Sex Differences in Cardiometabolic Risk Factors among Hispanic/Latino Youth

To determine the prevalence of obesity and cardiometabolic risk in US Hispanic/Latino youth and examine whether there are disparities by sex in cardiometabolic risk factors

Children and Adolescents With Medical Conditions

Physical health concerns are common among youth and are linked to mental health. Attention to the interplay between physical and mental health is critical for healthcare providers. This chapter highlights crosscutting issues, assessments, and interventions relevant to child health populations. To understand the interaction between medical and psychological health in youth, chronic pediatric conditions (Type 1 diabetes and sickle cell disease) are described as prototypes for understanding psychosocial issues (e.g., adherence, pain management) that affect youth with medical conditions. Evidence suggests that these children with medical conditions, especially those poorly managed or controlled, are at greater risk for psychosocial issues (e.g., stress, comorbid psychological concerns, family conflict) compared to the general population. Careful risk assessment and individual or family interventions are critical for these youth and are a focus here. Well-established interventions for diverse youth with medical conditions are discussed, and recommendations for future work in this area are provided

Adherence to Medical Regimens

In this chapter, the authors review research related to regimen adherence in pediatric patients with chronic health conditions. They focus on illustrative research in the areas of chronic illness, because considerable research has been conducted in the areas of pediatric diabetes and asthma. The authors also review research on evidence‐based interventions to promote adherence and then considers the issues of parental involvement, adaptations to interventions, and assessment of regimen adherence. Educational interventions for adherence provide verbal or written information about the nature of childhood illness and the various treatment options and strategies for disease management. Behavioral interventions are problem focused and address specific behaviors and barriers that preclude patients from optimal regimen adherence. Psychological interventions for disease management provide a comprehensive approach to addressing adherence. These interventions often target self‐management skills as well as emotional components, such as patient and family adjustment to the diagnosis

Grandparent Involvement and Children's Health Outcomes: The Current State of the Literature

Introduction: Grandparents are often highly involved as secondary caregivers for their grandchildren and may influence children's psychological and physical health outcomes. The purpose of the current review was to gather and synthesize research findings on the effects of grandparent involvement on children's physical health outcomes. Method: PubMed, PsycInfo, and MedLine were searched by 3 independent reviewers for articles that reported on grandparent involvement and children's health. Twenty-six articles were included for final review based on selection criteria. Results: Relatively few studies have examined the effects of grandparent involvement on children's health outcomes; therefore, the degree of their influence remains unclear. Four categories of children's health outcomes (disease/illness, weight, eating behaviors, and injury/safety) emerged during this review. Results indicated that the majority of studies available reported a negative effect of grandparent involvement on child's weight status. However, it is important to note that in most of these studies, the effects of grandparent involvement were not a primary outcome, and the amount of time grandparents spent with their grandchildren was not accounted for. Many studies in this review were qualitative studies, limiting the types of analyses that could be conducted. In addition, few longitudinal studies have been conducted in this area. Discussion: Based on this review, it is clear that grandparents are involved in caretaking for children across many cultures but to understand their role in children's health outcomes, more systematic and longitudinal research needs to be conducted

Trauma Exposure in Posttraumatic Stress and Acute Stress Disorders

This chapter reviews the literature on the association between traumatic stress exposure and rates of both posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) among children and adults. It begins by reviewing current definitions of PTSD and ASD, which vary substantially across diagnostic systems. The chapter highlights research linking large-scale events, such as natural disasters and acts of terrorism, with the emergence of PTSD and ASD, as well as the literature on the impact of individual traumatic events, such as sexual assault, child sexual abuse, and medical trauma. The chapter concludes by noting several important directions for future research in the area of trauma exposure and traumatic stress

Intrinsic motivation in ethnic minority youth with type 1 diabetes

Increasing intrinsic motivation (IM) may be an effective way to improve regimen adherence and glycemic control in youth with type 1 diabetes (T1D). This preliminary study evaluated the reliability and validity of a new measure of intrinsic motivation for diabetes management for ethnic minority youth with T1D. The 12-item Intrinsic Motivation Inventory for Diabetes Management (IMI-DM) was developed to assess perceptions of confidence in and the importance of engaging in self-care behaviors for diabetes management. Participants included 51 11-16 year-old minority adolescents (mean age = 13.5 years) with T1D and their parents. The IMI-DM demonstrated excellent internal consistency (α = 0.92). Higher IM was associated with better diabetes self-management behaviors and glycemic control, better youth self-concept, less depression and family conflict, and greater youth responsibilities for diabetes management. These findings provide preliminary support for the reliability and validity of a new diabetes-specific IM measure for youth with T1D, and identified some key individual and family factors that may be important to consider in interventions to improve regimen adherence and glycemic control in minority youth with T1D

Measurement of Parental Self-Efficacy for Diabetes Management in Young Children

Self-efficacy is an important construct in diabetes management, especially for parents of young children. The Parental Self-Efficacy Scale for Diabetes Management (PSESDM) was adapted from the Perceived Diabetes Self-Management Scale (PDSMS) to measure parental self-efficacy for diabetes management of young children. The PSESDM was administered to 49 primary caregivers of youth between 2-9 years of age with type 1 diabetes (T1D). Cronbach's alpha for the 8-item measure demonstrated adequate internal consistency (α = 0.84). Criterion-related validity was established. Higher scores on the PSESDM were associated with better glycemic control and quality of life in children. These preliminary findings provide support for the reliability and validity of the PSESDM, which may be a useful screening measure of diabetes-related parental self-efficacy for young children

Body image and disordered eating behaviors in Hispanic/Latino Youth: Findings from the Hispanic Community Health Study/Study of Latino Youth

Prevalence of certain disordered eating behaviors is higher among Hispanic youth compared to non-Hispanics. Understanding the role of body image and social attitudes towards weight in disordered eating may inform treatment in Hispanic youth. We analyzed data from the Hispanic Community Health Study/Study of Latino Youth (SOL Youth). Our sample included 1,463 children aged 8–16 years from four sites (Bronx, Chicago, Miami, San Diego) assessed in 2011–2014. Body image discrepancy score was calculated as the difference between perceived ideal body image and actual body image using two numbered visual graphs: adolescent (n = 728) or child (n = 735), each with slightly different scales. Questionnaires measured influences from social attitudes toward weight and disordered eating behaviors. Three disordered eating behaviors (dieting, overeating, and compensatory behaviors) were analyzed as the dependent variable. Logistic regression models adjusted for age, sex, acculturative stress, and field center to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI). Mean body image discrepancy score was −0.79 for adolescents (SE = 0.08) and −0.50 for children (SE = 0.05), with a negative score signifying a perceived actual body image larger than their ideal. Body image discrepancy was strongly associated with dieting (dieting ≥5 times/year aOR = 0.64, 95% CI 0.53, 0.77) and compensatory behaviors (aOR = 0.65, 95% CI 0.50, 0.85) among adolescents, and was strongly associated with overeating among children (aOR = 0.74, 95% CI 0.61, 0.91). Significant associations were not observed with social attitudes towards weight. Associations observed with body image discrepancy and disordered eating behaviors can inform interventions in Hispanic/Latino youth, which should consider acculturative stress

Stress and Resilience: Key Correlates of Mental Health and Substance Use in the Hispanic Community Health Study of Latino Youth

This study examined associations of immigrant generation, acculturation, and sources of stress and resilience with four outcomes-depression symptoms, anxiety symptoms, alcohol susceptibility, and smoking susceptibility. We used data from 1466 youth (ages 8-16) enrolled in the Hispanic Community Health Study of Latino Youth (SOL Youth), a probability sample of Hispanic/Latino youth living in Chicago (IL), Miami (FL), Bronx (NY), and San Diego (CA). We found no evidence of an immigrant paradox. Greater children's acculturative stress was associated with depression/anxiety symptoms; greater parent's acculturative stress was associated with smoking susceptibility. Family functioning and children's ethnic identity were associated with fewer depression/anxiety symptoms and lower alcohol/smoking susceptibility. Although acculturation-related stressors increase youths' risks for poor mental health and substance use, the development of positive ethnic identities and close, well-functioning family support systems can help protect Latino/Hispanic children from the negative behavioral and health-related consequences of stress