) with three error covariances. Conclusions: The modified NCI is not ideal for assessing neighborhood cohesion among this understudied population. Future research should prioritize psychometric testing alongside cognitive interviewing, to provide a contextualized measure of neighborhood cohesion for this population.

Structural and Intermediary Social Determinants of Health and the Emotional and Behavioral Health of US Children.

Children grow up in homes where varying environmental and socioeconomic contexts have a bearing on their emotional and behavioral health (EBH). This study used data from a representative sample of the child supplement of the US National Health Information Survey (NHIS) and applied the social determinants of health (SDoH) framework to explore factors associated with child EBH. We conducted a path analysis of the child's EBH measured by the strengths and difficulties questionnaire (SDQ) from their macro and socioeconomic contexts, e.g., policy, household, and other health system risk factors. For children in the sample, aged 4 to 17 years old (n = 9205), most path relationships to child SDQ scores were statistically significant. The total effects from a child's visit to a mental health specialist (0.28) and child's age (0.22) had the highest coefficients to child SDQ scores. A modified model showed a better fit with X2 (4) = 22.124, RMSEA = 0.021, and 90% CI [0.013-0.03], CFI = 0.98. Findings indicate that child factors such as being older, the use of mental healthcare services, and family socioeconomic status were significantly associated with EBH, calling attention to the need for more responsive policy and behavioral health interventions that address household/familial and child-level factors, critical determinants of child wellbeing.

Goal Orientation and Adolescent Social Competence: Ubuntu as a Mediator Among Black American Adolescents.

Social competence, which is the ability to demonstrate socio-emotional behavior skills, is crucial during adolescence with far-reaching implications across the lifespan. However, social competence development among youth is greatly influenced by social inequities, which places many Black American youth at a disadvantage due to the disproportionate burden on youth development in resource-constrained environments. Responsively, we sought to determine whether Afrocentric cultural norms (i.e., Ubuntu) and goal orientation contribute to the resilience of Black youth in developing social competence while controlling for social positions (i.e., social class and gender). For this study, we used the dataset of black boys and girls (average age of 14.68) from the Templeton Flourishing Children Project. Linear regression analysis followed by mediation analysis was conducted to identify the factors associated with higher degrees of social competence. Significant study findings indicate that Black youth reporting higher goal-oriented mindsets reported higher social competence scores. Goal orientation and social competence were mediated by Ubuntu, with the model explaining 63% variance in social competence in Black youth. The findings suggest prevention efforts that provide socialization centered around Afrocentric cultural norms may provide valuable means of bolstering social competence development in Black youth living in resource-constrained communities.

Predicting intention of intimate partner violence screening among Thai nursing students: A cross-sectional study.

AIM: Using the theory of planned behaviour, the aim of this study was to examine predictors of intention to screen patients for intimate partner violence among Thai nursing students. METHODS: We employed a cross-sectional, anonymous online survey study with convenience sampling of senior nursing students from across Thailand in April 2019. We administered the Intimate Partner Violence Screening Intention, Nursing Students, a 36-item tool, and analysed relationships between students' intentions and attitudes, subjective norms and perceived behavioural control towards intimate partner violence screening. PROCESS was used to test mediation analyses. RESULTS: Of N = 639 respondents. Most (90%) reported intention to screen patients for intimate partner violence. Approximately 41% reported having no intimate partner violence training in their nursing school. Results of the multiple logistic analysis showed that attitudes (OR: 8.5; 95% CI 1.2-4.6) and subjective norms (OR: 4.4; 95% CI 1.4-4.6) significantly predicted intention, whereas perceived behavioural control (OR: 1.7; 95% CI 0.5-4.9) did not. Moreover, attitudes and subjective norm significantly mediated the association between providing a screening tool at clinical sites, and intention. CONCLUSIONS: Attitudes and subjective norms were significant predictors of intention of intimate partner violence screening. However, participants lacked adequate role models and training. Future research should improve the predictive power of the framework by integrating additional constructs such as the availability of screening tools, the presence of role models, to design and evaluate effective training and support for future nurses to address intimate partner violence in practice. IMPACTS: It is time to seriously consider integrating intimate partner violence content and training into the Thai nursing curriculum, and address the policies, guidelines, and practice culture. PATIENT OR PUBLIC CONTRIBUTION: The study was designed to examine predictors of intention to screen patients for intimate partner violence. Thai senior nursing students were contributed in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

South Korean adolescents' delinquency, disclosure, parental knowledge, parent-child closeness, and delinquent peer associations.

The present study sought to examine longitudinal associations among delinquency, children's disclosure to parents, parent-child relationship quality, and parental knowledge in a South Korean sample. Longitudinal research shows that in Western samples, delinquency is negatively associated with the latter three variables. We also sought to test whether the associations varied across gender. We found little evidence of significant reciprocal relationships among the variables and no differences in associations across gender. A second analysis revealed that adolescents' involvement with delinquent peers was a good predictor of subsequent delinquency for males and females. Implications of the findings for future research and practice are discussed.

Mask wearing and self-harming thoughts among international students in the United States during COVID-19: The moderating role of discrimination.

Objective: This study examined associations among discrimination, mask-wearing behavior, and self-harming thoughts among international students in the United States during COVID-19. Participants: Undergraduate and graduate international students enrolled in universities during the 2020 summer semester participated in the online survey (N = 103). Methods: Perceived discrimination, mask-wearing behavior, and self-harming thoughts during COVID-19 were assessed by self-reports. Multivariable logistic regressions examined the association among discrimination, mask-wearing behavior, and self-harming thoughts and explored the potential moderation effect of discrimination on the association between mask-wearing and self-harming thoughts. Results: 18.6% of participants reported self-harming thoughts. Increased discrimination was significantly associated with increased odds of self-harming thoughts. Discrimination significantly moderated the association between mask wearing and self-harming thoughts. Conclusions: The findings highlight the importance of increased availability of culturally appropriate mental health services for international students and the need for increased advocacy to decrease discrimination against international students in the current societal context.

The hidden minority: Discrimination and mental health among international students in the US during the COVID-19 pandemic.

International students in the US occupy a precarious position at the intersection of immigration policy and global education mobility, one made more challenging by the disparate impact of COVID-19 on college students' mental health. Few studies, however, have explored the pandemic's effects on mental well-being among the international student population in the US. Our study aims to provide initial empirical evidence on the mental health status of these students, with a specific focus on discrimination, loneliness, anxiety, and depression. We propose a mediation framework and estimate the mediating effects of loneliness and anxiety in the relationships between discrimination and depression in a sample of US-based international students (N = 103). We collected cross-sectional data from July to August 2020, using a 50-item online survey instrument with three open-ended questions. Mediation analyses using PROCESS Macro were used to analyse quantitative data and thematic analysis was used to analyse qualitative data. Findings showed that higher levels of discrimination were significantly associated with higher levels of loneliness. Higher levels of loneliness were significantly associated with higher levels of anxiety, which in turn led to high levels of depressive symptoms. Our study contributes to understanding the needs and capacities of international students in the wake of COVID-19 and simultaneously provides pragmatic program and policy implications for inclusive higher education environments and the overall health and well-being of this crucial US student population.

Relations between stress, coping strategies, and prosocial behavior in U.S. Mexican college students.

Objective: We explored the explanatory roles of active and avoidant coping in the link between stress and emotional prosocial behavior in U.S. Mexican college students. Participants: Participants included 148 college students (Mage = 23 years, 67% female, 84% born in the U.S.) who self-identified as Mexican or U.S. Mexican or noted that their parents or grandparents were of Mexican or U.S. Mexican origin. Methods: Introduction to Psychology students at state universities in California and Texas completed a self-report survey packet and received class credit for their participation. Data were analyzed via path analysis using Mplus 8.1 software. Results: U.S. Mexican college students' stress was indirectly associated with their emotional prosocial behavior through both active and avoidant coping strategies. Conclusions: Relations between stress and adjustment (i.e., emotional prosocial behavior) is dependent upon individuals' coping tendencies. U.S. Mexicans may cope with their stress by engaging in emotional prosocial behavior.

Exposure to community violence and depressive symptoms: Examining community, family, and peer effects among public housing youth.

Exposure to community violence is an epidemic problem that causes debilitating effects on youth mental health. However, the relationships between violence exposure and youth mental health remain unclear when examining co-occurring socioecological risk and protective factors. The purpose of this study is to clarify the observed gaps in knowledge by utilizing structural equation modeling (SEM) to examine the mediating role of community violence exposure on the relationship between perceived neighborhood risk factors, parental behaviors, and peers on depressive symptoms in a sample of urban youth in low-income public housing communities (n = 320). Results indicate that community violence exposure and exposure to delinquent peers mediates the effects of perceived neighborhood risk and parenting behaviors on depressive symptoms. These findings suggest that while interventions that limit exposure to community violence and delinquent peers could reduce depressive symptoms, interventions that reduce community violence are essential to improve youth mental health.

Sexually Transmitted Diseases Among College Students in Sierra Leone: A Life Course Ecological Analysis.

Applying life course theory, this study examined the direct and indirect effects of adverse childhood experiences (ACEs) on the risk of contracting sexually transmitted diseases (STDs), mediated by early sexual activity (first sexual experience before age 15), number of lifetime sex partners, and mental health problems. The link between ACEs and mental health on college students' sexual risk is still understudied. Using cross-sectional data from a sample of 327 college students in Sierra Leone, this study tested the hypothesized mediation model using structural equation modeling analysis. The results showed that ACEs significantly increased sexual risks. Specifically, ACEs increased the risk of early initiation of sexual activity and the number of lifetime sex partners, which in turn increased the risk of STDs. Furthermore, ACEs significantly predicted negative mental health and were significantly associated with an increased risk of STDs. Effective future intervention strategies should include health education programs to address the lifelong effects of ACEs and mental health treatment.

The Disaster Adaptation and Resilience Scale: development and validation of an individual-level protection measure.

Given the increasing threat of disasters in the United States and elsewhere around the world, well-tested assessment tools that operationalise specific protective factors associated with adaptation and resilience to such events are needed. Consequently, the authors proposed, developed, and validated the Disaster Adaptation and Resilience Scale (DARS) to measure five domains found to support adaptive responses in individuals exposed to disasters: physical resources; social resources; problem-solving; distress regulation; and optimism. The development and validation processes of DARS occurred across two studies: the first comprised construct development, item generation, and expert review, whereas the second involved a full validation evaluation of the psychometric properties of the scale in a sample of adults exposed to a disaster in the US (N=625). The results revealed that DARS had psychometric properties that support its use among adults experiencing a disaster. A discussion is presented on how the scale can be employed in both research and practice.

Exposure to Violence and Posttraumatic Stress Among Youth in Public Housing: Do Community, Family, and Peers Matter?

This study examines the mediating roles of neighborhood risk factors, parental behaviors, and peers on the relationship between community violence exposure and posttraumatic stress in a sample of urban youth in low-income public housing communities. Data are from 320 African-American youth living in public housing in a northeastern city in the USA. Structural equation modeling was utilized to examine the stated relationships. Study results point to significant effects of violence exposure on posttraumatic stress in urban youth. While findings indicated indirect effects of neighborhood risk, parenting practices, and exposure to delinquent peers on posttraumatic stress, each of these paths operates through their relationship with violence exposure, with exposure to delinquent peers having the strongest mediating effect. Exposure to delinquent peers mediates the effects of neighborhood risks and parental behaviors on exposure to community violence, representing one potential intervention point to disrupt the deleterious effects of exposure to violence among youth. Our findings suggest interventions that address peer influence, and group norms may serve as protective factors against the risk of youth violence exposure. Overall, results highlight the co-occurring socioecological context of community violence exposure for youth living in public housing.

Intimate partner violence screening intention instrument for Thai nursing students: A principal component analysis.

BACKGROUND: Identifying factors related to intimate partner violence (IPV) screening intentions of future nurses is critical, but no studies specific to this research area exist in Thailand; nor does any validated instrument currently exist to systematically evaluate Thai nursing students' IPV training or measure their readiness to address IPV. The purpose of this study was to develop the Intimate Partner Violence Screening Intention, Nursing Students (IPVSI-NS) for Thai nursing students and identify components explaining their intentions to screen for intimate partner violence (IPV). METHOD: We designed a Thai-language, culturally appropriate 36-item instrument based on the theory of planned behavior (TPB), which describes intentions as the precursors of actual behaviour. We then conducted an anonymous cross-sectional online survey of female senior Thai nursing students (N = 594). Principal component analysis with varimax methods was used to examine the component structure of the instrument. The internal consistency reliability and convergent construct validity were evaluated. See Supporting File S1. RESULTS: A six-component structure was evident which explained 59.56% of variance and identified: attitudes (advantages and disadvantages of screening), subjective norms (support from important people, and opinions of important people and policy) and perceived behavioural control (training experience, teamwork, facility resources and screening barriers). CONCLUSION: The IPVSI-NS, based on the TPB, provides a psychometrically sound, reliable and valid tool for Thai nursing educators and researchers to advance nursing education, practice and research regarding IPV. RELEVANCE TO CLINICAL PRACTICE: Provides support for the components of the TPB (attitude, subjective norm and perceived behavioural control) as an excellent fit to predict intention of IPV screening for future clinical nurses. Implications for future research and educational practice are discussed.

Each post matters: a content analysis of #mentalhealth images on Instagram.

This study examined mental health-related content on a popular visual-based social media platform, Instagram. A content analysis was completed by using the search term '#mentalhealth' on public Instagram posts (N = 758). Our data showed that wellness practices related to mental health (e.g. exercise, healthy eating), anxiety, and depression are the most addressed mental health topics on Instagram. Additionally, posts that mention at least one type of mental health problem seek peer support and engagement from other users at a higher rate compared to posts that do not mention mental health disorder or topic (beyond the search term #mentalhealth). We discussed these findings in detail, as well as their theoretical and practical implications and the limitations of this study. We also suggested avenues for further research to promote evidence-based health communication techniques tailored to current visual-based social media platforms.