Religiosity of Latinas Living in the USA Curbs Depression and Anxiety During the COVID-19 Pandemic.

This mixed-methods study was conducted to explore the role of faith in mental health among Latino women (Latinas) during the COVID-19 pandemic. As part of a lifestyle study, surveys were administered to 89 participants during the 1st year of the pandemic. Specifically, a focus group was conducted with participants (n = 6) directly affected by COVID-19 (i.e., self or family member). The results showed inverse correlations between religiosity and both depression and anxiety, as well as positive correlations among religious practices, religious coping, and religiosity. Given these associations, future interventions should explore the role of faith in supporting individuals during difficult times.

Associations of hair dye and relaxer use with breast tumor clinicopathologic features: Findings from the Women's circle of Health Study.

BACKGROUND: Building upon our earlier findings of significant associations between hair dye and relaxer use with increased breast cancer risk, we evaluated associations of select characteristics of use with breast tumor clinicopathology. METHODS: Using multivariable-adjusted models we examined the associations of interest in a case-only study of 2998 women with breast cancer, overall and stratified by race and estrogen receptor (ER) status, addressing multiple comparisons using Bonferroni correction. RESULTS: Compared to salon application of permanent hair dye, home kit and combination application (both salon and home kit application) were associated with increased odds of poorly differentiated tumors in the overall sample. This association was consistent among Black (home kit: OR 2.22, 95 % CI: 1.21-5.00; combination: OR 2.46, 95 % CI: 1.21-5.00), but not White women, and among ER+ (home kit: OR 1.47, 95 % CI: 0.82-2.63; combination: OR 2.98, 95 % CI: 1.62-5.49) but not ER-cases. Combination application of relaxers was associated with increased odds of tumors >2.0 cm vs. <1.0 cm (OR = 1.82, 95 % CI: 1.23-2.69). Longer duration and earlier use of relaxers and combination application of permanent hair dyes and relaxers were associated with breast tumor features including higher tumor grade and larger tumor size, which often denote more aggressive phenotypes, although the findings did not maintain significance with Bonferroni correction. CONCLUSIONS: These novel data support reported associations between hair dye and relaxer use with breast cancer, showing for the first time, associations with breast tumor clinicopathologic features. Improved hair product exposure measurement is essential for fully understanding the impact of these environmental exposure with breast cancer and to guide risk reduction strategies in the future.

Working Together with God: Religious Coping, Perceived Discrimination, and Hypertension.

This study examined the relationships of perceived discrimination and religious coping with hypertension in a sample of Black and White Seventh-day Adventists. Data come from a community-based sample of 6128 White American, 2253 African American and 927 Caribbean American adults (67% women; mean age = 62.9 years). Results indicate lifetime unfair treatment was significantly associated with hypertension regardless of race/ethnicity. Positive religious coping was associated with lower odds of hypertension and did not interact with unfair treatment. Both positive and negative religious coping were indirectly associated with increased hypertension risk through an increase in perceived discrimination.

Prostate Cancer Screening among High-Risk Black Men.

We explored potential barriers and facilitators for prostate cancer screening choices among high-risk Black men. In our sample of 264 Black men over 45 years of age living in the U.S. who met the American Cancer Society criteria for screening, we found that only 49.6% had ever been screened. We investigated potential barriers including screening intention, access to care, medical mistrust, and fatalism. Potential facilitating factors investigated were provider-patient conversations encompassing the pros and cons of screening, ethnicity taken into account, insurance, and previous prostate cancer screening. Recommendations and resources are suggested to increase screening of high-risk Black men.

Mental Health and Sociocultural Determinants in an Asian Indian Community.

In a US population of adult male and female Sikh immigrant participants (N = 350), we explored sociocultural factors related to depression, giving participants a choice between English or Punjabi surveys. Language preference pointed to a subgroup with higher levels of depression and lower satisfaction with life. Underreporting of depression suggests a general reluctance to discuss depression. While multiple sociocultural variables were associated with depression bivariably, multivariate analysis identified negative religious coping and anxiety as unique predictors of depression. Community interventions should tap into the protective close-knit social fabric of this community as an opportunity to change the stigma of mental health.

Mindfulness-Based Intervention for Perinatal Grief in Rural India: Improved Mental Health at 12 Months Follow-Up.

Stillbirth is a significant global health problem that frequently results in perinatal grief with compound negative psychosocial impact. In low-resource settings with exceedingly high stillbirth rates, such as rural Chhattisgarh, India, it is vital to utilize low-cost, effective interventions. Mindfulness-based stress reduction is an evidence-based intervention utilized for a broad range of physical and mental health problems, and is adaptable to specific populations. The objective of this study was to explore the sustained effectiveness of a shortened, culturally adapted mindfulness-based intervention (MBI) designed to address complex grief after stillbirth. We used an observational, mixed-methods pre-post study design with 6-week and 12-month follow-up assessments among women with a history of stillbirth (N = 22). Analyses explored study outcomes and continued use of mindfulness skills. Pretest results showed elevated psychological symptoms and high levels of perinatal grief. General linear modeling repeated measures was used to explore 6-week and 12-month follow-up changes from baseline, controlling for significantly correlated demographic variables. Longitudinal results indicated significant reductions in perinatal grief and psychological symptoms; four of the five facets of mindfulness changed in the desired direction; and resilience scores indicated thriving. The shortened, culturally adapted, MBI pilot brought about sustained, significant reductions of perinatal grief and mental health symptoms, and participants reported use of mindfulness skills in day-to-day life. This study shows that the significant mental health needs among rural women of various castes and ethnicities in Chhattisgarh following stillbirth were successfully addressed by a promising MBI with potential scalability and sustainability.

India's Distorted Sex Ratio: Dire Consequences for Girls.

Female gender discrimination related to cultural preference for males is a common global problem, especially in Asian countries. Numerous laws intended to prevent discrimination on the basis of gender have been passed in India, yet the distorted female-to-male sex ratio seems to show worsening tendencies. Using detailed, two-year longitudinal chart abstraction data about delivery records of a private mission hospital in rural India, we explored if hospital birth ratio data differed in comparison to regional data, and what demographic and contextual variables may have influenced these outcomes. Using quantitative chart abstraction and qualitative contextual data, study results showed the female-to-male ratio was lower than the reported state ratio at birth. In the context of India's patriarchal structure, with its strong son preference, women are under tremendous pressure or coerced to access community-based, sex-selective identification and female fetus abortion. Nurses may be key to turning the tide.

Mindfulness-based Intervention for Perinatal Grief after Stillbirth in Rural India.

We explored the concept of using a Mindfulness-based intervention to reduce perinatal grief among Indian women. Data were collected using mixed methods to explore concept acceptability, receptivity, modality, and feasibility of the intervention. The intervention was piloted and evaluated with measures of perinatal grief, psychosocial wellbeing, religious coping, perceived social provision of support, and mindfulness. The intervention was well received and effective in teaching skills to help women deal with high levels of grief and subsequent mental health challenges. To overcome attendance barriers modification is necessary. Partnership with a local nursing school is critical to enhance sustainability of the intervention.

Does Insurance Matter? Implementing Dialectical Behavior Therapy with Two Groups of Youth Engaged in Deliberate Self-harm.

This paper presents the outcomes of a Dialectical Behavior Treatment (DBT) program, implemented in intensive outpatient care with two groups of adolescents (n = 55 and n = 45), ages 12-18, who engaged in deliberate self-harm (DSH) but had different insurance/funding sources and risk backgrounds. This pre-post study examined variability in clinical functioning and treatment utilization between the two groups and investigated moderating risk factors. Findings support DBT's effectiveness in improving clinical functioning for youth with DSH regardless of insurance type. However, lower rates of treatment completion among youth without private insurance call for extra engagement efforts to retain high-risk youth in DBT.

Recruiting and motivating black subjects to complete a lengthy survey in a large cohort study: an exploration of different strategies.

BACKGROUND: The effectiveness of multiple innovative recruitment strategies for enrolling Black/African American participants to the Adventist Health Study-2 (AHS-2) is described. The study's focus is diet and breast, prostate and colon cancer. METHODS: Promotions centered on trust, relationship building and incentives for increasing enrollment and questionnaire return rate. Of the sub-studies described, one had a randomized control group, and the others, informal controls. The subjects are from all states of the U.S. and some provinces of Canada. The offer of a Black art piece, follow-up calls, a competitive tournament as well as other strategies accounted for nearly 3,000 additional returns even though they were often used in small subsets. RESULTS: Flexibility and multiple strategies proved advantageous in gaining the cooperation of Blacks, who are usually reluctant to participate in research studies. CONCLUSIONS: Lessons learned during initial enrollment should help us retain our final Black cohort of 26,000, and obtain new information when required.

Factors Predicting Mental Health Among Women in Low-Income Communities of a Changing Society: A Mixed-Methods Study.

Purpose: To explore women's mental health in India's rapidly changing society. Participants and Methods: A convenience sample of low-income women (N = 286) in a medium-sized city in South-India participated in a mixed-methods, exploratory study in 2022. Institutional Review Board (IRB) approval was received from Loma Linda University in the US, and Christian Medical College-Vellore in India, in accordance with the declaration of Helsinki, prior to data collection. All study materials were forward and back translated for Tamil, the local language. Phase 1(n = 25) involved audio recorded key-informant interviews and focus groups. Verbatim transcripts were inductively coded, and emerging themes identified. Phase 2 (n = 261) entailed a quantitative survey including demographics, health history, and validated scales measuring mental health symptoms, coping strategies, social support, living situation, and life satisfaction. Data collectors were gender and language matched, research trained, community health nurses. Results: Qualitative themes included: 1) benefits of living in the city, 2) double duty for women doing household work and paid work, 3) challenges of living in the urban environment, 4) advantages of living in the village, 5) struggles associated with village life. Quantitative results: the average Hopkins Symptoms Checklist (HSCL) score of 1.82 (SD = 0.70) exceeded the 1.65 cut-off score for anxiety and depression symptomology. Among participants with elevated HSCL scores (n = 129) the average was markedly elevated (M = 2.39, SD = 0.56). These women were more likely to rely on wishful thinking, religious coping, and reported more post-migration living difficulties, less social support, and less satisfaction with life. Regression analysis further explored variables associated with participant HSCL scores. Conclusion: In this sample of low-income urban-dwelling women depression and anxiety symptomology was elevated. Given the limited mental health workforce and cultural stigmatization of mental health issues, further attention is required.

Middle school cycling program is associated with improved mental health and wellbeing in adolescents during COVID-19.

Introduction: The COVID-19 pandemic has exacerbated mental health issues among adolescents. Exercise is well-regarded for boosting mental health. Riding for Focus (R4F) is a 6-8 week cycling education program designed to equip middle school adolescents with basic cycling skills and introduce students to lifetime physical activity. A secondary goal of the R4F program is to improve adolescent mental health and psychosocial well-being. This study aimed to quantify the change in adolescent psychosocial well-being associated with the R4F program during the COVID-19 pandemic. Program evaluation also examined associations between participating in the R4F and mental health outcomes in the context of established risk factors, including gender, race, socioeconomic status, involvement in IEP programs, participation in after-school clubs, screen time, hours of sleep, and physical activity levels. Methods: Anonymous surveys were collected before and after the program in 20 schools in North America, with psychosocial well-being quantified using WHO-5 and PSC-17-Y. 1,148 middle school students, aged 11-14, completed pre intervention surveys. 815 students also completed post intervention surveys. Results: There was a general increase in psychosocial well-being after the R4F program and positive psychosocial well-being changes in students that identified as female, non-white, physically active, part of an IEP program, meeting screentime recommendations, and engaged in school programs, though effect sizes were small. Despite mental health improvements among underrepresented groups, relative risk assessments still indicated that males, white students, those from high socioeconomic status families still had reduced relative risk of developing psychosocial disorders post intervention. Discussion: These analyses illustrate the feasibility of cycling as a viable PE elective and the need for further, more robust studies to better assess the positive impacts of the R4F scholastic cycling program on the psychological health and well-being of middle school age children.

Social determinants of health and lung cancer surgery: a qualitative study.

Introduction: Social determinants of health (SDOH) are non-clinical factors that may affect the outcomes of cancer patients. The purpose of this study was to describe the influence of SDOH factors on quality of life (QOL)-related outcomes for lung cancer surgery patients. Methods: Thirteen patients enrolled in a randomized trial of a dyadic self-management intervention were invited and agreed to participate in semi-structured key informant interviews at study completion (3 months post-discharge). A conventional content analysis approach was used to identify codes and themes that were derived from the interviews. Independent investigators coded the qualitative data, which were subsequently confirmed by a second group of independent investigators. Themes were finalized, and discrepancies were reviewed and resolved. Results: Six themes, each with several subthemes, emerged. Overall, most participants were knowledgeable about the concept of SDOH and perceived that provider awareness of SDOH information was important for the delivery of comprehensive care in surgery. Some participants described financial challenges during treatment that were exacerbated by their cancer diagnosis and resulted in stress and poor QOL. The perceived impact of education varied and included its importance in navigating the healthcare system, decision-making on health behaviors, and more economic mobility opportunities. Some participants experienced barriers to accessing healthcare due to insurance coverage, travel burden, and the fear of losing quality insurance coverage due to retirement. Neighborhood and built environment factors such as safety, air quality, access to green space, and other environmental factors were perceived as important to QOL. Social support through families/friends and spiritual/religious communities was perceived as important to postoperative recovery. Discussion: Among lung cancer surgery patients, SDOH factors can impact QOL and the patient's survivorship journey. Importantly, SDOH should be assessed routinely to identify patients with unmet needs across the five domains. SDOH-driven interventions are needed to address these unmet needs and to improve the QOL and quality of care for lung cancer surgery patients.

Social determinants of health among family caregiver centered outcomes in lung cancer: a systematic review.

Background: Lung cancer is the leading cause of cancer death globally. Both lung cancer patients and family caregivers (FCGs) have unmet quality of life (QOL) needs. An understudied topic in lung cancer research is the role of social determinants of health (SDOH) on QOL outcomes for this population. The purpose of this review was to explore the state of research on SDOH FCGs centered outcomes in lung cancer. Methods: The databases PubMed/MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, and American Psychological Association (APA) PsycInfo were searched for peer-reviewed manuscripts evaluating defined SDOH domains on FCGs published within the last ten years. The information extracted using Covidence included patients, FCGs and study characteristics. Level of evidence and quality of articles were assessed using the Johns Hopkins Nursing Evidence-Based Practice Rating Scale. Results: Of the 344 full-text articles assessed, 19 were included in this review. The social and community context domain focused on caregiving stressors and interventions to reduce its effects. The health care access and quality domain showed barriers and underuse of psychosocial resources. The economic stability domain indicated marked economic burdens for FCGs. Four interconnected themes emerged among articles on the influence of SDOH on FCG-centered outcomes in lung cancer: (I) psychological well-being, (II) overall quality of life, (III) relationship quality, and (IV) economic hardship. Notably, most participants in the studies were White females. The tools used to measure SDOH factors included primarily demographic variables. Conclusions: Current studies provide evidence on the role of SDOH factors on lung cancer FCGs' QOL. Expanded utilization of validated SDOH measures in future studies would provide greater consistency in data, that could in turn inform interventions to improve QOL. Further research focusing on the domains of education quality and access and neighborhood and built environment should be carried out to bridge gaps in knowledge.

Living Near an Immigration Detention Center: Impact on Latinas' Health.

There is ample evidence that exposure to Immigration and Customs Enforcement (ICE) activities could widen Latinas' health disparities. Whether or not residing near an ICE detention center (IDC) further impacts their health is unknown. During nationwide increased ICE activities Latinas (N=45) attended an intervention at two separate sites: one near and another one far from an IDC. A focus group discussion and an interview were conducted using a grounded theory approach. Quantitative data were collected and analyzed. Participants residing near an IDC benefited less from the intervention and reported changes in anxiety levels and in mobility, and a sense of powerlessness. They also requested resources to respond to ICE overreach and broadcasting of their reality. Our results suggest that proximity to IDCs impacts immigrant communities and public health programming, which is inevitably embedded in political realities. These need to be addressed when providing much needed interventions.

Evaluating the Full Plate Living lifestyle intervention in low-income monolingual Latinas with and without food insecurity.

INTRODUCTION: Food insecurity has long been associated with poor physical and mental health, especially among women from underrepresented minorities. Despite efforts to reduce food insecurity, rates continue to rise and remain disproportionately high among Latinx living in the United States, a group reporting worse mental health symptoms than any other ethnic group during the COVID-19 pandemic. The need to reduce the health burden associated with food insecurity among Latinas is urgent and requires a more targeted and innovative approach. Interventions using a popular education approach have proven effective among underserved populations, especially when these are delivered by community health workers. However, food insecurity status of the participants is often unreported and it is not clear whether or not results vary between those with and without food insecurity. OBJECTIVES: The aim of this quasi-experimental study was to examine physical and mental health changes among Latinas with, and without, food insecurity following a multicomponent health intervention led by community health workers using a popular education approach. METHODS: Enrolled obese Latinas (N = 98) with and without food insecurity responded to demographic, health behaviors and mental health surveys and completed biometric measurements at baseline, immediately following the intervention and at 3 months. RESULTS: At baseline, participants with food insecurity reported more anxiety and depression than those without, but average body mass index was comparable. Depression, anxiety and body mass index were lower at 3 months post and no statistically significant differences were seen between the groups. Participants with food insecurity benefited as much from the intervention as those without.We found that, although community health workers are not licensed healthcare professionals, with proper training and support, they were able to successfully reduce the risk of chronic diseases and improve mental health symptoms among food-insecure Latinas. CONCLUSION: Given the promising results, similar interventions should be implemented on a larger scale in Latino communities among food insecure women. Long-term sustainability should also be explored.

Stress Correlates Related to Depressive Symptoms Among Young Black Men in Southern California.

Black men experience higher levels of chronic stress, life stressors, and discrimination due to oppressive social and economic conditions. Black men are at greater risk of depression, but most published research on stress and depression has focused on Black people in general, Black women, or older Black men. We sought to determine whether discrimination, perceived stress, major life stress, daily hassles, and social capital were associated with depressive symptoms in young Black men. Survey data were collected from April 2010 to March 2012 in Southern California from a convenience sample of Black men (N = 201). We used two-sample t tests and one-way analysis of variance (ANOVA) to examine the association of stress correlates with depressive symptoms. Logistic regression was conducted to estimate the likelihood of reporting depressive symptoms for each significant correlate. Over half of the sample reported depressive symptoms. Health status, perceived discrimination, urban hassles, perceived stress, and neighborhood trust and safety were significantly related to depressive symptoms. Those who reported higher perceived stress had higher odds of reporting depressive symptoms, whereas lower everyday discrimination experiences were associated with lower odds of depressive symptoms. Future studies should consider examining the effectiveness of embedding coping mechanisms for stress, including perceived discrimination, in health interventions for young Black men to prevent or reduce depression.

Racial/Ethnic Variances in COVID-19 Inoculation among Southern California Healthcare Workers.

Healthcare workers (HCWs) from minoritized communities are a critical partner in moving vaccine-hesitant populations toward vaccination, yet a significant number of these HCWs are delaying or deciding against their own COVID-19 vaccinations. Our study aims to provide a more nuanced understanding of vaccine hesitancy among racially and ethnically minoritized HCWs and to describe factors associated with vaccine non-acceptance. Analysis of a sub-sample of racially and ethnically minoritized HCWs (N = 1131), who participated in a cross-sectional study at two large Southern California medical centers, was conducted. Participants completed an online survey consisting of demographics, work setting and clinical role, influenza vaccination history, COVID-19 knowledge, beliefs, personal COVID-19 exposure, diagnosis, and impact on those closest to them. While overall most HCWs were vaccinated (84%), 28% of Black, 19% of Hispanic, and 8% of Asian American HCWs were vaccine-hesitant. Age, education level, occupation, history of COVID-19, and COVID-19 related knowledge were predictive of vaccine hesitancy. We found significant variations in COVID-19 related knowledge and reasons for vaccine hesitancy among Black (governmental mistrust), Hispanic (preference for physiological immunity), and Asian-American HCWs (concern about side effects) who were vaccine-hesitant or not. Our findings highlight racial and ethnic differences in vaccine-hesitancy and barriers to vaccination among HCWs of color. This study indicates the necessity of targeted interventions to reduce vaccine hesitancy that are mindful of the disparities in knowledge and access and differences between and among racial and ethnic groups.

Rapid Implementation of a Community-Academic Partnership Model to Promote COVID-19 Vaccine Equity within Racially and Ethnically Minoritized Communities.

Coronavirus disease 2019 (COVID-19) has highlighted inequities in mortalities and associated illnesses among non-Hispanic Black and Hispanic/Latino individuals. Immunization against COVID-19 is critical to ending the pandemic, especially within racial and ethnically minoritized communities. However, vaccine hesitancy and institutional mistrust in these communities, resulting from decades of mistreatment, structural racism, and barriers to vaccination access, have translated into low vaccination uptake. Trustworthy relationships with healthcare professionals and partnerships with faith and community leaders are critical to increasing vaccination rates within these minoritized communities. Loma Linda University researchers collaborated with local faith and community organizations in San Bernardino County, CA, to rapidly implement a three-tiered approach to increase the vaccination rates within non-Hispanic Black and Hispanic/Latino communities. This community-academic partnership model provided over 1700 doses of the COVID-19 vaccine within these vaccine-hesitant, targeted minoritized communities. As over 100,000 individuals are diagnosed with COVID-19 daily and updated vaccines targeting variants of the Omicron strain are expected to rollout in the coming months, the development of sustainable programs aimed at increasing vaccine uptake within vulnerable communities are of the utmost importance.

Marijuana users are likely to report opioid misuse among adults over 50 years in representative sample of the United States (2002-2014).

Background: In the wake of the rising rate of prescription opioid misuse, there has been increased public health interest in the possibility that cannabis might help to curb or prevent opioid use disorder. Previous studies were limited to young adult marijuana use population. Little is known about whether in older adult population, marijuana use is associated with a different type of nonmedical use opioids. We examined the association between marijuana use and nonmedical prescription opioids dependence and use among older adults.Methods: The National Survey on Drug Use and Health is a nationally U.S. representative cross-sectional survey. We analyzed data for 75,949 adults aged ≥ 50 who participated in the year 2002-2014.Results: Within the overall population, 3.8% of the older adults reported past-year marijuana use (estimate 3.5 million older adults Americans). Past-year marijuana use was very common (25%-37%) among nonmedical opioid dependence respondents compared to those who did not report nonmedical opioid dependence and use (3.5%-3.7%). Past-year marijuana user was significantly associated with an increase in odds of reporting opioid dependence (AOR 9.6 95% CI = 5.8-15.7), and past-year nonmedical use opioids (AOR 6.4 95% CI = 5.2-7.8). Illicit drug heroin was the most prevalent nonmedical used opioid (AOR 6.3 95% CI = 5.0-7.9), compared to codeine (AOR 4.5 95% CI = 3.5-5.7), hydrocodone (AOR 4.9 95% CI = 3.8-6.4), methadone or tramadol (AOR 4.9 95% CI = 2.0-12.3).Conclusion: Policymakers and healthcare providers should remain mindful that older adult marijuana users regardless of initial legitimate medical needs are likely to report nonmedical opioid use including illicit drug heroin.