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1.
Annu Rev Clin Psychol ; 20(1): 407-430, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38271635

RESUMO

In recent years there has been a surge of research conducted on the impostor phenomenon, with approximately half of all impostor phenomenon articles being published between 2020 and 2022 and growing interest in understanding how the impostor phenomenon affects racially and ethnically minoritized individuals. Questions around intersectionality remain about how to apply the impostor phenomenon to the experiences of minoritized individuals. In this review, we revisit the historical context of the impostor phenomenon. We address issues of nomenclature and current controversies regarding whether the impostor phenomenon (a) blames the victim, (b) should be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), and (c) is beneficial for individuals. In addition, we address the limitations of current research on racially and ethnically minoritized individuals, especially women of color. Finally, we conclude by discussing the need for a reconceptualized racialized impostor phenomenon as well as the need to establish new impostor phenomenon measures, conduct more quantitative research with diverse samples, and create culturally tailored interventions.


Assuntos
Transtornos de Ansiedade , Minorias Étnicas e Raciais , Autoimagem , Humanos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos de Ansiedade/etnologia , Minorias Étnicas e Raciais/psicologia
2.
Dev Psychopathol ; : 1-13, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38506061

RESUMO

Contemporary biological and contextually based theoretical frameworks have conceptualized how stress exposure may influence adaptation in youth. However, nearly all of this scholarship neglects the role of specific contextual features and/or biological processes that are involved in ethnic-racial minority youth's responses and adaptation to sociocultural stressors. Drawing on the theoretical principles of the developmental psychopathology framework and contemporary models of stress and adaptation, this article proposes a new multisystem model that explains how multiple levels and systems within and outside of individual youth influence their sociocultural adaptation. We provide empirical evidence to support components of this multisystem model. We propose that research based on our new theoretical framework will capture the sociocultural experiences of ethnic-racial minority youth by centering processes that are relevant to their lived experiences, coping, and adjustment. In doing so, this model will inform psychosocial interventions focused on promoting healthy adaptation among ethnic and racial diverse youth. Finally, we offer recommendations to guide future research on stress and adaptation among ethnic and racial diverse youth, in particular, and developmental psychopathology more broadly.

3.
J Adv Nurs ; 2024 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-39384554

RESUMO

BACKGROUND: Disordered eating in early adolescence impacts development, with long-term health implications. Minoritised adolescents might be at higher risk of disordered eating due to minority stress, but most research has focused on White, heterosexual, cisgender individuals; less is known about disordered eating among minoritised adolescents. We examined sexual, gender, racial, and ethnic identities in relation to disordered eating in early adolescence. METHOD: Using 2-year follow-up data from adolescents ages 10-14 in the Adolescent Brain Cognitive Development Study (N = 9385), we examined associations between sexual, gender, racial, and ethnic identities and past-2 week disordered eating (preoccupation with weight, weight control behaviors, and binge eating). RESULTS: Compared to heterosexual peers, gay/bisexual adolescents had higher odds of all three outcomes (AOR 1.90-3.32); those "questioning" their sexual identity had higher odds of preoccupation with weight (AOR 1.82) and binge eating (AOR 2.53). Compared to cisgender adolescents, transgender adolescents had higher odds of binge eating (AOR 2.62); those "questioning" their gender identity had higher odds of preoccupation with weight (AOR 2.45). Adolescents whose racial identity was categorised as "Another" had higher odds of preoccupation with weight (AOR 1.46) and weight control behaviors (AOR 1.58) compared to White adolescents. Finally, Hispanic adolescents had higher odds of all disordered eating outcomes than non-Hispanic adolescents (AOR 1.25-1.59). DISCUSSION: This study is among the first to reveal disparities in disordered eating among minoritised early adolescents. Further examination of these disparities can inform future interventions. Healthcare providers are encouraged to screen for disordered eating, recognising that minoritised early adolescents may be at risk.

4.
Endocr Pract ; 29(4): 295-300, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36464131

RESUMO

Diabetes affects nearly 37 million Americans, with disproportionately higher disease burden amongst those from minoritized communities. The result of this is greater rates of diabetic complications and mortality. To close this gap in care, it is important to assess the differences in both diagnosis and care between White and ethnic/racial minoritized persons with diabetes. The purpose of this narrative review is to explore this further by assessing the differences in diagnosis, management, diabetes education, and complications.


Assuntos
Complicações do Diabetes , Diabetes Mellitus , Humanos , Estados Unidos/epidemiologia , Disparidades em Assistência à Saúde , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Disparidades nos Níveis de Saúde
5.
Int J Behav Med ; 30(6): 878-890, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36482142

RESUMO

BACKGROUND: Decision aids have been shown to be effective in assisting the decision-making process in healthcare settings. This study aimed to examine the feasibility and acceptability of a linguistically appropriate printed decision aid for cervical cancer screening in South Asian women and to preliminarily estimate its effects on decisional conflicts, clarity of values, risk perception, the screening decision and screening uptake. METHODS: This was a pilot randomised controlled trial. Forty-eight South Asian women aged 25 to 64 years were recruited and allocated to either the intervention group or control group. The participants in the intervention group read a linguistically appropriate printed decision aid. RESULTS: All of the participants in the intervention group agreed that the decision aid was useful in aiding their decision-making. These participants showed significantly greater improvement in decisional conflicts, clarity of values and risk perceptions than those in the control group (all p < 0.05). The screening uptake rate was significantly higher in the intervention group than in the control group (p < 0.001). CONCLUSIONS: The decision aid was feasible and acceptable among South Asian women, and it resulted in reduced decisional conflict and increased screening uptake compared with usual care. To improve the convenience of using decision aids, they could be developed in various forms, such as printed and mobile application forms, to meet individual requirements. TRIAL REGISTRATION: The trial was registered at the Chinese Clinical Trial Registry on 23 October 2021 (ChiCTR2100052225).


Assuntos
Neoplasias do Colo do Útero , Humanos , Feminino , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Detecção Precoce de Câncer , Técnicas de Apoio para a Decisão , Minorias Étnicas e Raciais , Hong Kong , Projetos Piloto , Etnicidade , Grupos Minoritários , Tomada de Decisões
6.
J Community Psychol ; 51(4): 1785-1802, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36434809

RESUMO

AIMS: Racial variability in associations of neighborhood socioeconomic disadvantage and neighborhood disorder with adolescent health risk behaviors remains under-researched, which this study examined over 1 year among racially diverse adolescents. METHODS: High school students (N = 345; 18% Asian, 44% Black, 16% Multiracial, 22% White) completed surveys assessing neighborhood socioeconomic disadvantage and neighborhood disorder, and health risk behaviors (lifetime alcohol, cannabis, and cigarette use, number of sexual partners) at baseline (Year 1) and 1-year follow-up (Year 2). RESULTS: Asian, Black, and Multiracial adolescents were more likely to endorse health risk behaviors in Year 2 compared to White adolescents living in similarly disadvantaged neighborhoods at Year 1. Associations of neighborhood disorder with health risk behavior did not differ by race. CONCLUSION: Neighborhood socioeconomic disadvantage (but not neighborhood disorder) may predispose Asian, Black, and Multiracial adolescents to health risk behaviors. Findings may inform interventions to address racial disparities in adolescent health risk behaviors.


Assuntos
Asiático , Negro ou Afro-Americano , Comportamentos de Risco à Saúde , Características da Vizinhança , Fatores Socioeconômicos , Adolescente , Humanos , Etanol , Parceiros Sexuais , Brancos , Disparidades nos Níveis de Saúde
7.
Behav Med ; 48(2): 85-94, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35318897

RESUMO

The COVID-19 syndemic, with a disproportionately higher adverse impact on communities of color (i.e., COVID-19 infection and death), will likely exacerbate the existing health disparities in trauma-related symptoms between people of color (POC) and White Americans. However, no studies have examined the racial disparity in posttraumatic stress symptoms (PTSS) during COVID-19. Grounded in ecological theory and racial trauma framework, we investigated racial disparity in PTSS and three possible mechanisms, 1) COVID stress, 2) direct racism, and 3) indirect racism, for these disparities using a large U.S. national sample. Results indicated that POC reported higher levels of PTSS than White Americans. The PTSS racial disparity was accounted more by direct and indirect racism than by the COVID-19-specific stressors, after controlling for age, gender, education, income, parent status, adverse childhood experiences (ACEs), and intimate partner violence (IPV). Additional fine-grained analyses for Hispanic/Latinx Americans, Black/African Americans, and Asian American and Pacific Islanders by and large corroborated the above findings. Our findings highlighted the deleterious impact of the ongoing racism pandemic on the POC community as a public health crisis in addition to the COVID-19 pandemic.Supplemental data for this article is available online at at http://doi:10.1080/08964289.2021.2006131.


Assuntos
COVID-19 , Racismo , Transtornos de Estresse Pós-Traumáticos , Humanos , Pandemias , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Sindemia
8.
J Pediatr Nurs ; 67: e79-e84, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36328913

RESUMO

PURPOSE: The goals are to gauge caregivers' knowledge of at-home asthma triggers and identify the areas on which educational campaigns can focus to alleviate a child's asthma symptoms. DESIGN AND METHODS: Families with children with moderate to severe asthmatic symptoms who had been recently hospitalized or in the emergency room were invited to participate in a home visit program. As part of the home visit, caregivers of the asthmatic children were asked a series of questions on asthma triggers and the measures for eliminating the triggers (N = 218). RESULTS: Findings show a gap between caregivers' perception of asthma triggers and the actions to mitigate or avoid such triggers. CONCLUSIONS: Overall findings show that home environments were suboptimal for the management and control of child asthma conditions. Knowledge about home triggers as well as the actions and efforts by caregivers and landlords to mitigate these was found to be inadequate. Even when caregivers are aware of the presence of at-home triggers, actions to minimize exposure to the trigger do not always follow due to a lack of power, resource, and knowledge. PRACTICE IMPLICATIONS: The findings raise the need for additional research to investigate the reasons for the lack of actions, advocacy for low-income families to live in a healthy environment, continued education and empowerment, and patient/caregiver-doctor partnership. Additionally, the provision of community support through community advocacy and training of culturally competent healthcare providers are needed for the successful management of pediatric asthma among African American children.


Assuntos
Asma , Cuidadores , Criança , Humanos , Cuidadores/educação , Negro ou Afro-Americano , Visita Domiciliar , Asma/terapia , Percepção
9.
Am J Community Psychol ; 70(1-2): 166-183, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35156208

RESUMO

Mental health professionals in schools and the community are often overburdened and underfunded in high-need areas, limiting their capacity to deliver needed family-based mental health interventions. To address this issue, paraprofessional school personnel (e.g., family engagement liaisons) can facilitate these family-based mental health interventions alongside licensed mental health professionals, thereby increasing access to mental health services for families with mental health needs. To train professional and paraprofessional school personnel in maternal depression and interventions, we used storyboarding, a narrative storytelling method traditionally used to create films. Latinx families who had previously participated in a family-focused program for maternal depression shared real life stories focused on themes of (a) maternal depression, (b) impact on children, (c) cultural views and role of immigration, (d) self-harm and suicide, and (e) what families need. In this conceptual paper, we describe our engagement of families in a multistep process of storyboarding that resulted in video modules of family stories for a training website and in-person workshop for school professionals and paraprofessionals. We conclude with how community-engaged tools such as storyboarding can be used to increase awareness and reduce stigma of maternal depression among staff training to deliver family-focused mental health programs in schools.


Assuntos
Serviços de Saúde Mental , Saúde Mental , Criança , Depressão/terapia , Família , Humanos , Instituições Acadêmicas
10.
J Youth Adolesc ; 50(1): 126-143, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33263798

RESUMO

School belonging is a key indicator of students' academic well-being that is threatened by adults' and peers' transgressions of discrimination. Moreover, the hierarchical power structure at school enables adults and peers to enact ethnic-racial discrimination differently, which is also more or less salient among Black, Asian American, and Latinx youth. Therefore, this study aimed to disentangle the links between adult and peer-perpetrated racial discrimination at school, five distinct coping strategies, and school belonging across ethnic-racial groups. Participants were 1686 students in grades 9-12. These results indicated that adolescents who reported peer discrimination also reported greater proactive and aggressive coping. Black youth who reported more adult discrimination also reported more proactive coping, whereas Asian and Latinx youth who reported more peer discrimination reported more proactive coping. Peer discrimination was indirectly associated with greater school belonging via proactive coping, whereas adult discrimination was directly and negatively related to belonging. These findings suggest that adolescents may be selecting to proactively cope when faced with the discrimination source they most often navigate.


Assuntos
Grupo Associado , Racismo , Adaptação Psicológica , Adolescente , Adulto , Humanos , Instituições Acadêmicas , Estudantes
11.
Int J Eat Disord ; 53(10): 1667-1677, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32706499

RESUMO

OBJECTIVE: The link between dysregulated positive affect and binge-eating behavior in youth with obesity is poorly understood. In addition, it is unclear how putative associations differ across developmental periods of rapid biological and emotional change, such as puberty, and in racial and ethnic minority youth, who are more likely to be overweight but are underrepresented in the literature. METHOD: This study used a 2-week ecological momentary assessment protocol to examine independent and interactive effects of positive affect intensity/instability, and pubertal stage on two components of binge-eating behavior, loss of control eating (LOCE), and overeating. RESULTS: Participants were 38 youth with overweight/obesity (ages 8-14 years; 78% African American/Hispanic). Positive affect instability was calculated using probability of acute change (PAC), representing the likelihood of extreme affective changes, and mean squared successive difference (MSSD), representing the average change in affect over successive recordings. There were no main effects of positive affect intensity on LOCE or overeating, but positive affect instability was negatively associated with overeating severity using both MSSD (p = .005) and PAC metrics (p = .001). However, moderation analyses including interactions with pubertal status revealed more extreme changes in positive affect (i.e., higher PAC) were related to greater overeating (p = .001) and LOCE severity (p = .043) in mid-late pubertal youth but not in pre-early pubertal youth. DISCUSSION: Pubertal status may influence the association between disruptions in positive affect and dysregulated eating in youth, and positive affect instability may be important to consider in order to understand the emotional correlates of binge eating in youth with overweight/obesity.


Assuntos
Afeto/fisiologia , Transtorno da Compulsão Alimentar/psicologia , Avaliação Momentânea Ecológica/normas , Hiperfagia/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino
12.
Behav Med ; 46(1): 21-33, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30615590

RESUMO

The present study explored the Immigrant Paradox (IP), generational differences in problematic alcohol use (alcohol consumption and alcohol-related consequences), among immigrants and US born groups from a number of ethnic minority backgrounds. Our approach separates group differences in problematic alcohol consumption in a counterfactual manner for immigrants and the US born to answer the following counterfactual question: "What would problematic alcohol use levels be for the US born had they been exposed to the alcohol use generation (or protective) processes of immigrants and vice versa?" Multidimensional measures of enculturation (involvement with heritage culture), acculturation (involvement with US culture), acculturative stress, and demographic covariates were used to statistically explain these differences. The sample consisted of Asian American (n = 1,153), Black American (n = 833), and Latinx (n = 1,376) college students from 30 universities. Results indicated significant generational differences in mean levels of alcohol consumption but not alcohol-related consequences. Differences in measured characteristics (endowments) marginally explained differences between immigrants and the US born. On the other hand, endowments significantly explained generational differences and represented an increase in alcohol consumption among immigrants if they had the endowments of the U.S. born. Results are discussed in light of cultural and social factors that contribute to the IP.


Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Alcoolismo/etnologia , Aculturação , Adolescente , Negro ou Afro-Americano , Asiático , Emigrantes e Imigrantes/psicologia , Feminino , Hispânico ou Latino , Humanos , Masculino , Grupos Minoritários/psicologia , Estresse Psicológico/psicologia , Estudantes , Estados Unidos , Universidades , Adulto Jovem
13.
Child Psychiatry Hum Dev ; 51(3): 390-398, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31873822

RESUMO

A strong relationship exists between maternal depression and externalizing and internalizing problems in children, and caregiving burden might mediate this relationship. Yet, caregiving burden has rarely been tested as a mechanism underlying the relationship between maternal depression and child emotional and behavioral outcomes. Caregiving burden might be especially high in ethnic and racial minority mother-child dyads in low-income settings where there are more stressors in the environment and rates of maternal depression are elevated. A path analysis with 132 low-income urban mothers who mostly identified as racial and ethnic minorities confirmed our hypothesis that maternal depression has a direct effect on child externalizing and internalizing problems, and also an indirect effect through caregiving burden. We discuss implications of the findings with respect to research, practice, and policy with low-income, ethnic and racial minority families whose mothers have depression and care for children who exhibit externalizing and internalizing problems.


Assuntos
Sintomas Comportamentais/psicologia , Educação Infantil/psicologia , Filho de Pais com Deficiência/psicologia , Transtorno Depressivo/psicologia , Grupos Minoritários/psicologia , Mães/psicologia , Pobreza/psicologia , População Urbana , Adulto , Sintomas Comportamentais/epidemiologia , Criança , Filho de Pais com Deficiência/estatística & dados numéricos , Pré-Escolar , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Grupos Minoritários/estatística & dados numéricos , Mães/estatística & dados numéricos , Pobreza/estatística & dados numéricos , População Urbana/estatística & dados numéricos
14.
Fam Process ; 59(4): 1588-1607, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32134514

RESUMO

Adverse childhood experiences (ACEs) and trauma symptoms have been linked with intimate partner violence (IPV) perpetration and victimization among men, yet the field lacks depth in several key areas hampering progress toward violence intervention. Specifically, posttraumatic stress disorder (PTSD) dominates the field's scope of trauma symptoms under study, limiting understanding of other manifestations of trauma especially among men. Furthermore, most research focuses exclusively on men's physical IPV perpetration and rarely focuses on other types of IPV, severity of violence, or men's victimization. Also, few studies examine potential protective factors grounded in the ACE framework, such as mindfulness, among clinical populations. Finally, most research has not focused on men of color, despite some racial/ethnic minority groups disproportionate rates of IPV exposure. Therefore, the relationships between IPV frequency and severity (psychological, physical, injury) and ACEs, PTSD, trauma symptomology (separate from PTSD), and mindfulness self-efficacy were examined in a sample of 67 predominantly low-income men of color in a batterer intervention program. More than half of the sample (51.5%) reported exposure to four or more ACEs, and 31.1% met the clinical cutoff for a probable PTSD diagnosis. Higher ACE scores predicted increased rates for nearly all types of self-reported IPV perpetration and victimization. PTSD symptoms and complex trauma symptom severity together explained between 13% and 40% of IPV outcomes, and each was uniquely associated with certain types of self-reported IPV victimization and perpetration frequency and severity. Mindfulness self-efficacy was associated with decreased self-report psychological IPV perpetration and victimization frequency and severity. Clinical implications relevant to marginalized men are reviewed, including screening, training, and potential therapeutic interventions.


Las experiencias adversas en la infancia (EAI) y los síntomas de trauma se han asociado con la perpetración de violencia de pareja y la victimización entre los hombres, sin embargo, el ámbito carece de profundidad en varias áreas clave que obstaculizan el avance hacia la intervención en la violencia. Específicamente, el trastorno por estrés postraumático (TEPT) domina el alcance de los síntomas de trauma del ámbito estudiado, lo cual limita la comprensión de otras manifestaciones de trauma, especialmente entre los hombres. Además, la mayoría de las investigaciones se centran exclusivamente en la perpetración de violencia física de pareja por parte de los hombres y rara vez se centra en otros tipos de violencia de pareja, en la gravedad de la violencia o en la victimización de los hombres. Además, pocos estudios analizan posibles factores protectores basados en el marco de las EAI, como la conciencia plena, entre las poblaciones clínicas. Finalmente, la mayoría de las investigaciones no se han centrado en los hombres de color, a pesar de algunos índices desmesurados de exposición a la violencia de pareja de grupos raciales/étnicos minoritarios. Por lo tanto, se analizó la relación entre la frecuencia de la violencia de pareja y la gravedad de esta (psicológica, física, lesiones) y las EAI, el TEPT, la sintomatología del trauma (aparte del TEPT), y la autoeficacia de la conciencia plena en una muestra de 67 hombres de color, predominantemente de bajos recursos, en un programa de intervención para golpeadores. Más de la mitad de la muestra (el 51, 5 %) informó exposición a cuatro o más EAI y el 31, 1 % alcanzó el umbral de decisión clínica para un diagnóstico probable de TEPT. Los puntajes más altos de EAI predijeron índices mayores de casi todos los tipos de perpetración de violencia de pareja y victimización autoinformadas. Los síntomas de TEPT y la gravedad de los síntomas de trauma complejo explicaron juntos entre el 13 % y el 40 % de los resultados de la violencia de pareja, y cada uno estuvo asociado exclusivamente con ciertos tipos de gravedad y frecuencia de la victimización y la perpetración de violencia de pareja autoinformadas. La autoeficacia de la conciencia plena estuvo asociada con una menor victimización y perpetración autoinformadas de la frecuencia y la gravedad de la violencia psicológica de pareja. Se revisan las implicancias clínicas relevantes para los hombres marginados, entre ellas, la evaluación, la capacitación y las posibles intervenciones terapéuticas.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Violência por Parceiro Íntimo/psicologia , Atenção Plena , Marginalização Social/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Vítimas de Crime/psicologia , Estudos Transversais , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Inquéritos e Questionários , Adulto Jovem
15.
J Community Psychol ; 48(7): 2391-2409, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32789906

RESUMO

Previous research found adolescents with low self-worth often utilize delinquency as a method of "self-enhancing" as proposed by Kaplan, which suggests the effects of delinquency can be both enhancing and damaging to adolescents' later reports of self-worth. We tested Kaplan's self-enhancing thesis to determine the extent to which different levels of self-worth in early adolescents foretell long-term levels of self-worth associated with delinquency among adolescents placed at-risk. Data from a sample of 982 primarily Black American (95%) adolescents living in high-poverty neighborhoods were analyzed using global and behavioral self-worth measures collected annually between the ages of 12-17, with school delinquency as the self-enhancing mechanism. Gender (45% female, 55% male) and baseline self-worth measures were included in the model. We found empirical support for the positive effects of school delinquency consistent with self-enhancing theories, although with younger female participants only. Specifically, engaging in delinquent behaviors at age 12 had a positive effect on a females' behavioral self-worth. There were, however, differential effects for males. Although delinquency increased self-worth among females in the short-term, long-term effects were negative, as greater school delinquency resulted in lower self-worth at age 17. Additional gender results and implications for findings are discussed.


Assuntos
Comportamento do Adolescente/psicologia , Autoimagem , Estudantes/psicologia , Adolescente , Negro ou Afro-Americano , Alabama , Feminino , Humanos , Estudos Longitudinais , Masculino , Pobreza/psicologia , Medição de Risco , Instituições Acadêmicas
16.
Breast Cancer Res Treat ; 176(3): 687-696, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30771047

RESUMO

PURPOSE: The metabolic etiology of breast cancer has been explored in the past several years using metabolomics. However, most of these studies only included non-Hispanic White individuals. METHODS: To fill this gap, we performed a two-step (discovery and validation) metabolomics profiling in plasma samples from 358 breast cancer patients and 138 healthy controls. All study subjects were either Hispanics or non-Hispanic African Americans. RESULTS: A panel of 14 identified metabolites significantly differed between breast cancer cases and healthy controls in both the discovery and validation sets. Most of these identified metabolites were lipids. In the pathway analysis, citrate cycle (TCA cycle), arginine and proline metabolism, and linoleic acid metabolism pathways were observed, and they significantly differed between breast cancer cases and healthy controls in both sets. From those 14 metabolites, we selected 9 non-correlated metabolites to generate a metabolic risk score. Increased metabolites risk score was associated with a 1.87- and 1.63-fold increased risk of breast cancer in the discovery and validation sets, respectively (Odds ratio (OR) 1.87, 95% Confidence interval (CI) 1.50, 2.32; OR 1.63, 95% CI 1.36, 1.95). CONCLUSIONS: In summary, our study identified metabolic profiles and pathways that significantly differed between breast cancer cases and healthy controls in Hispanic or non-Hispanic African American women. The results from our study might provide new insights on the metabolic etiology of breast cancer.


Assuntos
Biomarcadores/sangue , Negro ou Afro-Americano , Neoplasias da Mama/sangue , Neoplasias da Mama/epidemiologia , Hispânico ou Latino , Metaboloma , Adulto , Neoplasias da Mama/etnologia , Neoplasias da Mama/etiologia , Estudos de Casos e Controles , Comorbidade , Suscetibilidade a Doenças , Feminino , Humanos , Redes e Vias Metabólicas , Metabolômica/métodos , Pessoa de Meia-Idade , Razão de Chances , Medição de Risco , Fatores de Risco
17.
BMC Public Health ; 19(1): 1657, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823753

RESUMO

BACKGROUND: Racial minority children, particularly from low-income households, are at risk for obesity. Family meals have a protective effect on child nutritional health. However, the current evidence is limited in racial and socioeconomic diversity. The objective of this study was to evaluate the impact of a family meals intervention, Simple Suppers, on improvements in diet and health outcomes from baseline (T0) to post-intervention (T1) in intervention compared to waitlist control participants, and determine retention of change in outcomes among intervention participants at 10-week follow-up (T2). METHODS: Simple Suppers was a 10-week family meals intervention implemented as a 2-group quasi-experimental trial. Ten 90-min lessons were delivered weekly. Data were collected at T0 and T1, and from intervention participants at T2. Participants were racially diverse 4-10 year-old children from low-income households. Setting was a faith-based community center. Main outcomes were daily servings of fruit, vegetables, and sugar-sweetened beverages and diet quality; z-scores for body mass index (BMI), waist circumference, systolic and diastolic blood pressure (BP); weight status categories; food preparation skills; and family meals (frequency of dinner, breakfast, TV viewing during meals, meals in dining area). Generalized linear mixed models (GLMMs) and mixed-effects ordinal regression models were used to assess intervention impact (T0:T1). Paired t-tests examined retention of change among intervention participants (T1:T2). RESULTS: One hundred forty children enrolled and 126 completed T1 (90% retention); 71 of 87 intervention participants completed T2(79% retention). Mean (SD) age was 6.9(1.9) yr, 62% female, 60% Black, and 42% low-income. Intervention vs waitlist controls had higher food preparation skills (p < 0.001) and lower TV viewing during meals (p = 0.04) at T1.There were no group differences in dietary intake or quality or z-scores for BMI, waist circumference, or BP, however intervention versus waitlist controls experienced a greater change toward healthy weight (p = 0.04) At T2, intervention participants demonstrated a retention of improved food preparation skills. CONCLUSIONS: Simple Suppers led to improvements in children's weight status, food preparation skills, and TV viewing during meals, but not diet or z-scores for BMI, waist circumference, or BP. Future research should examine the preventive effects of healthy family mealtime routines in children at greatest risk for obesity. TRIAL REGISTRATION: NCT02923050; Simple Suppers Scale-up (S3); Retrospectively registered on Oct 2016; First participant enrolled on Jan 2015.


Assuntos
Dieta/estatística & dados numéricos , Família , Refeições , Obesidade Infantil/prevenção & controle , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Obesidade Infantil/epidemiologia , Avaliação de Programas e Projetos de Saúde , Fatores de Risco
18.
AIDS Care ; 30(6): 739-745, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29063782

RESUMO

Racialized diasporic communities in Canada experience disproportionate burden of HIV infection. Their increased vulnerabilities are associated with interlocking challenges, including barriers in accessing resources, migration and settlement stress, and systemic exclusion. Further, people living with HIV (PLHIV) in these diasporic communities face stigma and discrimination in both mainstream Canadian society as well as their own ethno-racial communities. HIV stigma negatively impacts all aspects of HIV care, from testing to disclosure to treatment and ongoing care. In response to these challenges, a Toronto based community organization developed and implemented the CHAMP project to engage people living with HIV/AIDS (PLHIV) and leaders from different service sectors from the African/Caribbean, Asian and Latino communities to explore challenges and strategies to reduce HIV stigma and build community resilience. The study engaged 66 PLHIV and ethno-racial leaders from faith, media and social justice sectors in two stigma-reduction training programs: Acceptance Commitment Therapy Training (ACT) and Social Justice Capacity Building (SJCB). Data collection included pre-and post- intervention surveys, focus groups and monthly activity logs. Participants were followed for a year and data on changes in the participants' attitudes and behaviors as well as their actual engagement in HIV prevention, PLHIV support and stigma reduction activities were collected. CHAMP results showed that the interventions were effective in reducing HIV stigma and increasing participants' readiness to take action towards positive social change. Participants' activity logs over a period of 9 months after completing the training showed they had engaged in 1090 championship activities to advocate for HIV related health equity and social justice issues affecting racialized and newcomer PLHIV and communities.


Assuntos
Infecções por HIV/etnologia , Infecções por HIV/psicologia , Grupos Populacionais , Estigma Social , Adolescente , Adulto , Canadá/epidemiologia , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Curr Psychiatry Rep ; 20(10): 90, 2018 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-30155577

RESUMO

PURPOSE OF REVIEW: Eating disorders are recognized to occur across ethnic and racial groups. The aim of the present review was to examine recent advances in the understanding of the development, presentation, and intervention approaches specific to eating disorders among ethnic and racial minority groups. RECENT FINDINGS: An increasing number of measures have been found to be useful tools for assessing eating disorder risk and symptoms among ethnic and racial minority populations. In addition, further evidence has emerged supporting the relationship between higher levels of eating disorder symptoms and acculturation stress, as well as investment in appearance ideals. In contrast, the relationship between ethnic identity and eating disorder symptoms is less consistent, although several studies suggest that positive ethnic identity may be protective. Finally, increasing efforts have been made to develop and implement culturally sensitive interventions by tailoring evidence-supported treatments. Our understanding of and capacity to treat eating disorders among ethnic and racial minority groups continues to improve. However, further research is needed, particularly among neglected groups, such a smaller ethnic and racial groups, males, and intersecting minority statuses.


Assuntos
Etnicidade/estatística & dados numéricos , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Grupos Minoritários/estatística & dados numéricos , Humanos , Grupos Raciais/estatística & dados numéricos
20.
Burns ; 50(3): 760-766, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37981485

RESUMO

Burn injuries remain a significant source of trauma in the United States and disproportionately affect racial and ethnic minorities. Although disparities are well documented in adults, less is known regarding those in pediatric populations. To address this gap in literature, we aim to better characterize burn injuries, inpatient treatments, and post-discharge outcomes in minority pediatric burn patients. We hypothesize minority patients undergo more surgery and re-admissions than non-minority patients for burn care. This is a single institution retrospective chart review of pediatric patient admissions with burn injuries from July 1st, 2016 to July 1st, 2021. Demographics, details of injury, inpatient surgical and non-surgical care, and post-discharge outcomes were collected. Patients identifying as Hispanic/Latino, Black, and Asian were coded as minority patients. Univariate analysis was utilized. A total of 332 patients with average age of 4.9 years (SD: 4.4) and average total burn surface area (TBSA) of 8.5% (SD: 10.0) were collected. Minority patients were significantly more likely to experience accidental burn injury (p < 0.01), inhalational injury (p < 0.01), surgical management (p < 0.01), and to undergo skin graft (p < 0.01) than White patients. Minority patients were significantly more likely to undergo laser treatment after discharge (p < 0.01) than White patients. Our study shows minority pediatric patients are at risk for non-intentional burn injuries that undergo surgical management such as skin grafting and longitudinal reconstructive procedures including laser therapy more often. Short-term goals should include facilitating improved physical and psychosocial outcomes in this often-underserved patient population.


Assuntos
Queimaduras , Adulto , Humanos , Criança , Estados Unidos/epidemiologia , Pré-Escolar , Queimaduras/epidemiologia , Queimaduras/cirurgia , Estudos Retrospectivos , Assistência ao Convalescente , Alta do Paciente , Sobreviventes , Tempo de Internação
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