An Action Research Collaboration to Promote Mental Wellbeing Among Men of Color

Background: Action research seeks to affect social change by prioritizing partnership and participation. This approach fosters the equitable engagement of marginalized populations in research. In Boston, the marginalization of men of color has resulted in inequitable outcomes in education, employment, health, and other indicators of wellbeing. Objectives: A Boston-based coalition of community organizations was tasked with developing an action plan to promote mental wellbeing among men of color. The coalition engaged in action research to identify the individual, organizational, and community-level factors that contribute to mental wellbeing. Methods: The coalition collected 174 surveys and facilitated focus groups with 55 men. The planning process created valuable opportunities for relationship building and partnership development. Lessons Learned: The planning process reinforced the importance of proactive community engagement, continuous capacity building, inclusive data collection, and cross-sector collaboration.    Conclusions: Centering lived experience resulted in community-driven, culturally sensitive solutions to promote mental wellbeing among men of color

An Action Research Collaboration to Promote Mental Wellbeing Among Men of Color

Background: Action research seeks to affect social change by prioritizing partnership and participation. This approach fosters the equitable engagement of marginalized populations in research. In Boston, the marginalization of men of color has resulted in inequitable outcomes in education, employment, health, and other indicators of wellbeing. Objectives: A Boston-based coalition of community organizations was tasked with developing an action plan to promote mental wellbeing among men of color. The coalition engaged in action research to identify the individual, organizational, and community-level factors that contribute to mental wellbeing. Methods: The coalition collected 174 surveys and facilitated focus groups with 55 men. The planning process created valuable opportunities for relationship building and partnership development. Lessons Learned: The planning process reinforced the importance of proactive community engagement, continuous capacity building, inclusive data collection, and cross-sector collaboration.    Conclusions: Centering lived experience resulted in community-driven, culturally sensitive solutions to promote mental wellbeing among men of color

Childhood Abuse and Age at Menarche

Purpose—Physical and sexual abuse are prevalent social hazards. We sought to examine the association between childhood physical and sexual abuse and age at menarche. Methods—Among 68,505 participants enrolled in the Nurses’ Health Study II we investigated the association between childhood physical abuse and sexual abuse on menarche prior to age 11 (early) or after age 15 (late) using multivariate logistic regression analysis, mutually adjusting for both types of abuse. Results—Fifty-seven percent of respondents reported some form of physical or sexual abuse in childhood. We found a positive dose-response association between severity of sexual abuse in childhood and risk for early menarche. Compared to women who reported no childhood sexual abuse, the adjusted odds ratio [AOR] for early menarche was 1.20 (95% confidence interval [CI], 1.10, 1.37) for sexual touching and 1.49 (95% CI, 1.34, 1.66) for forced sexual activity. Only severe physical abuse predicted early menarche (AOR=1.22, 95% CI, 1.10–1.37). Childhood physical abuse had a dose-response association with late age at menarche: AOR 1.17 (95% CI, 1.04, 1.32) for mild, 1.20 (95% CI, 1.08, 1.33) for moderate, and 1.50 (95% CI, 1.27, 1.77) for severe physical abuse. Sexual abuse was not associated with late menarche. Conclusion—Childhood abuse was very prevalent in this large cohort of U.S. women. Severity of childhood sexual abuse was associated with risk for early onset of menarche, and physical abuse was associated with both early and late onset menarche. Implications and Contribution—The severity of childhood sexual abuse and severe physical abuse were associated with risk for accelerated menarche, while severity of childhood physical was associated with risk for delayed onset of menarche. The nature of the association between different forms of childhood adversities and reproductive lifespan may vary

Child maltreatment and hypertension in young adulthood

Maltreatment during childhood and adolescence has been associated with chronic conditions in adulthood including cardiovascular disease. However, less is known about the effects of childhood maltreatment on cardiovascular risk factors prior to development of cardiovascular disease, or whether these effects are evident in young adulthood. Furthermore, few studies have examined sex differences and most studies have relied on self-reported outcome measures that are subject to misclassification. We examined the relationship between child maltreatment and hypertension in young adulthood in the National Longitudinal Study of Adolescent Health, a nationally representative school-based sample of US adolescents. Participants retrospectively (mean age 29.9, n = 11384) reported on their experiences of child maltreatment prior to the 6th grade (prior to age 11) during follow-up. Child neglect, physical and sexual violence as well as a measure of social services visits to the home were examined. Blood pressure was measured during an in-home visit. Hypertension was defined as measured SBP of at least 140 mmHg or DBP of at least 90 mmHG measured in adulthood, or self-reported use of antihypertensive medications. In adjusted models, women who experienced sexual abuse in early childhood had a higher prevalence of hypertension (Prevalence Ratio (PR) 1.43 95% CI 1.00, 2.05) compared to women who did not experience sexual abuse. Among men, experiencing sexual abuse was not statistically significantly associated with hypertension. Experiencing neglect, physical abuse or having visitations by social services at home during childhood was not associated with hypertension among either women or men. Sexual abuse in early childhood is associated with hypertension in young women

Neighborhood-Level Interventions to Improve Childhood Opportunity and Lift Children Out of Poverty

Abstract Population health is associated with the socioeconomic characteristics of neighborhoods. There is considerable scientific and policy interest in community-level interventions to alleviate child poverty. Intergenerational poverty is associated with inequitable access to opportunities. Improving opportunity structures within neighborhoods may contribute to improved child health and development. Neighborhood-level efforts to alleviate poverty for all children require alignment of cross-sector efforts, community engagement, and multifactorial approaches that consider the role of people as well as place. We highlight several accessible tools and strategies that health practitioners can engage to improve regional and local systems that influence child opportunity. The Child Opportunity Index is a population-level surveillance tool to describe community-level resources and inequities in US metropolitan areas. The case studies reviewed outline strategies for creating higher opportunity neighborhoods for pediatricians interested in working across sectors to address the impact of neighborhood opportunity on child health and well-being

Achieving Health Equity: The Role of Innovative Community Partnerships

Video includes Symposium welcome and introductions. Navigate to 5:30 in the video for the keynote presentation. Dr. Renée Boynton-Jarrett, MD, ScD is Associate Professor of Pediatrics, Boston Medical Center/Boston University School of Medicine, and Director, Vital Village Community Engagement Network. Dr. Boynton-Jarrett is nationally recognized for her expertise in the role of early-life adversities as life course social determinants of health. Through BMC Vital Village Network she has supported the development of community-based strategies to promote child wellbeing and equity and prevent adversity by building community capacities. During this presentation, she will discuss the role of using a trauma-informed framework to promote systems alignment, and innovative, cross-sector partnerships to improve wellbeing and achieve equity. This presentation will review the contribution of early life adversities and adverse social environments to inequities in health, with a focus on the role of social stress as a driver of inequities. One learning objective is to review new medical competencies that consider structural violence and social forces, as a strategy to transform models of practice and care. An additional objective of the presentation is to situate the current use of metrics of wellbeing and improve the utility of metrics to track progress, and implement local improvements over time by sharing examples of how participatory strategies, community engagement, and community-based research methods can be incorporated in the work of Vital Village Network. Finally, the presentation will share strategies for scaling local innovations and the essential role of civic participation for building community capacity to achieve health equity. The BMC Vital Village Network integrates a trauma-informed framework to cultivate partnerships between community residents and agencies and align systems of care and education. This presentation will ask the question of what cross-sector partnerships and innovative strategies arise from a paradigm shift that frames early life adversities as life course social determinants of health

When Is Exposure to a Natural Disaster Traumatic? Comparison of a Trauma Questionnaire and Disaster Exposure Inventory

<div><p>Few studies have compared the sensitivity of trauma questionnaires to disaster inventories for assessing the prevalence of exposure to natural disaster or associated risk for post-disaster psychopathology. The objective of this analysis was to compare reporting of disaster exposure on a trauma questionnaire (Brief Trauma Questionnaire [BTQ]) to an inventory of disaster experience. Between 2011 and 2014, a sample of 841 reproductive-aged southern Louisiana women were interviewed using the BTQ and completed a detailed inventory about exposure to hurricanes and flooding. Post-traumatic stress disorder (PTSD) symptomology was measured with the Post-Traumatic Stress Checklist, and depression with the Edinburgh Depression Scale. The single question addressing disaster exposure on the BTQ had a sensitivity of between 65% and 70% relative to the more detailed questions. Reporting disaster exposure on the BTQ was more likely for those who reported illness/injury due to a hurricane or flood (74%-77%) or danger (77-79%), compared to those who reported damage (69-71%) or evacuation (64-68%). Reporting disaster exposure on the BTQ was associated with depression (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.43-3.68). A single question is unlikely to be useful for assessing the degree of exposure to disaster across a broad population, and varies in utility depending on the mental health outcome of interest: the single trauma question is useful for assessing depression risk.</p></div

Variation in traumatic experience reporting by experience of a natural disasters in Southern Louisiana women, N = 841.

<p>Variation in traumatic experience reporting by experience of a natural disasters in Southern Louisiana women, N = 841.</p

Prediction of mental illness by indicators of disasters relative to the Brief Trauma Questionnaire in southern Louisiana women, adjusted for covariates.

<p>BTQ, Brief Trauma Questionnaire; OR, odds ratio; CI, confidence interval; aROC, area under the receiver operating curve</p><p>*Adjusted for age, pregnancy status, race, and income.</p><p>^† relative to 1 experience; too few cases in the 0 category to converge.</p><p>Prediction of mental illness by indicators of disasters relative to the Brief Trauma Questionnaire in southern Louisiana women, adjusted for covariates.</p