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1.
Ann Behav Med ; 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34473823

RESUMO

BACKGROUND: When health promotion efforts intend to include African American men, they experience challenges with recruitment and retention, in addition to limited cultural saliency-interventions that do not align the cultural preferences and experiences of the target population produce less effective results. PURPOSE: This scoping review provides an understanding of (a) how health promotion efforts among African American men are developed and implemented, in addition to the (b) main outcomes, (c) retention rates, and (d) methodological rigor of those efforts. METHODS: The following databases were used: PubMed, EMBASE (Ovid), PsycINFO (EBSCO), CINAHL (EBSCO), Web of Science (Clarivate), and ProQuest. Included studies were restricted to those: (a) conducted among African American men and (b) reported the effects of a health promotion intervention. Interventions using single-group pre-post study, post-test-only study, non-randomized controlled trial, and randomized controlled trial (RCT) study designs were included. RESULTS: The results indicate that varying degrees of customization in the design and implementation of health promotion efforts targeting African American can improve recruitment, retention, and health-related outcomes. Results draw attention to the need for community input when designing and implementing efforts targeting these men. CONCLUSIONS: These results indicate that opportunities exist to innovate health promotion efforts among African American men, such as the intentional incorporation of the community's values, perspectives, and preferences in the effort (i.e., cultural saliency) and explicitly indicating how the efforts were culturally tailored to improve saliency. Opportunities also exist to innovate health promotion efforts among African American men based on literature-derived best practices.

4.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34210069

RESUMO

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.


Assuntos
Adaptação Psicológica , Comportamento do Adolescente/psicologia , Afro-Americanos/psicologia , Obesidade Pediátrica/psicologia , Estresse Psicológico/psicologia , Adolescente , Terapia Comportamental , Criança , Dieta/psicologia , Família/psicologia , Relações Familiares/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Masculino , Obesidade Pediátrica/terapia , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Programas de Redução de Peso
5.
Nutrients ; 13(6)2021 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-34204927

RESUMO

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child's weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction (B = -0.331, SE = 0.162, p = 0.043), and concern (B = -0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents.


Assuntos
Afro-Americanos/estatística & dados numéricos , Ingestão de Alimentos , Comportamento Alimentar , Pais/psicologia , Obesidade Pediátrica/etiologia , Adolescente , Afro-Americanos/psicologia , Bebidas Gaseificadas , Criança , Ingestão de Alimentos/etnologia , Ingestão de Alimentos/psicologia , Emoções , Ingestão de Energia , Comportamento Alimentar/etnologia , Comportamento Alimentar/psicologia , Feminino , Frutas , Humanos , Masculino , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/psicologia , Inquéritos e Questionários , Verduras
6.
Syst Rev ; 10(1): 184, 2021 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-34154638

RESUMO

BACKGROUND: Health promotion efforts among African American men have been met with significant challenges and have produced limited results. Interventions that do not align with the values, perspectives, and preferences of African American men often produce less effective results. Research among African American men has provided compelling evidence that these men prefer informal networks of health support. Recent successful health promotion efforts among these men have benefited from peer-to-peer models of implementation. To date, no known scoping or systematic review of peer-to-peer health promotion interventions among African American men has been conducted. The goal of this scoping review is to understand the extent of, design, implementation, and use of peer-to-peer interventions to promote health, improve quality of life, and prevent disease among African American men. METHODS: A review of the literature will be performed in PubMED, EMBASE, PsycInfo, CINAHL, and Web of Science. The development of this protocol was guided by the work of Arksey and O'Malley and the PICOS statement. Reporting will be guided by the PRISMA-ScR checklist. Eligible studies include those testing the effects of a peer-to-peer health promotion intervention targeting African American men. A comparison group will not be required. For the purposes of the current review, "peers" will be limited to other African American men. An initial screening of the titles and abstracts of potentially eligible studies will be completed by two independent reviewers. The full text of records that appear to meet the eligibility criteria will be accessed and further screened. Data will then be extracted and collected using a custom Microsoft Excel spreadsheet. Extracted data will include authors' name and publication year, target health issue(s), design of the intervention, components of the intervention, peer-led components of the intervention, peer role, length and type of training for peer leaders, intervention duration, frequency of the intervention, study design and number of participants, and main outcomes. Finally, results will be presented in table format and summarized in text format. DISCUSSION: Results will have implications for the design, implementation, and evaluation of health promotion interventions among African American men. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020198664.


Assuntos
Afro-Americanos , Promoção da Saúde , Atenção à Saúde , Humanos , Qualidade de Vida , Projetos de Pesquisa , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
7.
Soc Sci Med ; 282: 114139, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34171701

RESUMO

BACKGROUND AND AIM: Resilience resources are associated with positive mental and physical health outcomes. However, we know little about protective factors in low-income or racially or ethnically diverse populations of men. This study examined socioeconomic status and racial/ethnic differences in resilience resources among low-income Black, Latino, and White fathers of infants. METHODS: The Community Child Health Network conducted a cohort study of mothers and fathers in five sites across the U.S. A sample of fathers who identified as Black, Latino/Hispanic, or non-Hispanic White were recruited and interviewed at home on three occasions during the first year of parenting (n = 597). Several resilience resources were assessed: mastery, self-esteem, dispositional optimism, approach-oriented coping style, positive affect, social support, and spirituality. The first five resources were interrelated and scored as a composite. RESULTS: Multivariate analyses adjusted for covariates indicated that Black fathers had higher scores on the resilience resources composite compared to White and Latino fathers. Black fathers were also highest in spirituality, followed by Latino fathers who were higher than White fathers. There were significant interactions between race/ethnicity with income and education in predicting optimism, spirituality, and self-esteem. Higher education was associated with higher scores on the resilience resources composite and spirituality in Black fathers, and higher education was associated with higher self-esteem in Black and Latino fathers. Higher income was associated with higher optimism in White fathers. CONCLUSION: These results indicate that levels of individual resilience factors are patterned by income, education, and race/ethnicity in low-income fathers, with many possible implications for research and policy.


Assuntos
Afro-Americanos , Hispano-Americanos , Criança , Estudos de Coortes , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Lactente , Masculino , Pobreza
8.
Nutrients ; 13(5)2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34065195

RESUMO

The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated a need for further understanding of these weight-loss motivators in the context of SDT. The current study findings highlight the importance of addressing motivational factors and family influences in research and practice related to promoting healthy dietary habits and weight management strategies among adolescents with obesity.


Assuntos
Família/psicologia , Comportamento Alimentar/psicologia , Motivação , Manejo da Obesidade , Obesidade Pediátrica/psicologia , Adolescente , Índice de Massa Corporal , Feminino , Humanos , Masculino , Meio-Oeste dos Estados Unidos , Poder Familiar/psicologia , Obesidade Pediátrica/terapia , Perda de Peso
9.
Nutrients ; 13(6)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34063799

RESUMO

Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child's weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent's weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.


Assuntos
Terapia Familiar/métodos , Refeições/psicologia , Poder Familiar/psicologia , Obesidade Pediátrica/terapia , Programas de Redução de Peso/métodos , Adolescente , Adulto , Afro-Americanos/psicologia , Dieta Saudável/etnologia , Dieta Saudável/psicologia , Comportamento Alimentar/etnologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Refeições/etnologia , Pessoa de Meia-Idade , Motivação , Análise Multinível , Relações Pais-Filho/etnologia , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/psicologia , Avaliação de Programas e Projetos de Saúde
10.
Transl Behav Med ; 11(8): 1635-1637, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-34048585

RESUMO

COVID-19 has caused drastic increases in family stress contributing to deleterious social and emotional ramifications. Before COVID-19, millions of Americans lacked access to mental health resources, and now in the midst of a global pandemic, resources are more limited in times of greater need. In March 2020, the Coronavirus Aid, Relief, and Economic Security (CARES) Act provided funding for mental health reforms; yet many barriers remained to receiving sufficient care. In February 2021, the Society of Behavioral Medicine recommended federal legislators expand Community Behavioral Healthcare Centers, increase funding for Federally Qualified Healthcare Centers and School Based Health Centers, incentivize providers to accept Medicaid, and institute more statewide licensing flexibilities to expand the reach of mental health care. In March 2021, the American Rescue Plan was signed into law and provided an additional ~$4 billion in funding for community mental health services, implementing substance abuse prevention and treatment programs, increasing the behavioral health workforce, promoting behavioral telehealth within primary care, increasing school-based mental health services, implementing suicide prevention programs, and improving services for traumatized families. This significant investment in parents and children's mental health is a tremendous step in the right direction and provides reassurance that relief is underway. Ongoing surveillance of the programmatic and clinical outcomes that result from these new policy reforms will be important for identifying areas that may need continual support as our nation recovers from COVID-19.


Assuntos
Medicina do Comportamento , COVID-19 , Serviços de Saúde Mental , Criança , Humanos , Pais , SARS-CoV-2 , Estados Unidos/epidemiologia
11.
Transl Behav Med ; 11(8): 1517-1526, 2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-33999199

RESUMO

This study investigated the role of objectively measured moderate-vigorous physical activity (MVPA) and sedentary behavior on cardiometabolic risk factors of young Latino children. We hypothesized that MVPA would be associated with lower cardiometabolic risk when sedentary behavior is low. We studied 86 primarily low-income, Latino children using a cross-sectional study design. The study sample consisted of 51 girls and 35 boys, with mean age 5.6 (SD = .53) years. Physical activity was measured by accelerometry, anthropometric measures obtained, and fasting blood samples were used to measure cardiometabolic risk factors. Greater levels of sedentary behavior were associated with increased waist circumference (rs = .24, p < .05) and metabolic risks. MVPA, however, had significant beneficial associations with all cardiometabolic risk factors (rs-range = -.20 to -.45, p < .05) with the exception of plasma insulin. MVPA predicted latent variables representing anthropometric risk (ß = -.57, p < .01), cardiac risk (ß = -.74, p < .01), and metabolic risk (ß = -.88, p < .01). Sedentary behavior significantly moderated the effect of MVPA on anthropometric (ß-interaction = .49, p < .01), cardiac (ß-interaction = .45, p < .01), and metabolic risk (ß-interaction = .77, p < .01), such that more MVPA was associated with better health outcomes under conditions of lower sedentary behavior. The model explained 13%, 22%, and 45% variance in anthropometric, cardiac, and metabolic risk factors, respectively. Increased MVPA is associated with decreased cardiometabolic risk in young Latino children, particularly when sedentary behavior is low.


Assuntos
Doenças Cardiovasculares , Comportamento Sedentário , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Pré-Escolar , Estudos Transversais , Exercício Físico , Feminino , Hispano-Americanos , Humanos , Masculino , Fatores de Risco
12.
J Behav Med ; 44(4): 541-550, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33751355

RESUMO

This study evaluated the associations between parenting factors and adolescent weight related outcomes in African American adolescents with overweight and obesity. Baseline heights and weights were collected from 241 African American adolescents (11-16 years) with overweight and obesity. Self-reported adolescent perceptions of caregiver's parenting style (responsiveness, demandingness), parental feeding practices (monitoring, responsibility, weight related concerns, pressure-to-eat, and restriction), and their own dietary self-efficacy for healthy eating were assessed. Results demonstrated that greater parental responsiveness was significantly associated with lower adolescent body mass index (BMI) and higher adolescent dietary self-efficacy. In contrast, parental concern about adolescent weight was significantly associated with greater adolescent BMI, while greater parental responsibility for foods was associated with lower adolescent BMI. Although parental pressure-to-eat was significantly associated with higher dietary self-efficacy, greater parental restriction was associated with lower dietary self-efficacy. The results of this study highlight the importance of parental responsiveness and responsibility in understanding obesity related outcomes in African American adolescents with overweight and obesity.


Assuntos
Afro-Americanos , Poder Familiar , Adolescente , Índice de Massa Corporal , Comportamento Alimentar , Humanos , Obesidade , Sobrepeso , Relações Pais-Filho , Inquéritos e Questionários
13.
J Behav Med ; 44(4): 563-570, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33768390

RESUMO

This study evaluates whether parental provision of transportation for physical activity is associated with child/adolescent moderate-to-vigorous physical activity, while also evaluating community-level poverty. Self- and parental-reported surveys were administered with parents/caregivers and children in the Healthy Communities Study (N = 5138). Associations between individual-level demographics, community-level poverty, parental provision of transportation for physical activity, and moderate-to-vigorous physical activity were examined in multi-level models. Even when accounting for community-level poverty, which was significantly associated with lower moderate-to-vigorous physical activity, parental provision of transportation for physical activity was positively associated with greater moderate-to-vigorous physical activity. This study provides evidence for the importance of considering multiple systems of influence (e.g., community and individual factors) and considering how gaps in physical activity transportation for youth can be addressed in future health policies.


Assuntos
Exercício Físico , Pobreza , Adolescente , Criança , Humanos , Pais , Características de Residência , Inquéritos e Questionários , Transportes
14.
J Behav Med ; 44(3): 379-391, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33677766

RESUMO

The current study is a randomized controlled trial to test a novel 10-week climate-based intervention within pre-existing afterschool programs, designed to increase moderate-to-vigorous physical activity (MVPA) in underserved (low-income, minority status) middle school youth by addressing youth social developmental needs. Participants (n = 167; 56% female; 62% Black; 50% overweight/obese) enrolled in 6 middle schools were randomized to either the Connect through PLAY intervention or a wait-list control. Process evaluation measures (i.e., observations of external evaluators; staff surveys) indicated that essential elements were implemented with fidelity, and staff endorsed implementation ease/feasibility and acceptability. Regression analysis demonstrated that participation in the intervention (vs. control) was associated with an increase of 8.17 min of daily accelerometry-measured MVPA (56 min of additional weekly MVPA) at post-intervention controlling for baseline MVPA, school, gender, and weight status. The results provide support for social-motivational climate-based interventions for increasing MVPA in underserved youth that can inform future school-based health initiatives.Trial Registration: NCT03850821: https://clinicaltrials.gov/ct2/show/study/NCT03850821?term=NCT03850821&rank=1.


Assuntos
Exercício Físico , Instituições Acadêmicas , Acelerometria , Adolescente , Feminino , Promoção da Saúde , Humanos , Masculino , Motivação , Meio Social
15.
J Pediatr Psychol ; 46(8): 980-990, 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-33738484

RESUMO

OBJECTIVE: This study set out to examine the role of parenting practices in protecting or exacerbating the negative effects of parent and adolescent stress on adolescent body mass index (BMI) over time. Separate longitudinal models were conducted to evaluate how parenting practices interacted with parental perceived stress and adolescent perceived stress in predicting adolescent BMI. METHODS: Baseline data were collected from 148 African American adolescents (Mage = 12.93, SD = 1.75; Mz-BMI = 0.78, SD = 0.50; MBMI%-ile = 96.7, SD = 3.90) and their caregivers (Mage = 44.45, SD = 8.65; MBMI = 37.63, SD = 8.21) enrolled in the Families Improving Together for Weight Loss trial. Adolescents self-reported their perceptions of caregiver parenting style and feeding practices. Both caregivers and adolescents self-reported their perceptions of chronic stress. BMI for parents and adolescents was assessed objectively at baseline and 16 weeks post-intervention. RESULTS: Hierarchical regression models predicting adolescent BMI z-score (z-BMI) indicated a significant interaction between parental perceived stress and parental pressure to eat. Simple slopes analyses demonstrated that for those parents that exhibit higher pressure to eat, parent stress was positively associated with adolescent z-BMI. CONCLUSIONS: These findings provide preliminary support suggesting that certain parenting practices interact with chronic stress on adolescent weight-related outcomes and that future interventions may consider integrating these factors.

16.
Ann Behav Med ; 55(4): 376-382, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-32692356

RESUMO

BACKGROUND: African American women participate in less physical activity (PA), have higher rates of chronic disease, and report higher perceived stress relative to other race and sex demographic groups. PURPOSE: Based on the stress-buffering hypothesis, this study tested the hypothesis that social support would buffer the negative effects of perceived stress on moderate-to-vigorous PA (MVPA) under high, but not low, perceived stress. METHODS: Participants were 143 African American women (mean [M] age = 43.94, standard deviation [SD] = 8.62; M body mass index = 37.94, SD = 8.11) enrolled in the Families Improving Together (FIT) for Weight Loss Trial. Average daily minutes of MVPA were obtained via 7 day accelerometer estimates at baseline and 8 and 16 weeks. RESULTS: A multilevel growth model demonstrated a significant three-way interaction between stress, social support, and time (B = -0.31, standard error [SE] = 0.14, p = .03). Simple slopes analyses revealed that, at baseline, among participants with high social support (+1 SD), stress was positively associated with greater MVPA (B = 0.49, SE = 0.18, p = .008), whereas among participants with low social support (-1 SD), stress was not significantly associated with MVPA (B = -0.04, SE = 0.14, p = .81). However, at 8 and 16 weeks, stress was not significantly associated with MVPA for either high or low support groups. CONCLUSIONS: Findings highlight the importance of integrating constructs of stress and social support into future physical activity intervention programs for African American women and the need to evaluate changes in stress and social support longitudinally.

17.
Transl Behav Med ; 11(1): 291-293, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-31747039

RESUMO

In his book, "More than Medicine: The Broken Promise of American Health," Robert Kaplan brings together extensive data to make the case that healthcare priorities in the USA need to place greater emphasis on behavioral, social and environmental determinants of health. Kaplan argues that the effect sizes for health outcomes resulting from environmental exposures, stress, and socioeconomic status are all much larger than are many traditional biological risk factors. There are discrepancies between estimates of how much the National Institutes of Health spends on behavioral and social sciences research, but an independent evaluation suggests it is <5% of the entire budget. Addressing this neglect requires advocacy and bringing together of like-minded organizations to promote more funding for behavioral interventions, health promotion and public health policies to address important contextual factors such as poverty, lack of education, and poor environmental conditions. Importantly, Kaplan argues that several metrics to integrate life expectancy and quality of life have been proposed and allow healthcare providers to prioritize the value of health over the volume of healthcare delivered. Although standards exist, there are still a limited number of studies on the cost-effectiveness and cost-utility of behavioral and public health interventions.

18.
Front Psychiatry ; 11: 578688, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33173524

RESUMO

Early paternal involvement in infant care is beneficial to child and maternal health, and possibly for paternal mental health. The purpose of the present study was to examine the relationship between fathers' involvement in early infant parenting and their depressive symptoms during the infant's first year in a sample of 881 low-income Black, Hispanic, and White fathers recruited from five sites in the United States (urban, mixed urban/suburban, rural). Home interviews at 1 month after birth assessed three concepts based on prior research and community input: (1) time spent with the infant, (2) parenting self-efficacy, (3) material support for the baby. Paternal depressive symptoms at 1, 6, and 12 months after the birth of a child were assessed with the Edinburgh Postpartum Depression Scale. Generalized estimating equations tested whether the three indicators of father involvement at 1 month after birth predicted lower subsequent paternal depressive symptoms controlling for social and demographic variables. For fathers, greater time spent with the infant, parenting self-efficacy, and material support were all significantly associated with lower paternal depressive symptoms during the first year. When risk of depression (scores > 9) was examined, only parenting self-efficacy among fathers was associated with higher likelihood of clinical depression. Findings have implications for future research on mechanisms linking paternal involvement and paternal mental health, and for possible paid paternal leave policies in the future.

19.
Ann Behav Med ; 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32914830

RESUMO

BACKGROUND: Understanding determinants of metabolic risk has become a national priority given the increasingly high prevalence rate of this condition among U.S. adults. PURPOSE: This study's aim was to assess the impact of gene-by-neighborhood social environment interactions on waist circumference (WC) as a primary marker of metabolic risk in underserved African-American adults. Based on a dual-risk model, it was hypothesized that those with the highest genetic risk and who experienced negative neighborhood environment conditions would demonstrate higher WC than those with fewer risk factors. METHODS: This study utilized a subsample of participants from the Positive Action for Today's Health environmental intervention to improve access and safety for walking in higher-crime neighborhoods, who were willing to provide buccal swab samples for genotyping stress-related genetic pathways. Assessments were conducted with 228 African-American adults at baseline, 12, 18, and 24 months. RESULTS: Analyses indicated three significant gene-by-environment interactions on WC outcomes within the sympathetic nervous system (SNS) genetic pathway. Two interactions supported the dual-risk hypotheses, including the SNS genetic risk-by-neighborhood social life interaction (b = -0.11, t(618) = -2.02, p = .04), and SNS genetic risk-by-informal social control interaction (b = -0.51, t(618) = -1.95, p = .05) on WC outcomes. These interactions indicated that higher genetic risk and lower social-environmental supports were associated with higher WC. There was also one significant SNS genetic risk-by-neighborhood satisfaction interaction (b = 1.48, t(618) = 2.23, p = .02) on WC that was inconsistent with the dual-risk pattern. CONCLUSIONS: Findings indicate that neighborhood and genetic factors dually influence metabolic risk and that these relations may be complex and warrant further study. TRIAL REGISTRATION: NCT01025726.

20.
Health Promot Pract ; : 1524839920939572, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32639170

RESUMO

Background. The purpose of the current article is to demonstrate how formative process evaluation was used in a pilot study to optimize the design and implementation of two motivationally targeted community-based physical activity (PA) interventions for inactive African American women. Method. Fifteen African American women (M age: 41.6 years) were randomized to a challenge-focused program targeted toward high autonomous motivation or a rewards-focused program targeted toward low autonomous motivation. The challenge-focused program targeted enjoyment and valuation of PA and a team-based positive social climate through competitive intergroup activities and team-based goals, whereas the rewards-focused program targeted PA interest, competency, and partner-based social support through a walking program, individual-based goals with financial incentives, and partner-based action-plans. Results. Feedback from participants revealed high levels of acceptability of essential elements. Average weekly attendance exceeded the a priori goal of ≥75% of members in attendance each week. External systematic observation demonstrated that session content dose was ≥93% in both programs. Facilitator-level fidelity exceeded the a priori goal of averaging ≥3 on a 4-point scale for behavioral skills, communication, autonomy support, and session content. The process evaluation also revealed areas for improvement, including facilitator-level social support and behavioral skills at the group-level. Process data collected through FitBits revealed that participants were engaged in self-monitoring PA during the 6-week programs. Conclusions. The formative process evaluation demonstrated adequate levels of feasibility and acceptability and also provided key insights into adjustments needed before proceeding with implementing the motivationally targeted group-based programs in a larger randomized study.

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