Reducing Cardiovascular Disease Risk In Mid-Life and Older African Americans: A Church-Based Longitudinal Intervention Project At Baseline

Introduction: African Americans (AAs) experience higher age-adjusted morbidity and mortality than Whites for cardiovascular disease (CVD). Church-based health programs can reduce risk factors for CVD, including elevated blood pressure [BP], excess body weight, sedentary lifestyle and diet. Yet few studies have incorporated older adults and longitudinal designs. Purposes: The aims of this study are to: a) describe a theory-driven longitudinal intervention study to reduce CVD risk in mid-life and older AAs; b) compare selected dietary (fruit and vegetable servings/day, fat consumption), physical activity (PA) and clinical variables (BMI, girth circumferences, systolic and diastolic BP, LDL, HDL, total cholesterol [CHOL] and HDL/CHOL) between treatment and comparison churches at baseline; c) identify selected background characteristics (life satisfaction, social support, age, gender, educational level, marital status, living arrangement and medication use) at baseline that may confound results; and d) share the lessons learned. Methods: This study incorporated a longitudinal pre/post with comparison group quasi-experimental design. Community-based participatory research (CBPR) was used to discover ideas for the study, identify community advisors, recruit churches (three treatment, three comparison) in two-counties in North Florida, and randomly select 221 mid-life and older AAs (45 +) (n = 104 in clinical subsample), stratifying for age and gender. Data were collected through self-report questionnaires and clinical assessments. Results and Conclusions: Dietary, PA and clinical results were similar to the literature. Treatment and comparison groups were similar in background characteristics and health behaviors but differed in selected clinical factors. For the total sample, relationships were noted for most of the background characteristics. Lessons learned focused on community relationships and participant recruitment

Family context of mental health risk in Tsunami affected mothers: Findings from a pilot study in Sri Lanka

This study investigated direct and indirect influences of Tsunami exposure on mothers' PTSD and depressive symptoms using survey data from 325 Tsunami-affected families living in two villages in southern Sri Lanka. Findings generally support the hypothesized model in that life and property destruction contributed to the PTSD and depressive symptoms of mothers. Detrimental influences of Tsunami exposure also operated through the generation of more proximal secondary Tsunami risks such as post-Tsunami family problems. In addition, religious participation, familism, number of children, intact family status, and community support reduced mothers' depressive symptoms. Finally, intact family status and high religious participation moderated the detrimental influence of Tsunami exposure on mothers' PTSD symptoms. These findings can contribute directly to improving ongoing recovery and reconstruction programs and help to formulate future programs for families affected by the Tsunami and other natural disasters.Sri Lanka Tsunami Family Depression Posttraumatic stress disorder (PTSD) Mental health Mothers

Family context of mental health risk in Tsunami-exposed adolescents: Findings from a pilot study in Sri Lanka

Using survey data from 325 Tsunami-exposed adolescents and mothers from two villages in southern Sri Lanka, this pilot study investigated influences of Tsunami exposure and subsequent psychosocial losses on adolescent depressive and post-traumatic stress disorder (PTSD) symptoms. Findings generally support the study hypotheses: disaster exposure (for example experiences of property destruction and deaths of close others) contributes to depressive and PTSD symptoms in adolescents. Findings also show that psychosocial losses associated with Tsunami exposure, such as prolonged displacement, social losses, family losses, and mental health impairment among mothers, contribute to depressive and PTSD symptoms in adolescents. Results suggest that the influence of Tsunami exposure on adolescent mental health operates partially through Tsunami-related psychosocial losses. As expected, positive mother-child relationships provide a compensatory influence on both depressive and PTSD symptoms of adolescents. In addition, high levels of depressive symptoms among mothers increases the detrimental influence of other Tsunami-related psychosocial losses on adolescent mental health. These preliminary findings suggest ways to improve ongoing recovery and reconstruction programs and assist in formulating new programs for families exposed to both the Tsunami and other natural disasters. More importantly, findings from this pilot study emphasize the urgent need for larger systematic studies focusing on mental health following disaster exposure.Sri Lanka Tsunami disaster Adolescent mental health Family relations Social support Resilence PTSD

Overt and Subtle Racial Discrimination and Mental Health: Preliminary Findings for Korean Immigrants

Objectives. We examined differential effects of overt and subtle forms of racial discrimination on 2 dimensions of mental health—positive affect and depressive symptoms, and explored the mediating roles of emotional arousal and cognitive appraisal

Stressful Life Events, Marital Satisfaction, and Marital Management Skills of Taiwanese Couples

The association between stressful life events and marital satisfaction for 372 Taiwanese couples was examined, as was the moderating effects of three marital management skills (e.g., tolerance/sacrifice, empathy/consideration, soothing/alleviation) on that association. Multilevel modeling analysis showed that stressful life events reduced husbands’ and wives’ marital satisfaction. Spouses’ marital management skills were associated with an increase in their marital satisfaction (actor effects) except for husbands’ soothing and alleviation skills. Husbands’ tolerance and empathy were also related to an increase in the wife’s marital satisfaction (partner effects) and had significant interactions with the relationship between the wife’s stress and her marital satisfaction. Husbands’ and wives’ soothing skills also had significant interactions with the association between stressful life events and their own satisfaction. These results are discussed in relation to the life course, stress process, coping theories, and Chinese cultural values as well as their clinical implications of working with Chinese population

Social Support and Dietary Quality in Older African American Public Housing Residents

This study examined the role of social support in influencing dietary quality in older African American public housing residents, specifically investigating individual (age, education, gender, marital status, and living arrangement), social support (help with meals, social network size, frequency of contact, and proximity or distance from network), and dietary factors (number of meals consumed daily, dietary quality). A random sample (n = 80) of public housing residents age 55+ living in a Northeastern community was interviewed. Data were analyzed using Pearson correlation coefficients, multiple regression analyses, and structural equation modeling (SEM). Given the limited sample size, a SEM path model was developed based on observed associations in correlation and regression analyses. Results show that number of meals, frequency of contact, and proximity significantly influenced dietary quality. However, dietary quality was indirectly influenced by education, marital status, having a housemate, and help with meals, highlighting influence of both individual and social factors

Dietary Influence on Calcitropic Hormones and Adiposity in Caucasian and African American Postmenopausal Women Assessed by Structural Equation Modeling (SEM)

To examine differences in hydroxycholecalciferol (25(OH)D) and parathyroid hormone (PTH) concentrations between Caucasian and African American (AA) postmenopausal women, as well as the effects of dietary calcium, protein and vitamin D intakes on 25(OH)D, PTH, and body adiposity using structural equation modeling (SEM). Population-based prospective cohort study. Academic research using the baseline data from two longitudinal studies. Included n=113 Caucasian and n=40 African American, postmenopausal women who completed the baseline data collection and met inclusion criteria (dietary calcium intake \u3c 900 mg/day and being generally healthy) between 2006 and 2010. Dietary intake of calcium and vitamin D, assessed by dietary records, were examined in relation to calcitropic hormones concentrations and adiposity markers. Independent t-tests, confirmatory factor analysis, SEM and multi-group analyses were conducted to examine the aforementioned relationships as well as group differences among hormones, dietary intake, anthropometrics, age and other factors. Dietary calcium and protein intakes were significantly lower in AA women. Years since menopause were significantly higher in AA compared to Caucasian women. PTH and 25(OH)D levels were significantly lower in AA compared to Caucasian women. Dietary calcium and protein intakes did not influence body adiposity in either group of women. Dietary vitamin D had minimal indirect (via 25(OH)D levels) influence on adiposity. The study confirmed the positive relationship of 25(OH)D with adiposity markers and both AA and Caucasian women. The study provides a unique example of the use of SEM in nutrition research within a clinical context. This model should be further tested in other populations

Changes in family financial circumstances and the physical health of married and recently divorced mothers

This study investigates how divorce followed by single parenthood undermines the long-term physical health of rural mothers using four waves of survey data collected in Iowa, USA from 336 married and 80 divorced mothers during a 10-year period. Findings generally support the hypothesized pathways in that single-parenthood creates financial difficulties for rural mothers. Furthermore, this financial adversity is linked to self-assessed physical health trajectories that then contribute to change in morbidity. This reflects the developmental course of morbidity during the middle years. Methodologically, this extends existing research on the association between women's marital status and well being by explicitly examining individual trajectories of change in family financial strain and physical health, as well as by examining the dynamic association between both during the middle years.Single mothers Financial strain Physical health Divorce Parenting USA