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The study proposes and tests the pathways from receiving welfare assistance to children's bullying victimization. Specifically, the study examines whether children's difficulty making friends and school disconnection mediate the association between welfare assistance receipt to children's bullying victimization. The 2019 National Survey of Children's Health dataset was used, and the sample consisted of 12,230 caregivers of adolescents, aged 12-17 years. A path model was utilized to explore the proposed pathways. Findings suggest that welfare assistance receipt was not significantly associated with children's bullying victimization. It was positively related to children's bullying victimization through the mediating roles of having difficulty making friends and school disconnection. Schools and communities need to create spaces where youth can connect with peers, which is an important part of their development.
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Acoso Escolar , Víctimas de Crimen , Humanos , Acoso Escolar/psicología , Niño , Víctimas de Crimen/psicología , Adolescente , Masculino , Femenino , Instituciones Académicas , Grupo Paritario , Bienestar Social , Amigos/psicología , Protección a la Infancia/psicologíaRESUMEN
PURPOSE: From a life course perspective, important insights about how social determinants of health operate can be gained by analyzing the various forms that social climate can take in different life periods. For children, a critical aspect of social climate is exposure to bullying. Bullying can serve as a proxy for power imbalance and social exclusion analogous to adult social climate of discrimination and racism. DESIGN AND METHODS: We used the Year 9 follow-up data of the Fragile Families and Child Wellbeing Study (N=3301) that, for the first time included interviews with the children. We drew on a national sample of children and their families, which allowed us to account for broader contextual variables and represented a broad range of geographic areas and schools. Multinomial logistic regression was used to estimate the effects of exposure to bullying on self-rated health among primarily 9- to 10-year-old children while controlling for socio-demographic and diagnosed health-conditions. RESULTS: Both frequency and forms of bullying were positively associated with lower odds of reporting excellent, very good or good health. The effect of forms of bullying on children's self-rated health fell on a gradient. Subgroup analysis indicated a significant effect on self-rated health for children who experienced peer rejection but not for those who experienced physical aggression. CONCLUSIONS: The results of the study provide new evidence that the harmful health consequences of power imbalance and discriminatory practices may extend to children in early development. It also accentuates the need to study social determinants of health from both an ecological/contextual and a developmental angle. PRACTICE IMPLICATIONS: Echoing a plethora of nursing literature on the critical role of psycho-social pediatric care, this study further encourages pediatric nurses to expand their assessment and intervention priorities beyond a familial and developmental perspective, and to consider the evident physical health consequence of a child's overall social climate determinants.
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Agresión/psicología , Acoso Escolar/prevención & control , Protección a la Infancia/psicología , Determinantes Sociales de la Salud , Poblaciones Vulnerables/estadística & datos numéricos , Factores de Edad , Acoso Escolar/estadística & datos numéricos , Niño , Crianza del Niño/psicología , Preescolar , Femenino , Encuestas Epidemiológicas , Humanos , Entrevistas como Asunto , Modelos Logísticos , Estudios Longitudinales , Masculino , Análisis Multivariante , Medición de Riesgo , Autoevaluación (Psicología) , Factores Sexuales , Medio Social , Texas , Factores de Tiempo , Poblaciones Vulnerables/psicologíaRESUMEN
Background: Mental health outcomes are often passed-down in families, which underscores the importance of understanding mechanisms related to positive health outcomes. We focus on parent-child connectedness, which has been shown to not only decrease children's distress but strengthens their social coping resources. Methods: Utilizing four waves of the Fragile Families and Child Wellbeing Study, a national study of nearly 5000 mostly unmarried parents, we observed the influence of parents' depressive symptoms and thoughts of death (TOD) on their 9-year-old child's self-reported levels of connectedness to their parents. Results: Mothers and fathers reported similar rates of depression over time, with peak symptomology when their child turned 3 years old and declining levels as their children grew older. Compared to children whose mothers reported no symptoms, children whose mothers reported chronic depression and TOD were > 7 times as likely (OR = 8.13, p < 0.001) to report feeling distant from their mother, even if depression and TOD were only periodic (OR = 5.94, p < 0.001) or if their mother only reported depression (OR = 4.00, p = 0.002). Fathers reporting chronic depression earlier in their child's life had the highest odds of low child-reported connectedness (OR = 4.42, p < 0.001), but onset later in their child's lives (ages 5 and 9) also resulted in low reported connectedness from their children (OR = 2.73, p = 0.048). Conclusions: Given the ramifications of parental mental health for parent-child connectedness, upstream prevention approaches, such as screening in pediatricians' offices may be a key objective for mental health promotion. As trusted adults play critical roles in children's lives, universal prevention highlighting family bonds for new parents may be a salient intervention focus.
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Although research has documented factors associated with maternal smoking, we need a more in-depth understanding of the risk factors associated with changes in smoking behaviors during the postpartum period. We investigate smoking patterns during pregnancy and 1 year postpartum as a function of relevant psychosocial factors. We use data on 3,522 postpartum mothers from the Fragile Families and Child Wellbeing Study to analyze the predictors of smoking among mothers who did not smoke during pregnancy but smoked at 1 year postpartum, mothers who smoked both during pregnancy and postpartum, and mothers who did not smoke during either period. Our covariates are grouped into four categories of risk factors for smoking: socioeconomic status, health care, life course and health, and partner and social support. Postpartum mothers in our sample were more likely to smoke throughout or after their pregnancies if they had only a high school education or less, had a household income three or more times below the poverty line, had public or no health insurance, breastfed for less than 5 months, were not married to the infant's father, if the infant's father currently smoked, and if they attended religious services less than once a week. Mental health problems were consistently associated with an increased risk of constant and postpartum smoking relative to non-smoking. Psychosocial factors play a role in postpartum smoking, but they have a stronger effect in predicting smoking that persists throughout pregnancy and the first year postpartum.
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Estado Civil , Madres/psicología , Periodo Posparto , Fumar/psicología , Apoyo Social , Adolescente , Adulto , Niño , Femenino , Estudios de Seguimiento , Accesibilidad a los Servicios de Salud , Humanos , Lactante , Entrevistas como Asunto , Acontecimientos que Cambian la Vida , Modelos Logísticos , Masculino , Embarazo , Prevalencia , Factores de Riesgo , Fumar/epidemiología , Factores Socioeconómicos , Estrés Psicológico , Estados Unidos/epidemiología , Población UrbanaRESUMEN
Efforts to reduce infant mortality in the United States have failed to incorporate paternal involvement. Research suggests that paternal involvement, which has been recognized as contributing to child development and health for many decades, is likely to affect infant mortality through the mother's well-being, primarily her access to resources and support. In spite of that, systemic barriers facing the father and the influence on his involvement in the pregnancy have received little attention. The Commission on Paternal Involvement in Pregnancy Outcomes (CPIPO) has identified the most important social barriers to paternal involvement during pregnancy and outlined a set of key policy priorities aimed at fostering paternal involvement. This article summarizes the key recommendations, including equitable paternity leave, elimination of marriage as a tax and public assistance penalty, integration of fatherhood initiatives in MCH programs, support of low-income fathers through employment training, father inclusion in family planning services, and expansion of birth data collection to include father information.
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Conducta Paterna , Formulación de Políticas , Comités Consultivos , Empleo , Femenino , Política de Salud , Humanos , Permiso Parental/legislación & jurisprudencia , Embarazo , Impuestos/legislación & jurisprudencia , Estados UnidosRESUMEN
Hispanic women are 1.5-3 times as likely as non-Hispanic white women to have a child affected by neural tube defects. This disparity exists in spite of varied interventions designed to address the problem. The purpose of this research was to investigate Hispanic women's knowledge of folic acid, perceptions of existing education campaigns, and provide guidance for future promotion efforts. Three focus groups with Hispanic mothers (N = 18) were conducted to garner insights on these issues. Results suggested that these women understood the benefits of folic acid, did not see major cultural barriers to consuming folic acid-rich foods, and did not perceive insurmountable challenges to consuming a multivitamin with folic acid. For many women, an initial pregnancy served as their initial cue to action, suggesting a need for the continued development of education strategies that communicate the benefits of folic acid supplementation prior to pregnancy. Such strategies may necessitate targeting younger audiences, including teenagers.
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Dieta , Ácido Fólico , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Hispánicos o Latinos , Defectos del Tubo Neural/etnología , Adolescente , Adulto , Cultura , Femenino , Ácido Fólico/uso terapéutico , Humanos , Lenguaje , Defectos del Tubo Neural/prevención & control , Aceptación de la Atención de Salud , Embarazo , Vitaminas , Adulto JovenRESUMEN
Children in Latino immigrant families are significantly less likely to be placed in kinship care than other children are. Using grounded theory, the researchers conducted focus groups and individual interviews with child welfare workers working with Mexican origin families in south Texas to study the extent to which they use international kin placement resources. Key barriers to international kinship placement include lack of accurate information concerning international placements and conflicting agency mandates. Lack of child protective services policy enforcement also plays a role. Recommendations for practice and agency policy are discussed.
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Emigrantes e Inmigrantes , Familia , Cuidados en el Hogar de Adopción/organización & administración , Cooperación Internacional , Americanos Mexicanos , Política Organizacional , Manejo de Caso , Niño , Maltrato a los Niños , Humanos , México/etnología , Rol Profesional , TexasRESUMEN
BACKGROUND: Roughly 8% of the U.S. population report moderate or severe depression for two or more weeks and Latinos (3.7%) report higher rates of severe depression compared to non-Hispanic whites (2.6%) (Pratt and Brody, 2014). As the Latino population continues to grow in the U.S., there is little research on the manifestations for depression, and how this affects the family system longitudinally. METHODS: Based on data from the Fragile Families and Child Wellbeing Study, a 3-step latent class analysis examined the association of self-reported parental depressive symptoms and their children's perceived levels of closeness and openness to communicate with their parents over 9 years (N=3956 families). RESULTS: Latino parents reported four different depressive patterns, while non-Hispanic parents were more diversified and had six patterns in terms of latent class analysis. Latinos reported episodic symptoms, while NH parents were more likely to report chronic depressive symptoms over time. Regardless of race/ethnicity, parental depressive symptoms negatively affected their children's reported level of parental closeness and openness to communicate with mothers and fathers. LIMITATIONS: As with any self-report data, the risk of social desirability bias is likely still present. Additionally, these results cannot be generalized to the broader U.S. CONCLUSIONS: Due to the different mental health presentations over 9 years, and following the federal initiatives (National Institute of Mental Health, 2015) of early and consistent surveillance, we advise that clinicians and primary care physicians screen for depressive symptoms at least yearly.
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Depresión/psicología , Padre/psicología , Hispánicos o Latinos/psicología , Madres/psicología , Relaciones Padres-Hijo/etnología , Adulto , Niño , Preescolar , Comunicación , Depresión/etnología , Femenino , Humanos , Estudios Longitudinales , Masculino , Población Blanca/psicologíaRESUMEN
We explore opportunities as well as challenges associated with conducting a mixed methods needs assessment using a transformative paradigm. The transformative paradigm is a research framework that centers the experiences of marginalized communities, includes analysis of power differentials that have led to marginalization, and links research findings to actions intended to mitigate disparities. We argue that a community needs assessment is a natural fit for the use of a transformative framework, serving as an entry-point for the development of responsive programmatic and funding decisions. Based on a case study of efforts initiated by a local community health foundation to document disparities in their city, we show how an evaluation team used principles aligned with the transformative framework to guide the design and implementation of a community needs assessment. The needs assessment provided a better understanding of the power of community relationships, demonstrated how lack of trust can continue to constrain community voices, and revealed why agencies must actively support a social justice framework beyond the end of an assessment to ensure transformative change.
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Participación de la Comunidad/métodos , Evaluación de Necesidades/organización & administración , Justicia Social , Adolescente , Adulto , Competencia Cultural , Femenino , Hispánicos o Latinos , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Dinámica Poblacional , Pobreza , Grupos Raciales , Población Urbana , Adulto JovenRESUMEN
Farmworkers experience pervasive economic insecurity in part because of the seasonal nature of agricultural work and limited employment protections. Yet little is known about the adequacy of the social safety net in responding to farmworker needs. Using data from the 2005-2009 National Agricultural Workers Survey (N = 10,469), the current study analyzed predictors of social welfare participation among Latinos, who represent approximately 80 percent of all farmworkers. Nearly 95 percent are immigrants, although almost half of them have lived in the United States for more than 10 years. Descriptive analyses showed that, even among farmworker households whose income fell below the poverty line or that were headed by legally documented individuals, social services use was very low. Logistic regression analyses revealed that degree of social integration influenced social welfare participation, controlling for education, poverty status, family composition, and employment characteristics. Latino farmworkers who were recent immigrants (that is, in the United States for less than five years) had significantly lower odds of access to social insurance and public assistance programs relative to their U.S.-born counterparts. Low self-reported English ability significantly decreased access to most social insurance programs but not public assistance receipt. The findings indicate the need for social workers to engage in outreach efforts and policy advocacy to improve farmworkers access to social welfare.
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Agricultura/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Hispánicos o Latinos , Pobreza , Asistencia Pública/estadística & datos numéricos , Proveedores de Redes de Seguridad/estadística & datos numéricos , Femenino , Humanos , Masculino , Migrantes/estadística & datos numéricosRESUMEN
Little is known about the causes of maternal parenting stress in the Mexican American population. We examine determinants of parenting stress among Mexican American mothers in comparison to non-Hispanic white and non-Hispanic black mothers. We base our analysis on Belsky's conceptual model (1984), which specifies predictors of parenting stress in three domains: maternal characteristics, child characteristics, and social context. Using data from the Fragile Families and Child Wellbeing Study, a national survey of new mothers conducted in large cities beginning in 1998, we draw a sample of 2,898 mothers from diverse racial and ethnic backgrounds. Our findings suggest differences in the determinants of parenting stress by racial or ethnic group. Overall, the patterns of parenting stress for non-Hispanic white and non-Hispanic black mothers are fairly consistent with Belsky's parenting model. However, for Mexican American mothers social support, but not partner support, ameliorate parenting stress and depression is not associated with parenting stress. Importantly as well, despite significant social disadvantage, the levels of parenting stress in Mexican American mothers does not significantly differ from those of non-Hispanic whites. Specific recommendations are made to practitioners for culturally competent responses to parenting stress in the provision of social services to Mexican American families. Implications for future research are twofold: our study calls for the incorporation of diverse samples when examining the determinants of parenting stress and for the development of theoretical frameworks that reflect the unique aspects of psychosocial well-being among Mexican Americans.
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Although gay, lesbian, and bisexual (GLB) adolescents face many of the same developmental challenges as do heterosexual adolescents, they must also deal with the stress of being part of a stigmatized group. The purpose of this study was to examine the extent to which family support and involvement with the queer community may buffer the effects of life stress on substance use among GLB youths. Drawing on a large national online survey, the authors examined drug use in 1906 GLB youths 12 to 17 years of age. Overall, 20 percent of the youths reported using illegal substances in the past 30 days. Results from multivariate analyses revealed that stress, as measured by suicidal ideation, significantly increased the risk of drug use. A positive reaction from the mother to the youth's coming out served as a significant protective factor, whereas involvement in a queer youth group had no effect. The authors found evidence that, for GLB adolescents, parental acceptance of sexual identity is an important aspect of a strong family relationship and, thus, has important ramifications for their healthy development. Implications of the findings for social work practice are discussed.
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Bisexualidad , Homosexualidad Femenina , Homosexualidad Masculina , Relaciones Padres-Hijo , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Niño , Recolección de Datos , Femenino , Humanos , Masculino , Estados Unidos , Adulto JovenRESUMEN
OBJECTIVE: This study investigates how prenatal demographic, social, and behavioral characteristics of Mexican origin immigrant mothers, which are linked to their relatively healthy birth outcomes, influence the subsequent health of their children in comparison to other racial and ethnic groups. METHODS: We use data from the Fragile Families and Child Wellbeing Study of a cohort of 2,819 children born between 1998 and 2000 to analyze chronic health conditions at age 5 using logistic regression models. RESULTS: Multivariate analyses revealed no significant differences in chronic health conditions at age 5 between children of Mexican immigrant mothers and non-Hispanic white children, controlling for socioeconomic status and access to health care. In contrast, children of U.S.-born Mexican American mothers had significantly higher odds of chronic conditions compared to non-Hispanic white children. Social support and health care use are related to child health outcomes but do not explain racial and ethnic differences. CONCLUSIONS: Health policy must respond in order to help maintain the healthy outcomes of Mexican American children of immigrants and reverse the deteriorating health of children in subsequent generations, in light of considerable socioeconomic disadvantage and inadequate access to health care.
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El uso de catéteres centrales ha aumentando de forma importante a pesar de su mayor morbi-mortalidad en comparación con las FAV. Las principales complicaciones son trombosis, bacteriemia-sepsis y limitación de la eficacia dialítica disminuyendo la calidad de vida de los pacientes y elevando el coste sanitario. En nuestra unidad, el sellado se realizaba con heparina sódica al 5% y actualmente utilizamos TauroLockTM Hep 500(R), compuesta de (ciclo)-taurolidina (agente antimicrobiano biocompatible), citrato al 4% y heparina 500 UI/ml. Objetivo: comprobar la eficacia del Taurolock para reducir la incidencia de colonización intraluminal y trombosis al compararla con heparina sódica al 5%. Material y método: realizamos un estudio observacional longitudinal de cohorte y analizamos colonización intraluminal, trombosis, biofilm y uso de antibioterapia. Resultados: observamos mejoría en la permeabilidad del catéter, disminución del uso de urokinasa, reducción de sesiones en unipunción y del uso de antibiótico. Conclusiones: nuestro estudio muestra que el sellado del catéter para hemodiálisis con una solución que contiene taurolidina como antimicrobiano puede reducir significativamente la incidencia de sepsis relacionada con el catéter. La taurolidina parece se efectiva y segura y no conlleva riesgos ni efectos secundarios. La adicción de 500 ui de heparina a la solución de sellado junto con citrato al 4% ha disminuido los eventos trombóticos reduciendo el uso de fibrilolíticos y el uso de unipunción totalmente, presentando una mejoría de la eficacia dialítica
The use of central catheters has increased significantly despite their greater morbi-mortality compared to AVF. The main complications are thrombosis, bacteriaemiasepsis, and limitation of dialysis efficacy, reducing quality of life for patients and increasing the healthcare cost. In our unit, 5% heparin sodium was previously used as lock solution and we currently use TauroLockTM Hep 500(R), composed of (cyclo)-taurolidine (biocompatible antimicrobial agent) 4% citrate and heparin 500 UI/ml. Objective: to verify the efficacy of Taurolock in reducing the incidence of intraluminal colonization and thrombosis compared with 5% heparin sodium. Material and method: we carried out a longitudinal observational cohort study and we analysed intraluminal colonization, thrombosis, biofilm and use of antibiotherapy. Results: we observed an improvement in catheter permeability, a reduction in the use of urokinase, reduction in unipuncture sessions and in use of antibiotic. Conclusions: our study shows that using a lock solution that contains taurolidine as an antimicrobial agent for haemodialysis catheters can significantly reduce the incidence of catheter-related sepsis. Taurolidine appears to be effective and safe and does not entail risks or side effects. The addition of 500 iu of heparin to the lock solution together with 4% citrate has reduced thrombotic events by reducing the use of fibrilolytics and eliminating completely the use of unipuncture, presenting an improvement in dialysis efficacy
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Humanos , Cateterismo/normas , Obstrucción del Catéter/estadística & datos numéricos , Catéteres Venosos Centrales/estadística & datos numéricos , Anticoagulantes/uso terapéutico , Hemostáticos/análisis , Infecciones Relacionadas con Catéteres/prevención & control , Catéteres de Permanencia/efectos adversos , Heparina/uso terapéutico , Diálisis Renal/métodos , Insuficiencia Renal Crónica/terapiaRESUMEN
OBJECTIVES: We examined racial and ethnic disparities in low birthweight (LBW) among unmarried mothers and the extent to which demographic, economic, psychosocial, health, health care, and behavioral factors explain those disparities. METHODS: Using a sample of 2,412 non-marital births from a national urban birth cohort study, we estimated multiple logistic regression models to examine disparities in LBW between non-Hispanic white (NHW), non-Hispanic black (NHB), U.S.-born Mexican-origin (USMO), and foreign-born Mexican-origin (FBMO) mothers. RESULTS: NHW mothers were almost as likely as NHB mothers to have LBW infants. USMO mothers had 60% lower odds and FBMO mothers had 57% lower odds than NHW mothers of having LBW infants. FBMO mothers had no advantage compared to USMO mothers. Controlling for prenatal health and behaviors substantially reduced the LBW advantages for USMO and FBMO mothers. The odds of LBW for NHB mothers relative to NHW mothers increased with the addition of the same covariates. CONCLUSIONS: Racial and ethnic disparities in LBW among unmarried mothers--an economically disadvantaged population--do not mirror those in the general population. Prenatal health and behaviors are strongly associated with LBW in this group and explain a sizable portion of the Mexican-origin advantage. The lack of a significant black-white disparity in this group suggests that poverty plays an important role in shaping racial disparities in the general population. The finding that controlling for prenatal health and behaviors widens rather than narrows the racial disparity suggests that efforts to ameliorate black-white disparities in LBW should focus on social and health risks throughout the life course.
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Etnicidad/psicología , Etnicidad/estadística & datos numéricos , Disparidades en el Estado de Salud , Recién Nacido de Bajo Peso , Mujeres Embarazadas/etnología , Mujeres Embarazadas/psicología , Adulto , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Modelos Logísticos , Masculino , Madres/psicología , Madres/estadística & datos numéricos , Embarazo , Factores de Riesgo , Padres Solteros/estadística & datos numéricos , Factores Socioeconómicos , Estados Unidos/epidemiología , Salud UrbanaRESUMEN
Based on an in-depth analysis of current empirical research, this article presents a framework for understanding the cultural experience of the Mexican American population and presents implications for innovative health promotion practices with women and their families. The framework sheds light on the complex ways in which individuals from this population integrate their cultural values in their everyday responses to health. Three patterns emerge: (a) cultural expectations and beliefs can be shared by and work complementarily in the family and the larger social context; (b) cultural beliefs can be a source of tension and stress as a result of pressures in the environment; and (c) cultural values can become less important than other concerns, such as problems related to access when dealing with the healthcare system.
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Características Culturales , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud , Americanos Mexicanos , Salud de la Familia , Relaciones Familiares/etnología , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Condiciones Sociales , Estados Unidos/etnología , Salud de la MujerRESUMEN
We used six waves of the National Longitudinal Survey of Youth-Child Data (1986-1996) to assess the relative impact of adverse birth outcomes vis-à-vis social risk factors on children's developmental outcomes. Using the Peabody Individual Achievement Tests of Mathematics and Reading Recognition as our outcome variables, we also evaluated the dynamic nature of biological and social risk factors from ages 6 to 14. We found the following: (1) birth weight is significantly related to developmental outcomes, net of important social and economic controls; (2) the effect associated with adverse birth outcomes is significantly more pronounced at very low birth weights (< 1,500 grams) than at moderately low birth weights (1,500-2,499 grams); (3) whereas the relative effect of very low-birth-weight status is large, the effect of moderately low weight status, when compared with race/ethnicity and mother's education, is small; and (4) the observed differentials between moderately low-birth-weight and normal-birth-weight children are substantially smaller among older children in comparison with younger children.