Participatory environmental health research: A tool to explore the socio-exposome in a major european industrial zone.

OBJECTIVES: We show that participatory research approaches can be a useful tool across disciplines and data collection methods to explore the socio-exposome near one of the largest industrial harbors in Europe. We analyzed resident involvement in each project and their capacity to affect structural changes. METHODS: Longitudinal participatory environmental monitoring studies on lichens, petunias, aquatic systems and groundwater were conducted under the program VOCE (Volunteers for the Citizens' Observation of the Environment), which mobilized nearly 100 volunteers to collect and report data. A community-based participatory health survey, Fos EPSEAL was also carried out during the same period. We describe citizens' involvement in each study following Davis and Ramirez-Andreotta's (2021) 'best practice' grid. We also use residents' insights to refine understanding of the socio-exposome. RESULTS: The region is significantly impacted by industrial pollution and fenceline communities are disproportionately exposed. The community-based participatory health survey documented negative health outcomes among the residents, including a higher prevalence of chronic symptoms and diabetes (e.g., 11.9%) in the Fos-Berre Lagoon region than in other communities. This methodology shows the benefits of the co-production of knowledge in environmental health: not only does it enable epistemological transformations favorable to the vulnerable population, but it also triggered public action (i.e., media and public authorities' attention leading to official expertise reports, filing of collective complaints before the courts). CONCLUSION: This body of multiple participatory research studies over time is a useful approach to better understand the socio-exposome and health issues in an industrial zone.

Who has to act? A qualitative exploration of emerging adults' critical consciousness during the COVID-19 pandemic.

The COVID-19 pandemic and violence against people of Color during 2020 brought troubling racial inequities to the forefront of American discourse. In line with the Critical Consciousness (CC) and Social Justice Youth Development (SJYD) frameworks, emerging adults may have developed their capacity for critical reflection, motivation, and action against systemic inequities. We drew from interviews with 27 emerging adults (ages 18-23) across the US, and used thematic analysis to explore differences in their reflections, motivations to act, and actions based on their racial/ethnic identification. We found nuanced variability in their critical reflections based on self, social, or global awareness and experiences of marginalization. White and Asian emerging adults used vague language or expressed feeling their reflections were insufficient. Black and Latinx emerging adults emphasized the importance of education and raising awareness. Although all emerging adults took action based on a sense of duty, few engaged in critical action; decisions to take in-person action varied based on whether they viewed racism or COVID-19 as a greater threat. Findings demonstrate that emerging adults' experiences of racialization may have related to their CC development. We share implications for community psychologists conducting antiracist research addressing White fragility and dismantling racial hierarchy.

Associations between critical consciousness and well-being in a national sample of college students during the COVID-19 pandemic.

Critical consciousness (CC) may promote well-being, particularly during the COVID-19 pandemic. In a national survey of 707 college students conducted in April 2020, we first validated the Short Critical Consciousness Scale (ShoCCS) among youth groups not often specifically examined in CC measurement (i.e., Asian, immigrant-origin, LGBQ+, and women youth). Next, we examined associations between ShoCCS subscales and validated measures of both anxiety (Generalized Anxiety Disorder-7) and hopefulness (The Individual-Differences Measure in Hopefulness). The ShoCCS achieved measurement invariance across racial/ethnic groups and immigrant-origin status, and partial invariance among LGBQ+ and women-identifying youth. We found critical reflection and action associated with anxiety for the full sample, but no evidence of moderation by sociodemographic factors. ShoCCS subscales were differentially associated with hopefulness for Asian youth and LGBQ+ youth. This study contributes to the evolution of CC measurement and extends the field by identifying well-being associations during the onset of the COVID-19 pandemic.

Exploring civic behaviors amongst college students in a year of national unrest.

This study examined the role of demographics, civic beliefs, and the impact of the COVID-19 pandemic in association with distinct forms of civic participation. College students were recruited across 10 institutions of higher education to complete an online survey. Bivariate, multivariable linear, and logistic regressions were performed. Findings indicated that participants from traditionally marginalized backgrounds were more likely to engage in systemchallenging forms of civic participation and community engagement than those from more privileged backgrounds. Participants who rated high in critical reflection, viewed racism as a key issue, and were heavily impacted by the COVID-19 pandemic were also more likely to engage in system-challenging forms of civic participation. Participants who endorsed beliefs supporting current systems of power were more likely to report they intended to vote. Results highlight implications for antiracist activism, community engagement, and traditional political civic behaviors.

Interdisciplinary community-based participatory health research across the industrial region of the Étang de Berre : The EPSEAL Fos Crau study.

BACKGROUND: We conducted a community-based participatory environmental health study in three towns: two in the heart of Marseille's industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône), and one on the periphery located about 30 km away (Saint-Martin-de-Crau). METHODS: We first conducted a cross-sectional survey of a random sample of residents in each of the three towns. We asked study participants to self-report a wide variety of health issues (Port-Saint-Louis: n = 272, Fos-sur-Mer: n = 543, Saint-Martin-de-Crau: n = 439). We then conducted focus groups with residents and other stakeholders to share preliminary data in order to propose areas of reflection and collaboratively produce contextually-situated knowledge of their health and environment. We directly standardized the prevalences (by age and gender) to the French metropolitan population to make our results more comparable. RESULTS: Study participants who lived closer to the core industrial zone (residents of Fos-sur-Mer and Port-Saint-Louis-du-Rhone) had higher prevalences of eye irritation, nose and throat problems, chronic skin problems and headaches than people who lived further away (residents of Saint-Martin-de-Crau). Residents also offered diverse qualitative insights about their environment and health experiences. DISCUSSION: We observed elevated prevalences of diseases that affected residents across the industrial zone (Fos-sur-Mer and Port-Saint-Louis-du-Rhône) compared to those living outside (Saint-Martin-de-Crau), and qualitative evidence of how residents made sense of their health experiences strengthening an understanding of their own empirical observations which helps to produce knowledge about health in an industrial context. The results of the workshops show an important benefit from the co-production of local knowledge. CONCLUSION: We encourage future researchers to do in-depth, community-based research to comprehensively describe the health of residents in other heavily polluted zones, product local knowledge and to help identify policy solutions, engender trust among the local people, and identify opportunities for intervention.

Fostering youth civic engagement through effective mentorship: Understanding the college student volunteer mentors who succeed.

College student volunteers play a critical role in many school-based educational programs and can foster valuable near-peer relationships with adolescents, yet how to best select these volunteers has been understudied. We studied college student volunteer mentors for Generation Citizen, a non-profit that provides school-based action civics education programming, and their adolescent students. We identify three common characteristics possessed by the strongest college mentors. Participants were nine college volunteer mentors (67% female; 78% White); these mentors worked in pairs (and one trio) in four different classrooms. Using an action research approach, we conducted semistructured interviews, surveys, and classroom observations to generate quantitative and qualitative data. Effective mentors were: person-oriented, emphasizing the mentor-student connection; aligned with the organization's mission; and constantly honing their craft of mentorship. We recommend college volunteer programs select applicants for positions based on these key indicators to foster mission-driven and motivating educational programming.

Does the Type and Timing of Educational Attainment Influence Physical Health? A Novel Application of Sequence Analysis.

Nontraditional education trajectories are common, but their influence on physical health is understudied. We constructed year-by-year education trajectories for 7,501 National Longitudinal Survey of Youth 1979 participants aged 14 to 48 years (262,535 person-years of education data from 1979 to 2014). We characterized trajectory similarity using sequence analysis and used hierarchical clustering to group similar educational trajectories. Using linear regression, we predicted physical health summary scores of the participants at age 50 years from the 12-item Short-Form Survey, adjusting for available confounders, and evaluated effect modification by sex, race/ethnicity, and childhood socioeconomic status. We identified 24 unique educational sequence clusters on the basis of highest level of schooling and attendance timing. General education development credentials predicted poorer health than did high school diplomas (ß = -3.07, 95% confidence interval: -4.07, -2.07), and bachelor's degrees attained at earlier ages predicted better health than the same degree attained at later ages (ß = 1.66, 95% confidence interval: 0.05, 3.28). Structurally marginalized groups benefited more from some educational trajectories than did advantaged groups (e.g., Black vs. White Americans with some college; those of low vs. high childhood socioeconomic status who received an associate's or bachelor's degree). Both type and timing of educational credentials may influence physical health. Literature to date has likely underestimated the impact of educational trajectories on health.

Association of Adult Depression With Educational Attainment, Aspirations, and Expectations.

INTRODUCTION: Social factors across one's lifespan may contribute to the relationship between low educational attainment and depression, but this relationship has been understudied. Previous studies assessing the association between educational attainment and depression did not fully account for prior common determinants across the life course and possible interactions by sex or race/ethnicity. It is also unclear whether the link between educational attainment and depression is independent of the role of aspired educational attainment or expected educational attainment. METHODS: We used generalized linear log link models to examine the association between educational attainment at age 25 and depression at age 40 in the National Longitudinal Survey of Youth 1979 cohort, adjusting for confounders and mediators from childhood, adolescence, and adulthood. RESULTS: Members of each educational attainment group were less likely to be depressed at age 40 than those with less education. After adjusting for educational aspirations and educational expectations, the risk ratios became closer to the null. Neither sex nor race/ethnicity interacted with educational attainment. Additionally, low educational expectations in adolescence, but not low educational aspirations, was associated with a higher risk of depression at age 40. CONCLUSION: Our study provides a nuanced understanding of the role of education, educational expectations, and educational aspirations as part of education's effect on risk of depression after controlling for a thorough set of confounders and mediators. Our findings may help advance the study of social determinants of depression.

Use of Research Evidence Generated by Youth: Conceptualization and Applications in Diverse U.S. K-12 Educational Settings.

Youth-Led Participatory Action Research (YPAR) is a social justice-focused approach for promoting social change and positive youth development in which youth conduct systematic research and actions to improve their schools and communities. Although YPAR is oriented to generating research for action, with evidence-based recommendations often aimed at influencing adults with power over settings and systems that shape youths' lives, we have little understanding of how YPAR evidence influences the thinking and/or actions of adult policymakers or practitioners. In general, the participatory research field lacks a theoretically informed "use of research evidence" lens, while the use of evidence field lacks consideration of the special case and implications of participatory research. To start to address these gaps, this paper presents a conceptual linkage across these two fields and then provides six illustrative case examples across diverse geographic, policy, and programmatic contexts to demonstrate opportunities and challenges in the use of YPAR evidence for policy and practice. Our illustrative focus here is on U.S. K-12 educational contexts, the most-studied setting in the YPAR literature, but questions examined here are relevant to YPAR and other systems domestically and internationally, including health, educational, and legal systems. HIGHLIGHTS: The use of research evidence (URE) field identifies characteristics of research and conditions that strengthen URE. Youth-led Participatory Action Research is a special case for factors that influence research use. Six case examples across diverse K-12 contexts illustrate facilitators and barriers for YPAR use. We propose next steps for community psychology research and action to promote the study and use of YPAR evidence.

Similarities in Maternal Weight and Birth Weight Across Pregnancies and Across Sisters.

Objectives The current study examined how prepregnancy body mass index (BMI), gestational weight gain, and birth weight cluster between births within women and between women who are sisters. Methods Using data from the National Longitudinal Survey of Youth 1979 cohort, we utilized nested, multivariable hierarchical linear models to examine the correlation of these three outcomes between births (n = 6006) to women (n = 3605) and sisters (n = 3170) so that we can quantify the clustering by sibship and by woman for these three pregnancy-related outcomes. Results After controlling for confounding covariates, prepregnancy BMI (intraclass correlation (ICC) 0.24, 95% CI 0.16, 0.32), gestational weight gain (ICC 0.23, 95% CI 0.16, 0.31), and infant's birthweight (ICC 0.07, 95% CI 0.003, 0.13) were correlated between sisters. Additionally, all three outcomes were significantly correlated between births for each sister, suggesting that prepregnancy BMI (ICC 0.82, 95% CI 0.81, 0.83), gestational weight gain (ICC 0.45, 95% CI 0.42, 0.49), and birth weight (ICC 0.31, 95% CI 0.28, 0.35) track between pregnancies in the same woman. Conclusions for Practice The observed clustering both within women and between sisters suggests that shared genetic and environmental factors among sisters play a role in pregnancy outcomes above and beyond that of women's own genetic and environmental factors. Findings suggest that asking a woman about her sisters' pregnancy outcomes could provide insight into the possible outcomes for her current pregnancy. Future research should test if collecting such a family history and providing tailored clinical recommendations accordingly would be useful.

School climate and physical adolescent relationship abuse: Differences by sex, socioeconomic status, and bullying.

Little is known about the association between school climate and adolescent relationship abuse (ARA). We used 2011-2012 data from surveys of California public school students (in the United States of America) who were in a dating relationship in the last year (n = 112 378) to quantify the association between different school climate constructs and physical ARA. Fifty-two percent of students were female, and all students were in 9th or 11th grade (approximately ages 14-17). Over 11% of students reported experiencing physical ARA in the last year. Increased school connectedness, meaningful opportunities for participation, perceived safety, and caring relationships with adults at school were each significantly associated with lower odds of physical ARA. Increased violence victimization and school-level bullying victimization were associated with higher odds of physical ARA. These school climate-ARA associations were significantly moderated by student sex, school socioeconomic status, and school-level bullying victimization. School climate interventions may have spillover benefits for ARA prevention.

Excessive Gestational Weight Gain and Subsequent Maternal Obesity at Age 40: A Hypothetical Intervention.

OBJECTIVES: To model the hypothetical impact of preventing excessive gestational weight gain on midlife obesity and compare the estimated reduction with the US Healthy People 2020 goal of a 10% reduction of obesity prevalence in adults. METHODS: We analyzed 3917 women with 1 to 3 pregnancies in the prospective US National Longitudinal Survey of Youth, from 1979 to 2012. We compared the estimated obesity prevalence between 2 scenarios: gestational weight gain as reported and under the scenario of a hypothetical intervention that all women with excessive gestational weight gain instead gained as recommended by the Institute of Medicine (2009). RESULTS: A hypothetical intervention was associated with a significantly reduced estimated prevalence of obesity for first (3.3 percentage points; 95% confidence interval [CI] = 1.0, 5.6) and second (3.0 percentage points; 95% CI = 0.7, 5.2) births, and twice as high in Black as in White mothers, but not significant in Hispanics. The population attributable fraction was 10.7% (95% CI = 3.3%, 18.1%) in first and 9.3% (95% CI = 2.2%, 16.5%) in second births. CONCLUSIONS: Development of effective weight-management interventions for childbearing women could lead to meaningful reductions in long-term obesity.

Diverging Paths: Understanding Racial Differences in Civic Engagement Among White, African American, and Latina/o Adolescents Using Structural Equation Modeling.

There is increasing concern about the large civic engagement gap between Whites and Latina/o and African American youth. Some suggest this may be because traditional models and measures of civic engagement may not be as applicable for youth from historically marginalized groups. With an urban sample of middle and high school-age youth (n = 903, 52% female), we used structural equation modeling to identify differences in civic pathways between youth from different racial/ethnic backgrounds. We found significant differences between groups including much stronger relationships between exposure to democratic practices and civic self-efficacy and knowledge for African American and Latina/o youth than for White youth and a stronger relationship between civic knowledge and future civic engagement for Whites and Latina/os than for African Americans. These findings suggest that educators and researchers interested need to take into account the diversity of youths' racial experiences when examining youth civic development.

Action Civics for Promoting Civic Development: Main Effects of Program Participation and Differences by Project Characteristics.

Using both quantitative and qualitative data, this study examined the effect of participating in an action civics intervention, Generation Citizen (GC), on civic commitment, civic self-efficacy, and two forms of civic knowledge. The sample consisted of 617 middle and high schools students in 55 classrooms who participated, or were soon to participate, in Generation Citizen. Hierarchical linear models revealed that participating in Generation Citizen was associated with positive gains in action civics knowledge and civic self-efficacy. Qualitative coding identified three types of project characteristics that captured variability in the action projects student chose to complete: context, content, and contact with decision makers. Interactions between project characteristics and participation in GC revealed differences in civic outcomes depending on project characteristics.

Invited Commentary: Multigenerational Social Determinants of Health­Opportunities and Challenges.

An emerging area of social epidemiology examines the relationship between grandparental education and grandchild health. In an accompanying article, Huang et al. (Am J Epidemiol. 2015;182(7):568-578) join the small but growing body of research on this topic. It is useful to contextualize Huang et al.'s work within the much larger body of research examining relationships between education and health within a single generation or across 2 generations. These investigators have generally concluded that higher educational attainment is robustly associated with better health. There are many potential mechanisms through which education and other social exposures may affect health outcomes in a single generation or across generations, and estimating direct and indirect effects can be helpful for assessing specific mechanisms. Researchers conducting multigenerational analyses are faced with several challenges, including limited availability of data for some measures (e.g., educational attainment, and sometimes for 1 grandparent only), limited age ranges of participants, disparate social and political contexts in which study participants of different generations have lived, and patterns of social class reproduction. We encourage future researchers to weave together the careful analytical considerations illustrated by Huang et al. with a rich understanding of the social context for each of the generations studied to help overcome these challenges and advance our understanding of multigenerational social determinants of health.

Socioeconomic disadvantage in childhood as a predictor of excessive gestational weight gain and obesity in midlife adulthood.

BACKGROUND: Lower childhood socioeconomic position is associated with greater risk of adult obesity among women, but not men. Pregnancy-related weight changes may contribute to this gender difference. The objectives of this study were to determine the associations between: 1. childhood socioeconomic disadvantage and midlife obesity; 2. excessive gestational weight gain (GWG) and midlife obesity; and 3. childhood socioeconomic disadvantage and excessive GWG, among a representative sample of childbearing women. METHODS: We constructed marginal structural models for seven measures of childhood socioeconomic position for 4780 parous women in the United States, using National Longitudinal Survey of Youth (1979-2010) data. Institute of Medicine definitions were used for excessive GWG; body mass index ≥30 at age 40 defined midlife obesity. Analyses were separated by race/ethnicity. Additionally, we estimated controlled direct effects of childhood socioeconomic disadvantage on midlife obesity under a condition of never gaining excessively in pregnancy. RESULTS: Low parental education, but not other measures of childhood disadvantage, was associated with greater midlife obesity among non-black non-Hispanic women. Among black and Hispanic mothers, childhood socioeconomic disadvantage was not consistently associated with midlife obesity. Excessive GWG was associated with greater midlife obesity in all racial/ethnic groups. Childhood socioeconomic disadvantage was not statistically significantly associated with excessive GWG in any group. Controlled direct effects were not consistently weaker than total effects. CONCLUSIONS: Childhood socioeconomic disadvantage was associated with adult obesity, but not with excessive gestational weight gain, and only for certain disadvantage measures among non-black non-Hispanic mothers. Prevention of excessive GWG may benefit all groups through reducing obesity, but excessive GWG does not appear to serve as a mediator between childhood socioeconomic position and adult obesity in women.

Racial/Ethnic Disparities in Inadequate Gestational Weight Gain Differ by Pre-pregnancy Weight.

Pre-pregnancy body mass index (BMI) varies by race/ethnicity and modifies the association between gestational weight gain (GWG) and adverse pregnancy outcomes, which disproportionately affect racial/ethnic minorities. Yet studies investigating whether racial/ethnic disparities in GWG vary by pre-pregnancy BMI are inconsistent, and none studied nationally representative populations. Using categorical measures of GWG adequacy based on Institute of Medicine recommendations, we investigated whether associations between race/ethnicity and GWG adequacy were modified by pre-pregnancy BMI [underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)), or obese (≥30.0 kg/m(2))] among all births to Black, Hispanic, and White mothers in the 1979 USA National Longitudinal Survey of Youth cohort (n = 6,849 pregnancies; range 1-10). We used generalized estimating equations, adjusted for marital status, parity, smoking during pregnancy, gestational age, and multiple measures of socioeconomic position. Effect measure modification between race/ethnicity and pre-pregnancy BMI was significant for inadequate GWG (Wald test p value = 0.08). Normal weight Black [risk ratio (RR) 1.34, 95 % confidence interval (CI) 1.18, 1.52] and Hispanic women (RR 1.33, 95 % CI 1.15, 1.54) and underweight Black women (RR 1.38, 95 % CI 1.07, 1.79) experienced an increased risk of inadequate GWG compared to Whites. Differences in risk of inadequate GWG between minority women, compared to White women, were not significant among overweight and obese women. Effect measure modification between race/ethnicity and pre-pregnancy BMI was not significant for excessive GWG. The magnitude of racial/ethnic disparities in inadequate GWG appears to vary by pre-pregnancy weight class, which should be considered when designing interventions to close racial/ethnic gaps in healthy GWG.

Pregnancy and post-delivery maternal weight changes and overweight in preschool children.

OBJECTIVES: High maternal weight before and during pregnancy contributes to child obesity. To assess the additional role of weight change after delivery, we examined associations between pre- and post-pregnancy weight changes and preschooler overweight. SAMPLE: 4359 children from the Children and Young Adults of the 1979 National Longitudinal Survey of Youth (NLSY) born to 2816 NLSY mothers between 1979 and 2006 and followed to age 4-5years old. EXPOSURES: gestational weight gain (GWG) and post-delivery maternal weight change (PDWC). OUTCOME: child overweight (body mass index (BMI) ≥85th percentile). RESULTS: Adjusted models suggested that both increased GWG (OR: 1.08 per 5kg GWG, 95% CI: 1.01, 1.16) and excessive GWG (OR: 1.29 versus adequate GWG, 95% CI: 1.06, 1.56) were associated with preschooler overweight. Maternal weight change after delivery was also independently associated with child overweight (OR: 1.12 per 5kg PDWC, 95% CI: 1.04, 1.21). Associations were stronger among children with overweight or obese mothers. CONCLUSIONS: Increased maternal weight gain both during and after pregnancy predicted overweight in preschool children. Our results suggest that healthy post-pregnancy weight may join normal pre-pregnancy BMI and adequate GWG as a potentially modifiable risk factor for child overweight.

Community-Based Participatory Research for Epidemiology, Health Equity, and Community Goals: Insights From Brazil, France, and USA.

BACKGROUND: Community-based participatory research coproduces knowledge by emphasizing bidirectional exchanges between participants, communities, and researchers. PURPOSE, RESEARCH DESIGN, AND STUDY SAMPLE: We highlight three studies in historically marginalized communities on separate continents (Richmond, CA, USA; Rio de Janeiro, Brazil; Marseille industrial zone, France) to exemplify how community-based participatory research improves research, offers tangible community benefits, and values residents more than traditional research methods. DATA ANALYSIS: We provide insights into the process of conducting meaningful community-based participatory epidemiologic research. RESULTS: In each of these communities, community-based participatory research led to high-quality research that helped inform context-appropriate policies and programs to improve health and advance health equity in these communities. CONCLUSIONS: We recommend that researchers consistently engage with community members during all phases of research so that they can engage more participants, more deeply in the research process, build local capacity, improve data collection and data quality, as well as increase our understanding of research findings to inform future applied research and practice.

Inequalities in emerging adult college students' sleep quality during the COVID-19 pandemic.

OBJECTIVE: To examine inequalities in sleep quality during the COVID-19 pandemic by gender, sexual orientation, race/ethnicity, and socioeconomic position (SEP), and test associations between discrimination and sleep quality in a national longitudinal cohort of emerging adult college students. PARTICIPANTS: Participants were enrolled in college full-time and were aged 18-22 at baseline. METHODS: Participants completed online surveys in spring 2020 (N = 707) and summer 2021 (n = 313). Measures included the Pittsburgh Sleep Quality Index (PSQI) and the Everyday Discrimination Scale. RESULTS: Most students reported poor sleep quality (78% in 2020; 82% in 2021) and those from marginalized groups generally experienced worse sleep quality. Discrimination was associated with poorer concurrent sleep quality at both time points. CONCLUSIONS: Sleep inequalities among college students continued to manifest during the pandemic, even when students were not necessarily on campus. Colleges should take a multi-pronged approach to promote sleep quality through individual, community, and institutional interventions.