Family Efficacy within Ethnically Diverse Families: A Qualitative Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136302/1/famp12149.pd

Neighborhood Context and Perceptions of Stress Over Time: An Ecological Model of Neighborhood Stressors and Intrapersonal and Interpersonal Resources

We examine the association between neighborhood socio‐economic disadvantage and perceived stress during middle and late adolescence among African American youth (N = 665; 51 % female; M = 15.9 years at baseline). In addition, we explored the ways through which neighborhood stressors interacted with an individual’s intra‐ and interpersonal resources (e.g., coping, social support and substance use), to affect their perceived stress trajectories during adolescence. First, we tested a neighborhood stressors model and found that youth who lived in neighborhoods with greater socioeconomic disadvantage had higher baseline stress and a steeper increase in stress over time. When we included individual‐level risk and promotive factors in the model, however, the effect of neighborhood disadvantage on perceived stress was no longer significant, and the stress trajectory was explained by adolescent substance use, social support and perceptions of the neighborhood. Our results support theories of stress and coping, and the importance of proximal intra‐ and interpersonal factors in either amplifying or mitigating perceptions of stress. We discuss implications of the neighborhood context and how our findings may inform future prevention and intervention related to adolescent stress and development.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117087/1/ajcp9571.pd

Partner support in a cohort of African American families and its influence on pregnancy outcomes and prenatal health behaviors

Abstract Background We examined how two indicators of partner involvement, relationship type and paternal support, influenced the risk of pregnancy outcomes (preterm birth, low birth weight) and health behaviors (prenatal care, drug use, and smoking) among African American women. Methods Interview and medical record data were obtained from a study of 713 adult African American women delivering singletons between March 2001 and July 2004. Women were enrolled prenatally if they received care at one of three Johns Hopkins Medical Institution (JHMI) prenatal clinics or post-partum if they delivered at JHMI with late, no or intermittent prenatal care. Relationship type was classified as married, unmarried/cohabitating, or unmarried/non-cohabitating. Partner support was assessed using an 8-item scale and was dichotomized at the median. Differences in partner support by pregnancy outcome and health behaviors were assessed using linear regression. To assess measures of partner support as predictors of adverse pregnancy outcomes and health behaviors, Poisson regression was used to generate crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). Results There were no statistically significant differences in pregnancy outcomes or health behaviors by relationship type or when partner support was examined as a continuous or categorical variable. Modeled as a dichotomous variable, partner support was not associated with the risk of preterm birth (PR = 0.81, 95% CI = 0.56, 1.56), low birth weight (PR = 0.77, 96% CI = 0.48, 1.26), or health behaviors. Conclusions Paternal involvement was not associated with pregnancy outcomes or maternal health behaviors. Attention to measurement issues and other factors relevant for African American women are discussed.http://deepblue.lib.umich.edu/bitstream/2027.42/112953/1/12884_2013_Article_844.pd

Partner support in a cohort of African American families and its influence on pregnancy outcomes and prenatal health behaviors

Abstract Background We examined how two indicators of partner involvement, relationship type and paternal support, influenced the risk of pregnancy outcomes (preterm birth, low birth weight) and health behaviors (prenatal care, drug use, and smoking) among African American women. Methods Interview and medical record data were obtained from a study of 713 adult African American women delivering singletons between March 2001 and July 2004. Women were enrolled prenatally if they received care at one of three Johns Hopkins Medical Institution (JHMI) prenatal clinics or post-partum if they delivered at JHMI with late, no or intermittent prenatal care. Relationship type was classified as married, unmarried/cohabitating, or unmarried/non-cohabitating. Partner support was assessed using an 8-item scale and was dichotomized at the median. Differences in partner support by pregnancy outcome and health behaviors were assessed using linear regression. To assess measures of partner support as predictors of adverse pregnancy outcomes and health behaviors, Poisson regression was used to generate crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). Results There were no statistically significant differences in pregnancy outcomes or health behaviors by relationship type or when partner support was examined as a continuous or categorical variable. Modeled as a dichotomous variable, partner support was not associated with the risk of preterm birth (PR = 0.81, 95% CI = 0.56, 1.56), low birth weight (PR = 0.77, 96% CI = 0.48, 1.26), or health behaviors. Conclusions Paternal involvement was not associated with pregnancy outcomes or maternal health behaviors. Attention to measurement issues and other factors relevant for African American women are discussed

Direct and Proxy Recall of Childhood Socio‐Economic Position and Health

Background The utility of proxy reporting within the life course framework has not been adequately assessed; therefore we sought to assess the magnitude and type of agreement that exists between index and proxy reports for bodyweight, health, and socio‐economic position ( SEP ) in childhood. Methods Participants were enrolled as part of an ongoing study of preterm birth in African American women in M etro D etroit. Post‐partum women and their mothers ( n  = 333 pairs) provided retrospective reports about the woman's childhood bodyweight, health, and SEP . Agreement was assessed using kappa, weighted kappa (κ), and intraclass correlation coefficients ( ICC ). Log‐linear models were used to describe the pattern of agreement for ordinal data. Results Birthweight and weight at age 18 was reported with a high level of agreement ( ICC  = 0.86 and 0.71, respectively). Kappa indicated moderate agreement for early and late childhood/adolescent weight. Log‐linear models suggested that there was diagonal agreement plus linear by linear association for early childhood weight and linear by linear association in late childhood/adolescence. Reports of childhood medical problems and hospitalisations had only moderate agreement. Agreement for SEP in both early (κ = 0.14) and late childhood/adolescence (κ = 0.20) was poor. Log‐linear models suggest a linear by linear association, indicating a positive association between the responses. Conclusions Results suggest that proxy reports may be utilised in conjunction with an index report to provide an estimate of the accuracy of report or to more fully capture experiences over the life course. This may be particularly useful when multiple developmental periods are examined.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97462/1/ppe12045.pd

Trajectories of organized activity participation among urban adolescents: Associations with young adult outcomes

Organized activity participation provides opportunities for adolescents to develop assets that may support favorable outcomes in young adulthood. Activity participation may be especially beneficial for marginalized youth because they are likely to face stressors that increase risk of negative outcomes. We used growth mixture modeling to identify activity participation trajectories among African American adolescents in an urban, disadvantaged community (Wave 1: mean age = 14.86 years, standard deviation = 0.64; 49% male, N = 681). We also investigated if young adult outcomes differed by participation trajectory subgroups, the results of which suggested that a 3‐class model best fit the data: low initial and decreasing levels of participation (74%); moderate initial and consistent (21%); and moderate initial and increasing (5%). Adolescents in the increasing class reported higher life satisfaction and lower substance use in young adulthood compared to the decreasing class. Youth who increase participation in activities over time may experience greater opportunities for building assets related to positive development that support health and well‐being into young adulthood.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136459/1/jcop21863.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136459/2/jcop21863_am.pd

The influence of dyadic symptom distress on threat appraisals and self-efficacy in advanced cancer and caregiving

Physical and psychological symptoms experienced by patients with advanced cancer influence their wellbeing; how patient and family caregivers' symptom distress influence each other's wellbeing is less understood. This study examined the influence of patient and caregiver symptom distress on their threat appraisals and self-efficacy to cope with cancer

Meaning‐based coping, chronic conditions and quality of life in advanced cancer & caregiving

ObjectiveThis study examined the relationship between the number of co‐existing health problems (patient comorbidities and caregiver chronic conditions) and quality of life (QOL) among patients with advanced cancer and their caregivers and assessed the mediating and moderating role of meaning‐based coping on that relationship.MethodsData came from patients with advanced cancers (breast, colorectal, lung, and prostate) and their family caregivers (N = 484 dyads). Study hypotheses were examined with structural equation modeling using the actor‐partner interdependence mediation model. Bootstrapping and model constraints were used to test indirect effects suggested by the mediation models. An interaction term was added to the standard actor‐partner interdependence model to test for moderation effects.ResultsMore patient comorbidities were associated with lower patient QOL. More caregiver chronic conditions were associated with lower patient and caregiver QOL. Patient comorbidities and caregiver chronic conditions had a negative influence on caregiver meaning‐based coping but no significant influence on patient meaning based coping. Caregiver meaning‐based coping mediated relationships between patient comorbidities and caregiver health conditions and patient and caregiver QOL. No significant moderating effects were observed.ConclusionsDespite the severity of advanced cancer for patients and caregivers, the co‐existing health problems of one member of the dyad have the potential to directly or indirectly affect the wellbeing of the other. Future research should consider how the number of patient comorbidities and caregiver chronic conditions, as well as the ability of patients and caregivers to manage those conditions, influences their meaning‐based coping and wellbeing. Copyright © 2016 John Wiley & Sons, Ltd.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138410/1/pon4146_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138410/2/pon4146.pd

Condom Use Trajectories in Adolescence and the Transition to Adulthood: The Role of Mother and Father Support

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92028/1/jora775.pd

Adolescent Resilience: Promotive Factors That Inform Prevention

Resilience theory provides a framework for studying and understanding how some youths overcome risk exposure and guides the development of interventions for prevention using a strengths‐based approach. In this article, we describe basic concepts of the theory, such as promotive factors, and distinguish assets and resources that help youths overcome the negative effects of risk exposure. We also present three models of resilience theory—compensatory, protective, and challenge—and review empirical research on three promotive factors—ethnic identity, social support, and prosocial involvement—that include individual, family, and community levels of analysis and have modifiable qualities for informing interventions. Finally, we present examples of how research findings from the three promotive factors can be translated into interventions to enhance youth development.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/101789/1/cdep12042.pd