Examining the association between relationship status and number of chronic health conditions among U.S. Latinx adults

Project files include 1 page pdf.Title: Association between marital status and number of chronic health conditions among U.S. Latinx adults Authors: Yessenia C. Villalobos, Elizabeth L. Budd Background: Being married versus single is associated with better health outcomes among non-Latinx White adults, especially for men. Although rates of chronic diseases are high among Latinx adults, the association between marital status and chronic diseases among U.S. Latinx adults is unknown. Objectives: To examine the association of marital status and number of chronic health conditions among U.S. Latinx adults and how this association varies by gender. Methods: 798 U.S. Latinx adults (Mage = 39.64±15.05y; 59% female; 46% married or in a civil union; 35.6% single) answered a Qualtrics Panels survey. Marital status, current chronic health conditions, and gender were assessed using the Demographic and Health Data Questionnaire. One-way ANOVA stratified by gender was conducted. Results: Marital status was associated with the number of chronic health conditions (p<.001); respondents who were not married, but in a relationship had significantly fewer chronic health conditions than those married or in a civil union. Additionally, those widowed had significantly more chronic health conditions than those single and those not married, but in a relationship. Among women, those not married, but in a relationship had fewer chronic conditions than those married or in a civil union (p<.05). Among men, those single and those not married, but in a relationship had fewer chronic health conditions than those married or in a civil union (p<.001). Conclusions: Across genders among Latinx adults, not being married was associated with fewer chronic health conditions, inconsistent with literature on non-Latinx White adults. Health promotion efforts could target married Latinx adults

Socioeconomic inequalities in outcome of pregnancy and neonatal mortality associated with congenital anomalies: population based study

Objectives To investigate socioeconomic inequalities in outcome of pregnancy and neonatal mortality associated with congenital anomalies

Healthcare provider-delivered healthy eating recommendations among U.S. Hispanic/Latino adults

8 pagesU.S. Hispanic/Latino adults are at heightened risk for developing diet-related chronic diseases. Healthcare provider recommendations have shown to be effective for promoting health behavior change, but little is known about healthcare provider healthy eating recommendations among Hispanics/Latinos. To investigate the prevalence of and adherence to healthcare provider-delivered healthy eating recommendations among a U.S. sample of Hispanic/Latino adults, participants (N = 798; M = 39.6±15.1 years; 52% Mexican/Mexican American) were recruited via Qualtrics Panels to complete an online survey in January 2018. Most (61%) participants reported having ever received a healthcare provider-delivered dietary recommendation. Higher body mass index (AME = 0.015 [0.009, 0.021]) and having a chronic health condition (AME = 0.484 [0.398, 0.571]) were positively associated with receiving a dietary recommendation while age (AME = 0.004 [ 0.007, 0.001]) and English proficiency (AME = 0.086 [ 0.154, 0.018]) were negatively associated. Participants reported adhering regularly (49.7%) and sometimes (44.4%) to recommendations. There were no significant associations with patient characteristics and adherence to a healthcare provider-delivered dietary recommendation. Findings inform next steps toward increasing implementation of brief dietary counseling from healthcare providers to support prevention and management of chronic diseases among this under-studied population

Perceived Neighborhood Crime Safety Moderates the Association Between Racial Discrimination Stress and Chronic Health Conditions Among Hispanic/Latino Adults

12 pagesBackground: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition. Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability. Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = −0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = −0.004, 95% CI [−0.01, −0.00]). Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos

The quality of school wellness policies and energy-balance behaviors of adolescent mothers

INTRODUCTION: In this study, we 1) compared the quality of school wellness policies among schools participating in Moms for a Healthy Balance (BALANCE), a school- and home-based weight loss study conducted with postpartum adolescents in 27 states; and 2) assessed the relationship between policy quality with energy-balance behaviors and body mass index z scores of postpartum adolescents. METHODS: As a part of BALANCE, we collected data on high-calorie food and beverage consumption, minutes spent walking, and height and weight for 647 participants. The School Wellness Policy Coding Tool was used to assess the strength and comprehensiveness of school district wellness policies from 251 schools attended by participating adolescent mothers. RESULTS: Schools averaged low scores for wellness policy comprehensiveness and strength. When compared with participants in schools with the lowest policy comprehensiveness scores, adolescent mothers in schools with the highest scores reported consuming significantly fewer daily calories from sweetened beverages while reporting higher consumption of water (P = .04 and P = .01, respectively). School wellness policy strength was associated with lower BMI z scores among adolescent mothers (P = .01). CONCLUSION: School wellness policies associated with BALANCE may be limited in their ability to promote a healthy school environment. Future studies are needed to evaluate the effect of the strength and comprehensiveness of policy language on energy balance in high-risk postpartum adolescents. Evidence from this work can provide additional guidance to federal or state government in mandating not only policy content, but also systematic evaluation

Comparing knowledge, accessibility, and use of evidence-based chronic disease prevention processes across four countries

<p>Background: Evidence-based chronic disease prevention (EBCDP) effectively reduces incidence rates of many chronic diseases, but contextual factors influence the implementation of EBCDP worldwide. This study aims to examine the following contextual factors across four countries: knowledge, access, and use of chronic disease prevention processes.</p><p>Methods: In this cross-sectional study, public health practitioners (N = 400) from Australia (n = 121), Brazil (n = 76), China (n = 102), and the United States (n = 101) completed a 26-question survey on EBCDP. One-way ANOVA and Pearson's Chi-Square tests were used to assess differences in contextual factors of interest by country.</p><p>Results: Practitioners in China reported less knowledge of EBCDP processes (p < 0.001) and less use of repositories of evidence-based interventions, than those from other countries (p < 0.001). Academic journals were the most frequently used method for accessing information about evidence-based interventions across countries. When selecting interventions, Brazilian and Chinese practitioners were more likely to consider implementation ease while the Australian and United States practitioners were more likely to consider effectiveness (p < 0.001).</p><p>Conclusions: These findings can help inform and improve within and across country strategies for implementing EBCDP interventions.</p

Parent Gender Affects the Influence of Parent Emotional Eating and Feeding Practices on Child Emotional Eating

12 pagesExtant research supports a direct association between parent’s own emotional eating and their child’s emotional eating, and demonstrates correlations among parent emotional eating, feeding practices, and child emotional eating. However, the majority of this work focuses on the separate influences of these factors. The current study aims to add to the literature by simultaneously examining the indirect effects of three major parental feeding practices (i.e., emotion regulation, instrumental, and restrictive feeding) in the association between parent emotional eating and child emotional eating, and exploring how these indirect effects vary based on parent gender. Parents (86 fathers, 324 mothers) of an elementary school-age child (M = 8.35, SD = 2.29, range = 5–13) completed an online survey through Qualtrics Panels. Results suggested that restrictive feeding partially accounted for the association between parent and child emotional eating in the combined sample of mothers and fathers. Exploratory analyses revealed that the indirect effects of parental feeding practices in the association between parent emotional eating and child emotional eating varied based on parent gender. Among mothers, restrictive feeding was the only feeding practice that partially accounted for the association between maternal and child emotional eating, whereas all three feeding practices fully accounted for the association between father and child emotional eating. As the bulk of the literature on parent emotional eating and feeding has solely focused on mothers, these findings offer insight into how feeding practices may differentially function in the relation between parent emotional eating and child emotional eating for mothers versus fathers

Developing a survey tool to assess implementation of evidence-based chronic disease prevention in public health settings across four countries

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Socioeconomic inequalities in pregnancy outcome associated with Down syndrome: a population-based study.

OBJECTIVE: To investigate socioeconomic inequalities in outcome of pregnancy associated with Down syndrome (DS) compared with other congenital anomalies screened for during pregnancy. DESIGN AND SETTING: Retrospective population-based registry study (East Midlands & South Yorkshire in England). PARTICIPANTS: All registered cases of DS and nine selected congenital anomalies with poor prognostic outcome (the UK Fetal Anomaly Screening Programme (FASP)9) with an end of pregnancy date between 1 January 1998 and 31 December 2007. MAIN OUTCOME MEASURES: Poisson regression models were used to explore outcome measures, including socioeconomic variation in rates of anomaly; antenatal detection; pregnancy outcome; live birth incidence and neonatal mortality. Deprivation was measured using the Index of Multiple Deprivation 2004 at super output area level. RESULTS: There were 1151 cases of DS and 1572 cases of the nine severe anomalies combined. The overall rate of antenatal detection was 57% for DS, which decreased with increasing deprivation (rate ratio comparing the most deprived tenth with the least deprived: 0.76 (0.60 to 0.97)). Antenatal detection rates were considerably higher for FASP9 anomalies (86%), with no evidence of a trend with deprivation (0.99 95% CI (0.84 to 1.17)). The termination of pregnancy rate following antenatal diagnosis was higher for DS (86%) than the FASP9 anomalies (70%). Both groups showed wide socioeconomic variation in the termination of pregnancy rate (rate ratio: DS: 0.76 (0.58 to 0.99); FASP9 anomalies: 0.80 (0.65 to 0.97)). Consequently, socioeconomic inequalities in live birth and neonatal mortality rates associated with these anomalies arise that were not observed in utero. CONCLUSIONS: Socioeconomic inequalities exist in the antenatal detection of DS, and subsequent termination rates are much higher for DS than other anomalies. Termination rates for all anomalies are lower in more deprived areas leading to wide socioeconomic inequalities in live born infants with a congenital anomaly, particularly DS, and subsequent neonatal mortality