Association of Self-Efficacy and Self-Regulation with Nutrition and Exercise Behaviors in a Community Sample of Adults

This study examined the association of self-efficacy and self-regulation with nutrition and exercise behaviors. The study used a cross-sectional design and included 108 participants (54 men, 54 women). Nutrition behaviors (fruit/vegetable consumption, dinner cooking, and restaurant eating) and exercise were measured using total days in last week a behavior was reported. Instruments measuring self-efficacy and self-regulation demonstrated excellent Cronbach’s alphas (.93–.95). Path analysis indicated only fruit/vegetable consumption and exercise were associated with self-efficacy and self-regulation. Self-regulation showed direct association with fruit/vegetable consumption and exercise, but self-efficacy had direct association only with exercise. Self-efficacy and self-regulation should be strategically used to promote health behaviors

Translation and Adaptation of the Center for Epidemiologic Studies-Depression (CES-D) Scale Into Tigrigna Language for Tigrigna Speaking Eritrean Immigrants in the United States

Depression is one of the oldest known mental health conditions. It is acknowledged to be a global health problem that affects people from any culture or ethnic group. The prevalence of depression widely varied across countries and cultures. The cross-cultural relevance of the concept of depression, its screening or diagnosis, and cultural equivalence of items used to measure symptoms of depression has been area of research interest. Differences in prevalence rates in depression have been suggested as being due to research artifacts, such as use of instrument developed for one culture to another culture. With the current trend of globalization and increased rate of immigration, the need for measurement scales that can be used cross-culturally is becoming essential. Translation and adaptation of existing tools to different languages is time saving and cost effective than developing a new scale. The Center for Epidemiologic Studies Depression Scale [CES-D; (Radloff, 1977)] has been widely used as a screening tool for depressive symptoms in community and clinical settings. It has been widely accepted and translated to multiple languages and its measurement equivalence tested across groups. This study was designed as a mixed method study. The purpose of this study was three fold: (a) translate and adapt the CES-D scale into Tigrigna Language for use by Tigrigna speaking Eritrean immigrants in the United States using the forward backward translation and cognitive interview techniques (b) test the psychometric properties of the Tigrigna version CES-D scale using confirmatory factor analysis under the framework of structural equation modeling and (c) test measurement equivalence of the scale by comparing data collected from 253 Eritrean immigrants using the Tigrigna version CES-D scale with a secondary data collected from 1918 non Eritrean US citizens using the English version CES-D scale in a separate study. The baseline four factor CES-D scale model originally suggested for the general population fitted the data from both samples. The fit indices for the Tigrigna sample were (χ2 = 299.87, df = 164, RMSEA = .06, SRMR = .06, GFI = .89, and CFI = .98) and for the English sample (χ2 = 1496.81, df = 164, RMSEA = .07, SRMR = .04, GFI = .92, and CFI = .98). The Multi-group confirmatory factor analysis showed reasonably adequate fit (χ2 (328) = 1796.68, RMSEA= .07, SRMR = .06, GFI = .89, CFI = .98). Fourteen of the 20 CES-D items were invariant across the two samples suggesting partial metric invariance. Partial full factor invariance was also supported. In conclusion, the findings of this study provide adequate evidence in support of the applicability of the four factor CES-D scale for measuring depressive symptoms in Tigrigna speaking Eritrean immigrants/refugees in the United States

Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States

Objective. To identify factors associated with opioid use during pregnancy and to compare perinatal morbidity, mortality, and healthcare costs between opioid users and nonusers. Methods. We conducted a cross-sectional analysis of pregnancy-related discharges from 1998 to 2009 using the largest publicly available all-payer inpatient database in the United States. We scanned ICD-9-CM codes for opioid use and perinatal outcomes. Costs of care were estimated from hospital charges. Survey logistic regression was used to assess the association between maternal opioid use and each outcome; generalized linear modeling was used to compare hospitalization costs by opioid use status. Results. Women who used opioids during pregnancy experienced higher rates of depression, anxiety, and chronic medical conditions. After adjusting for confounders, opioid use was associated with increased odds of threatened preterm labor, early onset delivery, poor fetal growth, and stillbirth. Users were four times as likely to have a prolonged hospital stay and were almost four times more likely to die before discharge. The mean per-hospitalization cost of a woman who used opioids during pregnancy was $5,616 (95$5,166–$6,067), compared to$4,084 (95% CI: $4,002–$4,166) for nonusers. Conclusion. Opioid use during pregnancy is associated with adverse perinatal outcomes and increased healthcare costs

Maternal Opioid Drug Use during Pregnancy and Its Impact on Perinatal Morbidity, Mortality, and the Costs of Medical Care in the United States

Objective. To identify factors associated with opioid use during pregnancy and to compare perinatal morbidity, mortality, and healthcare costs between opioid users and nonusers. Methods. We conducted a cross-sectional analysis of pregnancy-related discharges from 1998 to 2009 using the largest publicly available all-payer inpatient database in the United States. We scanned ICD-9-CM codes for opioid use and perinatal outcomes. Costs of care were estimated from hospital charges. Survey logistic regression was used to assess the association between maternal opioid use and each outcome; generalized linear modeling was used to compare hospitalization costs by opioid use status. Results. Women who used opioids during pregnancy experienced higher rates of depression, anxiety, and chronic medical conditions. After adjusting for confounders, opioid use was associated with increased odds of threatened preterm labor, early onset delivery, poor fetal growth, and stillbirth. Users were four times as likely to have a prolonged hospital stay and were almost four times more likely to die before discharge. The mean per-hospitalization cost of a woman who used opioids during pregnancy was $5,616 (95$5,166–$6,067), compared to$4,084 (95% CI: $4,002–$4,166) for nonusers. Conclusion. Opioid use during pregnancy is associated with adverse perinatal outcomes and increased healthcare costs

Electronic cigarette use during pregnancy and the risk of adverse birth outcomes: A cross-sectional surveillance study of the US Pregnancy Risk Assessment Monitoring System (PRAMS) population.

BackgroundResearch on health effects and potential harms of electronic cigarette (EC) use during pregnancy is limited. We sought to determine the risks of pregnancy EC use on pregnancy-related adverse birth outcomes and assess whether quitting ECs reduces the risks.MethodsWomen with singleton live births who participated in the US Pregnancy Risk Assessment Monitoring System (PRAMS) survey study 2016-2020 were classified into four mutually exclusive groups, by their use of ECs and combustible cigarettes (CCs) during pregnancy: non-use, EC only use, CC only use, and dual use. We determined the risk of preterm birth, low birth weight, and small-for-gestational-age (SGA) by comparing cigarette users to non-users with a modified Poisson regression model adjusting for covariates. In a subset of women who all used ECs prior to pregnancy, we determined whether quitting EC use reduces the risk of preterm birth, low birth weight, and SGA by comparing to those who continued its use. All analyses were weighted to account for the PRAMS survey design and non-response rate.ResultsOf the 190,707 women (weighted N = 10,202,413) included, 92.1% reported cigarette non-use, 0.5% EC only use, 6.7% CC only use, and 0.7% dual use during pregnancy. Compared with non-use, EC only use was associated with a significantly increased risk of preterm birth (adjusted risk ratio [aRR]: 1.29, 95% confidence interval [CI]: 1.00, 1.65) and low birth weight (aRR: 1.38, 95%CI: 1.09, 1.75), but not SGA (aRR: 1.04, 95%CI: 0.76, 1.44). Among 7,877 (weighted N = 422,533) women EC users, quitting use was associated with a significantly reduced risk of low birth weight (aRR: 0.76, 95%CI: 0.62, 0.94) and SGA (aRR: 0.77, 95%CI: 0.62, 0.94) compared to those who continued to use ECs during pregnancy.ConclusionsPregnancy EC use, by itself or dual use with CC, is associated with preterm birth and low birth weight. Quitting use reduces that risk. ECs should not be considered as a safe alternative nor a viable gestational smoking cessation strategy