Socioeconomic and Cultural County-level Factors Associated with Race/Ethnic Differences in Body Mass Index in 4th Grade Students in Texas

Purpose: To evaluate the relationship between county-level socioeconomic environment and the propensity to be overweight or obese by race/ethnic group in a sample of fourth grade children the Texas public school system. Methods: The data used come from the School Physical Activity and Nutrition (SPAN) surveillance study – a surveillance study of school-aged children in Texas. The outcome variable used was Body Mass Index (BMI) categorized as underweight/normal/healthy, overweight, and obese. Exposure variables were derived from county-level Hispanic and Black concentration and socioeconomic data using the Human Security Index (HSI) as a framework. We made comparisons between Non-Hispanic White, Black and Hispanic children enrolled in the fourth grade. We used bivariate and regression analysis using jackknife variance estimates. Results: Hispanic and Black children were more likely to be obese and overweight than non-Hispanic White children. Hispanic and Black children were more likely to live in counties with higher economic, educational and social stress than non-Hispanic White children. In the logistic regression analysis comparing the odds of overweight or obese to underweight/healthy/normal weight, both Hispanic and Black children continued to have a higher odds of overweight and obesity than non-Hispanic White children. In separate regression analyses for each race/ethnic group (ie, Hispanic, Black, and White students) the county-level educational and social stress variables had a significant association with overweight and obesity in Hispanic children only. Hispanic ethnic concentration was associated with the odds of being overweight but not obese, while percent Black was associated with obesity in Hispanic children. There were no significant associations between socioeconomic or ethnic concentration and overweight or obese in Black children. Discussion: The results from this study indicate that county-level effects on childhood obesity may be more than just socioeconomics and ethnic concentration. Future research should involve multiple levels of analysis, including census tract, school and home variables simultaneously, in order to understand how the environments children live in impact their risk for obesity and how these influences may vary by race/ethnicity

Using a single feature to discriminate and form categories: The interaction between color, form and exemplar number

There is relatively little work that has focused on how infants use a single feature to discriminate objects or flexibly group objects together. Existing research suggests that the ease with which infants learn form and color discriminations is not equal. However, which of these dimensions is easier when discriminating between objects is still unclear. The studies in this paper tested how infants used these two dimensions under varying levels of diversity in a discrimination task. Combining traditional analyses with latent-states Markov-modeling, infant learning in these studies was characterized by a bend of overt behavior and attentional processes. Infants were able to learn both a color and form-based discrimination, but only generalized the form distinction to new stimuli. When presented with diversity on the irrelevant dimension, infants in the form condition learned quickly. However, infants in the color-condition did not show signs that they learned the distinction. The results show that infants could use both dimensions to distinguish between objects, but that form-based distinctions were easier and more likely to be generalized to new objects

Community Readiness to Align and Better Support Families with Perinatal Substance Use Issues and the Impacts of the Covid-19 Pandemic on Progress

Problem: Drug overdose is the leading cause of maternal death in Texas. More than 60% of children in custody of Texas Child Protective Services (CPS) have substance use listed as a contributing factor in their CPS case, compared to the national rate of 34%. Pregnant and postpartum women and infants are a special population impacted by substance use and require a coordinated response from multiple sectors to ensure optimal outcomes for both the mother and her infant. Purpose: In 2018, needs and readiness assessments were conducted in Houston, Texas, focused on improving care and service coordination for pregnant women with substance use disorder (SUD). The purpose of this paper is to briefly describe the results of the assessments and discuss how the Covid-19 pandemic has impacted implementation of the recommendations. Methods: In late 2018, 59 stakeholders from 5 different sectors were interviewed to assess the current system of care and identify recommendations they felt would improve outcomes for pregnant women with SUD. These interviews were followed by 5 collaborative meetings with stakeholders to finalize the recommendations, and a readiness assessment (n=25) to determine the feasibility of implementing the recommendations. The goals of this survey were to determine which of these recommendations were most important, had organizational support for implementation, and would result in improvements within a year of being implemented. Interviews were conducted again in 2020 (n=9) to describe the progress that had been made on the recommendations and assess the impact the Covid-19 pandemic has had on implementing programs and initiatives that support peripartum women with SUDs. Results/Discussion: The stakeholder interviews revealed substantial cross-sector misunderstanding about each sector’s roles and responsibilities. Further, several barriers to coordination were identified. Interviews and collaborative meetings led to the development of 25 recommendations that would improve cross-sector collaboration. There were 25 completed responses to the readiness survey focused on implementing these recommendations. Of the recommendations, 9 had above-average ratings on importance and had ratings indicating substantial short-term impact for pregnant women. Six additional recommendations had above-average ratings on importance, but it was determined that their benefits take longer to be seen. Progress made towards 8 of the recommendations and how the Covid-19 pandemic has impacted this progress are described. Implications: The Covid-19 pandemic has created both opportunities and barriers to progress in the treatment and care of pregnant women with SUD. This analysis identifies resulting changes that must be considered for future planning and intervention implementation

Fatherhood during COVID-19: fathers' perspectives on pregnancy and prenatal care

Background and objective: In early 2020, the novel COVID-19 virus arrived in the United States and resulted in broad, sweeping changes to safety procedures within healthcare settings, including prenatal care settings. While implemented to protect both providers and patients, this protocol limited fathers’ ability to attend prenatal care appointments. At this time, limited research has been published on the effects of COVID-19 healthcare protocols on fathers’ experiences and perceptions of prenatal care and parenting. This study aimed to understand how COVID-19 affected expectant fathers and fathers with newborns perceptions and experiences during pregnancy, prenatal care, and early parenting. Materials and methods: Structured interviews were completed with fathers expecting a child and fathers with children born after March 2020. Interviews were completed by video conference and recorded. Audio from each interview was transcribed. Content and thematic analysis was performed. Results: In total, 34 fathers were interviewed. Three broad themes were identified from the data including changing prenatal care policies that did not consider fathers, unique stressors associated with COVID-19, and isolation’s negative impact on connecting to the pregnancy and support. Fathers reported limited engagement with the prenatal care system due to pandemic-related organizational and systematic changes in healthcare delivery. Results also suggest that fathers experienced elevated feelings of both stress and isolation from the pregnancy and prenatal care. Conclusions: Ultimately, this study highlights the need for providers and organizations to develop strategies for transforming prenatal healthcare delivery into inclusive, family centered care during emergency situations, as well as use this opportunity to build family centered care into normal prenatal care operations

Learning Stimulus-Location Associations in 8-and 11-Month-Old Infants: Multimodal Versus Unimodal Information

Research on the influence of multimodal information on infants' learning is inconclusive. While one line of research finds that multimodal input has a negative effect on learning, another finds positive effects. The present study aims to shed some new light on this discussion by studying the influence of multimodal information and accompanying stimulus complexity on the learning process. We assessed the influence of multimodal input on the trial-by-trial learning of 8- and 11-month-old infants. Using an anticipatory eye movement paradigm, we measured how infants learn to anticipate the correct stimulus–location associations when exposed to visual-only, auditory-only (unimodal), or auditory and visual (multimodal) information. Our results show that infants in both the multimodal and visual-only conditions learned the stimulus–location associations. Although infants in the visual-only condition appeared to learn in fewer trials, infants in the multimodal condition showed better anticipating behavior: as a group, they had a higher chance of anticipating correctly on more consecutive trials than infants in the visual-only condition. These findings suggest that effects of multimodal information on infant learning operate chiefly through effects on infants' attention

Parental negative emotions are related to behavioral and pupillary correlates of infants' attention to facial expressions of emotion

Previous evidence revealed links between maternal negative emotions and infants ’ attention to facial expressions of emotion in clinical and community samples. This study investigated the associations between infants’ attention to emotional faces and infants’ and parents’ negative emotions in a community sample. Infants ’ (N= 57,M age= 14.26 months) fixations and pupil responses to fearful, sad, angry versus happy and neutral faces were measured with an eye-tracker. Mothers’ and fathers’ negative emotions (negative affect, depression, and anxiety), and infants’ negative temperament were measured with questionnaires. Infants looked longer at fearful than happy or neutral faces, while they showed less pupil dilation to fearful than to happy or neutral faces. Higher levels of maternal negative emotions were related to less pupillary arousal to emotional facial expressions in infants, while paternal negative emotions did not predict infants’ pupil responses. Exploratory analyses suggested a significant link between paternal but not maternal negative emotions and infants’ fixations that was moderated by infant negative temperament: Higher levels of negative emotions in fathers were related to longer fixations in children with high levels of negative temperament, while it was related to shorter fixations in infants with low levels of negative temperament. The findings provide support for the idea that exposure to mothers’ and fathers’ negative emotions play a role on the development of infants’ attention to facial expressions in typical development